Certified Registered Nurse Anesthetist

Everything You Should Know

What is a CRNA?

Certified Registered Nurse Anesthetist or CRNAs are advanced practice registered nurses with doctorate level education. They administer anesthesia and other medications independently or under anesthesia care team guidance.

Pronounced: [sur-tuh-fyd] [rej-uh-sterd] [nurs] [uh-nes-thi-tist]


Nurse anesthetists have been providing anesthesia to patients in the United States for more than 150 years. The first record of a nurse anesthetist was Sister Mary Bernard, who began practicing in 1887 at St. Vincent's Hospital in Erie, PA. The first CRNA education program followed in 1909. In 1945 the American Association of Nurse Anesthetists (AANA) implemented a certification program and 92 candidates took the examination.


World Wars 1 and 2 had a major effect on training and recruitment of nurse anesthetists. As of August 2018, there were 121 accredited nurse anesthesia programs in the United States and Puerto Rico. With 1,799 active clinical sites, 80 nurse anesthesia programs award doctoral degrees annually. By 2025, all graduating CRNAs will have doctorate degrees. Graduates have an average of 9,369 hours of clinical experience.


There is no statistically significant difference in the risk of anesthesia complications based on the degree of restrictions placed on CRNAs by state SOP laws. Researchers studying anesthesia safety found no differences in care between CRNAs and anesthesiologists. There is also no difference in patient outcomes when anesthesia services are provided by CRNAs, physicians, or CRNAs supervised by physicians.


CRNAs are qualified to work in any practice setting/model. They perform the same functions as physician anesthesiologists and are NOT required to practice under a physician anesthesiologist. CRNAs can administer anesthesia independently or together in a team model with physician anesthesiologists.


The average salary for an anesthesiologist is approximately 2.5 times greater than a nurse anesthetist, even though Medicare pays the exact same fee for the anesthesia service no matter who it was provided by. The higher cost has to be shouldered by either the hospital or the patient. Nurse anesthesia care is 25 percent more cost effective than the next least costly anesthesia delivery model.


In most states, CRNAs are the sole anesthesia professionals in nearly all of rural hospitals, which ensures patient access to surgical services.8 A recent study published in the September/October 2015 Nursing Economics found that CRNAs are providing the majority of anesthesia care in U.S. counties with lower-income populations and populations that are more likely to be uninsured or unemployed.

State Associations of Nurse Anesthetists