How to Become a CRNA: Steps and Timeline

To become a certified registered nurse anesthetist (CRNA), you earn a BSN, get your RN license, build critical care experience, complete an accredited doctoral nurse anesthesia program, pass the national certification exam, and get licensed as an advanced practice nurse in your state. Plan on years of ICU work before anesthesia school, plus about three years in the program itself. The path is long and competitive, but each step is clear.

What CRNAs do

A certified registered nurse anesthetist is an advanced practice registered nurse (APRN) who provides anesthesia care before, during and after surgical, obstetric, diagnostic and other procedures. CRNAs perform pre-anesthesia assessments, give and manage general and regional anesthesia and sedation, monitor patients throughout procedures, and manage emergence and recovery. They work in hospitals, ambulatory surgery centers, obstetric units, office-based practices and the military. How independently a CRNA practices depends on state law and facility policy.

Step 1: Earn a BSN

Nurse anesthesia programs require a bachelor's degree, and most ask for a BSN. If you have an ADN, an RN-to-BSN program gets you there while you keep working. Keep your grades strong, especially in science courses, because programs look closely at GPA and many set minimums.

Step 2: Pass the NCLEX-RN and get licensed

You need an unencumbered RN license to apply, and you may need a license in each state where you will do clinical training. If you are early in the process, here is how NCLEX-RN registration works.

Step 3: Build critical care experience

Every program requires experience as an RN in critical care, and this is where much of your timeline goes. Accreditation standards set a minimum, individual programs often ask for more, and competitive applicants frequently bring more still. Ask each program for its exact requirement.

What counts as critical care is up to each program. Most look for adult, pediatric or neonatal ICU experience where you independently manage:

• Mechanically ventilated patients
• Vasoactive and sedation infusions that you titrate
• Invasive monitoring such as arterial lines and central lines
• Unstable, high-acuity patients

Many programs do not accept emergency department, PACU or step-down experience on its own, though policies differ. If you are a new grad, aim for an ICU job or ICU residency as early as you can.

Step 4: Strengthen your application

While you build ICU experience:

• Earn the CCRN. AACN's critical care certification is required or strongly preferred by many programs. See this rundown of ICU nursing certifications.
• Shadow a CRNA. Many programs ask for it, and it shows you understand the role.
• Take on high-acuity assignments, plus charge, precepting and unit committees.
• Check prerequisites. Some programs require specific science courses, a recent statistics course or the GRE; others do not.
• Keep certifications current. BLS, ACLS and PALS are commonly required.
• Plan your finances. Programs are full-time and demanding, and many advise students not to work during school.

The ICU nursing professionals group is where ICU nurses talk shop, including about applying to anesthesia school.

Step 5: Complete a doctoral nurse anesthesia program

Programs must be accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). Since January 2022, all new students must enroll in a program that awards a doctoral degree, either a Doctor of Nursing Practice (DNP) or a Doctor of Nurse Anesthesia Practice (DNAP).

Programs typically run about three years full-time. They combine coursework in advanced physiology, pharmacology and the principles of anesthesia with extensive clinical training across many types of cases and techniques. Admission interviews are common and often include clinical questions on ICU pharmacology, hemodynamics and ventilator management, so review the basics of your own practice.

Step 6: Pass the National Certification Examination

After graduating, you take the National Certification Examination (NCE), administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). Passing earns you the CRNA credential. NBCRNA also runs the recertification program you will follow throughout your career; check NBCRNA for its current requirements.

Step 7: Get your APRN license

Apply for APRN licensure or recognition with the board of nursing in the state where you will practice. Requirements, prescribing rules and supervision rules vary by state. If you might move during your career, read how APRN licensure works across states.

Timeline at a glance

Put together, a traditional BSN, your ICU years and about three years of anesthesia school add up to eight years or more for most people starting from scratch. Nurses who already hold a BSN and ICU experience are much closer than that.

Common application mistakes

• Applying with only the bare minimum of experience. Meeting a program's minimum makes you eligible, not competitive. Admissions committees look for depth: very sick patients, complex drips and steady growth over time.
• Choosing an ICU for convenience. A lower-acuity unit may not give you the experience programs want, so look closely at the patient population before you accept a job.
• Treating the CCRN as optional when the programs you want prefer it.
• Skipping the shadow day. Watching a CRNA work helps you explain honestly why you want anesthesia.
• Not knowing the pharmacology of your own patients. Interviewers often ask why a drip was chosen or how a drug works.

Paying for school and seeing CRNA pay

Doctoral tuition and living costs add up over three years without a full paycheck, so build a budget early. Read about student loan forgiveness programs for nurses to see which might apply to you, and confirm the details with each program's administrator.

CRNA pay depends on state, setting and practice model. Listings on the CRNA jobs page show the pay, so you can see real offers in the areas you are considering, and the free pay calculator helps when you compare them.

Next step

If you are still building critical care experience, browse ICU nurse jobs to find units that will give you the high-acuity patients programs look for.

General information for nurses, not medical, legal, tax or financial advice. Follow your facility's policies, your state board of nursing and the terms of your employer or contract.