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How to Become a CRNA: The Ultimate Step-by-Step Guide

It’s one thing to dream of being a CRNA and another to take steps toward becoming one. Use this guide to learn how to become a CRNA so you can make your dreams a reality.

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A smiling asian female surgeon in scrubs and a surgical cap, standing confidently in a well-equipped operation theater.

Long before there were degree programs for certified registered nurse anesthetists (CRNAs) — long before certifications were even required to practice — Catherine S. Lawrence was blazing a trail in nursing that has endured for almost two hundred years.

During the Civil War, Lawrence made history by becoming the first nurse to administer anesthesia to wounded soldiers awaiting surgery. Since then, the CRNA profession has grown and evolved exponentially. Today, this specialty is over 61,000 nurses strong and growing, according to the American Association of Nurse Anesthesiology (AANA).

Although you don’t have to be on the battlefield to practice, working as a CRNA still entails working at the frontlines of allied healthcare. Whether you’ve dreamt of this career path for years or you’re just beginning to consider this option for the first time, we’ll give you a detailed look at how to become the kind of CRNA that would make Lawrence proud. Keep reading for insights into the attributes that make someone well-suited to this position, the steps you’ll have to take to earn the appropriate qualifications, and what you can expect to earn once you do.

Is Becoming a CRNA Right for You?

Becoming a nurse of any kind requires a huge commitment, so it’s important to choose your specialization wisely. Being a certified registered nurse anesthetist isn’t for everyone, so it’s important to learn as much as you can about this specialty as early in your nursing journey as possible. That’s why we’ve compiled the following essential questions to ask yourself to determine whether this career path is right for you.

Am I prepared to commit to an advanced degree program?

CRNAs receive a great deal of training to gain the expertise needed to do their job effectively. This means that you not only have to earn a bachelor’s degree and nursing license, but are also required to complete a graduate degree program that provides you with specialized instruction both inside the classroom and in a real-world healthcare setting. This could mean a minimum of seven years of education, so if you don’t feel confident you can commit to spending so much time pursuing an advanced education, then entering the workforce after earning your RN license may be a better idea.

Am I willing to stay on top of changing certification and licensure requirements?

The nursing field and the niche specialties within it are constantly changing. Part of being in the profession means keeping up with the latest practices so that you can perform at your best, provide top care to your patients, and maintain your licenses and certifications. Although all nurses must renew their certifications and licenses periodically, a specialty as complex as anesthesiology requires an additional level of commitment to staying on top of developments as they occur.

There has been an ongoing call to increase the minimum education for CRNAs from a master’s degree to a Doctor of Nursing Practice. The American Association of Colleges of Nursing (AACN) published a position paper in 2004 outlining the need for this change, since then there has been a groundswell of support among colleges and universities. As a result, a growing number of DNP degree programs have been developed so nurses can effectively meet the evolving demands of this specialty.

Can I adapt to new technologies that enhance patient care and safety?

With the rapid changes in technology, the way nurses practice can and does change very quickly. Regardless of the t area of nursing you’re in, the technology you learn and use today may not be the technology you’ll be using tomorrow. For example, in an episode of the Beyond The Mask Podcast, CRNA Adam Flowe, Chief Nurse Anesthetist at Duke University, discusses the role that computerized surgical implants will play in how CRNAs will work in the future.

Will I be able to stay calm and focused in an operating room?

Every emergency medicine setting is fast-paced and stressful. As a result, if you don’t feel that you can effectively keep yourself calm and focused during a procedure, you may want to explore non-emergency specialties like nursing informatics or education. If you do want to move forward to pursue a CRNA career, there are strategies you can employ to ensure you don’t let stress get in the way of providing the best patient care.

Step One: Start Your Collegiate Journey Towards Nursing

Like anything else, the journey to becoming a CRNA starts with the first step. In this case, the first step is applying for and beginning your initial nursing training so you can best position yourself to meet your goal later on. The following are the first steps you need to take to get where you want to go.

Apply to Colleges and Universities

The first hurdle to becoming a CRNA being admitted to a top college nursing program. Since schools usually require that students gain general admission before applying to a nursing bachelor’s degree program, this is the time to think about what you need to do to fulfill the requirements of the nursing schools you’re interested in.

Build a Strong Academic Record

You’ll spend the first years of your undergraduate education taking relevant coursework designed to prepare you for admission into nursing school. However, it’s also important to perform well in classes that aren’t prerequisites for nursing school admission to earn the overall grade point average departments expect. This can vary from one school to the next, but generally you will be expected to have at least a 3.0 grade point average to be admitted into nursing school.

Complete Prerequisites

Every nursing school will require certain prerequisite courses, as well as minimum average grades in these courses to be admitted into their BSN program. These standards may differ. For example, the University of Iowa expects students to earn a minimum GPA of 2.0 in natural science prerequisite classes, including nutrition, human anatomy, and chemistry. Similarly, Texas State University requires prerequisite classes in mathematics, anatomy and physiology, and functional biology. Students are expected to have a minimum GPA of 3.0 GPA in these courses.

Step Two: Become a BSN-Prepared Nurse

Once you’ve completed your prerequisite classes, you’ll have to complete the rest of your undergraduate education in a nursing program. In this section we cover this stage of the process, from applying to nursing school to through applying for your state license.

Apply to Nursing School

If you’ve spent your first two years in college wisely, then you’re well-aware of what nursing schools expect and have worked to meet those requirements. If you’re applying to multiple schools, keep in mind that though the admission standards are generally the same, each school will have its own specific standards.

For example, if you’ve already earned a nursing degree and want to enroll in a bridge program, The Ohio State University has an RN to BSN program that requires applicants to have an associate degree or diploma in nursing, a minimum GPA of 2.0, and an active RN license.

On the other hand, if you don’t have previous nursing education or experience, a school will look at what you’ve accomplished by the time you put in your application. For example, the University of Kansas looks at how students have performed in their coursework, particularly the nursing prerequisites. The school also considers students’ extracurricular activities, references, and level of interest in nursing.

Pass Your Nursing Courses

The prerequisites to enter nursing school laid the foundation for you to take the classes required in your BSN program. This curriculum can be rigorous, and includes coursework that covers the foundations of nursing practice, pharmacology, mental health nursing, and reproductive health, among other core subjects. You may also have the opportunity to take classes that prepare you for the nursing licensure examination.

Participate in Clinical Rotations

Clinical rotations are where your nursing education comes to life. Hands-on experience allows you to apply what you’ve learned in classes to a real-world setting. The specific program you enroll in will dictate what you can expect during your nursing clinicals, but most include performing duties like taking patients’ vital signs, administering medication, and helping a medical team during procedures.

Prepare for and Pass the NCLEX-RN

After completing your training inside and outside of the classroom, your next step toward becoming a nurse anesthetist is passing the National Council Licensure Examination (NCLEX) to obtain your nursing license. To prepare, you may be able to take classes at your school or work through test plans on your own. Administered by the National Council of State Boards of Nursing, the NCLEX is a computerized test made up of multiple choice, fill in the blank, and drag-and-drop questions.

Apply for State Licensure

Once you’ve passed the NCLEX, it’s time to apply for a license in your state. Different states have different application procedures, so contact your state board of nursing to find out exactly how it works.

Step Three: Complete Additional Requirements for CRNAs

You’ve overcome two major hurdles toward becoming a CRNA. Continue reading to find out how to move forward after earning your state licensure. In this section, you’ll learn what you need to do to continue your training before you begin your job search.

Gain Critical Care Experience

Being on the frontlines of the nursing profession means being comfortable in challenging environments. As such, preparing to become a CRNA means you have to gain critical care experience by working in medical surgical units, emergency centers, or intensive care units, among other settings. In fact, CRNA programs expect applicants to have this experience prior to being admitted. To get the most out of this work, the University at Buffalo suggests that you find an environment that will give you the broadest experience working with critically-ill patients.

Graduate From an Advanced Nurse Anesthesia Program

Although you can currently become a CRNA by earning a master’s degree, as more and more employers expect nurse anesthetists to earn a terminal degree, a doctorate is increasingly becoming every aspiring CRNA’s best bet. Explore different programs that interest you to find the one that aligns most with your needs.

Pass the National Certification Examination

Whether you earn a master’s or doctoral degree, you will be required to pass the National Certification Examination (NCE) to practice nurse anesthesiology. This three-hour test includes content designed to measure your understanding of basic sciences; equipment, instrumentation, and technologies; general principles of anesthesia; and anesthesia for surgical procedures and special populations.

Step Four: Launch and Advance Your Career as a CRNA

Your years of hard work have paid off and you’re ready to look for a CRNA job. In this section, we’ll provide some strategies to help you optimize your job search and find the position that is the best fit for you.

Prepare for the Job Market

Just as you would with any other nursing specialty, when looking for a CRNA position, you want to make sure you understand what employers want so you put your best foot forward. Study the job market and the organizations that are hiring to ensure you’re presenting yourself to employers in the best way.

Network and Job Search

In addition to applying directly to jobs posted by healthcare facilities, it’s a good idea to connect with other professionals who may be aware of or have the power to fill job openings at their place of work. One of the best ways to connect with other professionals is to join associations like the American Nurses Association and the American Association of Nurse Anesthesiology and attend.

Interview and Accept a Job Offer

Your credentials will speak for themselves, but only to a point. To land your dream job, you will have to go through the interview process. To position yourself for a job offer you’ll want to accept, prepare for and understand the purpose of frequently asked interview questions, which may cover anything from your understanding of nurse anesthetist procedures, to your experience in the specialty, to your goals for the future.

Consider Specializations and Advanced Roles

Do you want to work primarily in a specific setting? As a CRNA, you can choose to work in places like cardiac care centers or children’s hospitals, among many others. You can also specialize in a specific patient population, from obstetric to geriatric, or even pediatric patients.

Engage in Continuous Learning and Recertification

Part of being a nurse is learning continuously; in fact, keeping your license up to date depends on it. The number of continuing education credits you need will depend on the state you live in, but regardless of where you live, you can take continuing education classes provided by the American Association of Nurse Anesthesiology.

A Look at Career and Salary Prospects for CRNAs

Working on challenging cases in high-pressure environments can be extremely rewarding in its own right, but becoming a CRNA is also rewarding financially. The need for nurse anesthetists is growing exponentially, with the availability of new jobs within the profession expected to increase by 12.7 percent annually — this amounts to 2,900 new jobs each year. After landing one of these many jobs, you can expect to make a comfortable living pulling in somewhere between $131,840 and $208,000 (the median salary is $195,610).

Area Occupation NameBaseProjectionChangePercent ChangeAverage Annual Openings
United StatesNurse Anesthetists44,20049,8005,60012.7%2,900

Source: Projections Central

AreaOccupation10th PercentileMedian90th Percentile
U.S.Nurse Anesthetists$131,840$195,610$208,000

Source: U.S. Bureau of Labor Statistics

The CRNA Career at a Glance

CRNAs play a unique role in healthcare. CRNAs begin their education like any other nurse, their skills and responsibilities are distinct from their peers — we’ll look at the specifics of how below.


Nurse anesthetists work with patients before, during, and after a surgical procedure. Before surgery, CRNAs perform physical assessments; educate patients on how their procedure is performed and their anesthesia administered; and obtain consent for treatment. During the procedure, CRNAs work with their team to ensure patients receive the correct anesthetic in the correct amount. After surgery, CRNAs monitor patients to ensure they remain in stable condition and set them on the road to recovery.

Specialties and Areas of Practice

There are several avenues you can take if you’re interested in pursuing a CRNA specialization. CRNAs work in trauma, obstetric, dental, orthopedic, and gastrointestinal specialties. You may also choose to specialize by working primarily in a specific setting, like a rural hospital or critical care center.

Work Environments

CRNAs work in a variety of environments. After completing the necessary education, certification, and training, you’ll be qualified to seek employment at surgical clinics, hospitals, doctors’ offices, and outpatient care centers.