Certified Registered Nurse Anesthetists (CRNAs)

Individuals interested in pursuing a career in medicine, particularly in the prevention of pain and management of anesthesia, have the option of studying to become a Certified Registered Nurse Anesthetist (CRNA). 

Similarly to anesthesiologists, CRNAs are tasked with ensuring that patients undergo surgery without pain or recollection.¹ They are also able to prescribe medicine and order diagnostic tests. The roles are very similar. Two 2010 studies “concluded that there is no significant difference in the quality of care when the anesthetic is delivered by a [CRNA] or by an anesthesiologist.”² What separates CRNAs and anesthesiologists is the amount of education and the work environment.^1,3 

Anesthesiologists are medical doctors, who have completed undergrad, medical school, residency and sometimes a fellowship as well. This amounts to over a decade of school.⁴ CRNAs have a shorter path. Most complete undergrad, obtain their RN license, complete a year of critical care experience, and then complete a CRNA program. These programs can range from two to three years.³ One reason to choose a career as a CRNA is this accelerated career path.  

Another reason is CRNAs have the highest job satisfaction among advanced practice nurses, according to Marc Code, director of the Samuel Merritt University nurse anesthesia program.¹ A 2011 AANA study reported that 89% of the CRNAs surveyed described themselves as being “very satisfied” with the mean response being 4.4/5.⁵ The study found their satisfaction was impacted by their sense of autonomy and their ability to work with clinically competent peers. It was also affected by CRNA representation at administrative levels and employers who provided opportunities for education and advancement.⁵ 

Code suggests that part of the appeal of the role is the growth and freedom. “[CRNAs] can work in a team setting and [they] can work independently. Nurse practitioners cannot work independently.”¹ CRNAs are able to move beyond the operating room and find roles in more areas within the perioperative setting. This results in more opportunities for CRNAs to practice the full scope of their education. Their level of training allows CRNAs to collaborate with surgeons, anesthesiologists, dentists, and other health care professionals.¹ 

As a result, CRNAs also have a high level of compensation reflective of their ability to handle critical tasks. Their skill level also allows CRNA to have their own anesthesia service and earn more than they would at a hospital or surgery center.¹ In recent years, 17 states have opted out of physician supervision for CRNAs. These conditions not only allow CRNAs to have lucrative independent practices, but it also allows them to travel into underserved areas to provide anesthesia care.¹ In rural areas, ⅔ of all anesthetic care is administered by a CRNA.³ 

While compensation and satisfaction are both high, a 2019 AANA review reported a surge in burnout amongst CRNAs. Their median burnout score (2.45) was higher compared with nursing (2.2) and other personnel (2.1), which was similar to physicians (2.45), and low compared with residents (4.05).⁶ 

Studies suggest an effective way to improve CRNA burnout is to develop and implement interventions.⁶ In response, hospitals have started wellness initiatives. Surveys of those initiatives suggest that of those surveyed, 70% planned to attend future wellness events, and 42% stated that the event provided at least some information or skills that will improve their overall job satisfaction. Studies performed at the Mayo Clinic suggest that careful focus on the contributing factors can help to minimize burnout while creating a culture of highly engaged anesthesiologist and CRNAs.⁷ 

1. Farmer, Robin. “Why You Should Consider Becoming a Nurse Anesthetist.” Daily Nurse, Springer Publishing Company, 17 June 2016, https://dailynurse.com/consider-becoming-nurse-anesthetist/. 

2. “Who Should Provide Anesthesia Care?” The New York Times, The New York Times, 7 Sept. 2010, https://www.nytimes.com/2010/09/07/opinion/07tue3.html?_r=2&ref=opinion. 

3. “CRNA vs. Anesthesiologist: What’s the Difference?” Texas Wesleyan University, 23 Mar. 2016, https://txwes.edu/academics/health-professions/graduate-programs/nurse-anesthesia/news-and-events/department-news/top-five-list/top-five-list-news-archive/crna-vs-anesthesiologist-whats-the-difference/. 

4. Scherman, Jess. “What Is It REALLY Like Being a Nurse Anesthetist?” Rasmussen College, 10 Dec. 2018, https://www.rasmussen.edu/degrees/nursing/blog/what-is-nurse-anesthetist/. 

5. Mileto, Lisa, and Barbara Penprase. “Job Satisfaction Among Certified Registered Nurse Anesthetists: A Multigenerational Analysis.” Anesthesia EJournal, vol. 2, no. 1, 1 July 2014, https://anesthesiaejournal.com/index.php/aej/article/view/17/20. 

6. Del Grosso, Brian, and A Suzanne Boyd. “Burnout and the Nurse Anesthetist: An Integrative Review .” AANA Journal, vol. 87, June 2019, https://www.aana.com/docs/default-source/aana-journal-web-documents-1/burnout-and-the-nurse-anesthetist-an-integrative-review-june-2019.pdf?sfvrsn=d49f0a19_4. 

7. Tarantur, Natalie. “Anesthesia Professional Burnout-A Clear and Present Danger.” Anesthesia Patient Safety Foundation, Anesthesia Patient Safety Foundation, Oct. 2018, www.apsf.org/article/anesthesia-professional-burnout-a-clear-and-present-danger/.