Meeting your goal of becoming a Registered Nurse is an accomplishment that you should be proud of. It takes hard work and dedication to make it through nursing school and to then successfully pass the National Council Licensure Examination. A career as an RN can be rewarding and valuable on its own, but after several years of practice, many RNs find themselves wondering how they can advance their careers. There are several different options available to RNs looking to improve their employment and financial opportunities. One of the best ways for RNs to do this is by taking the steps towards becoming a CRNA. While becoming a CRNA is not an easy task, the good news is, that if you are an RN, you are already well on your way.
An RN who is considering becoming a CRNA has likely had some experience or involvement with a CRNA during their work as an RN. Some RNs, however, may simply be enticed by the increase in salary and autonomy that comes with being a CRNA and may not know what the job actually looks like on a day-to-day basis. This is where it becomes important to do some research. Even if you have a general understanding of what a CRNA does, you may be able to get a better idea of the job requirements and demands by job-shadowing a CRNA. RNs can contact CRNAs that they know or can ask a hospital or medical center to set them up with a CRNA that they can job-shadow for a day. This will give an RN the best insight into what it takes to be a CRNA. They can experience the day-to-day stresses and rewards that come with a CRNA career, and will also have the ability to ask a current CRNA any questions they may have. The path to becoming a CRNA is not cheap or easy, so when an RN makes the decision to take that step, it is important to be assured that they are making the right choice. Job-shadowing is a great initial step to take before jumping into the CRNA education and licensure process.
Outline of the Process – RN to CRNA
Once an RN has made the decision to become a CRNA, there is a fairly standard set of steps that need to be completed in order to obtain licensure. The American Association of Nurse Anesthetists lists the below requirements for becoming a CRNA:
- A Bachelor of Science Degree, preferably in Nursing
- A current license as a registered nurse
- At least one year of experience in a critical care setting (For admission into a CRNA program)
- Graduation from an accredited CRNA program
- A passing score on the National Certification Examination
CRNA Education Requirements
The first step an aspiring CRNA must take is applying and getting accepted into an accredited CRNA school or program. The Council of Accreditation of Nurse Anesthesia currently recognizes 114 nurse anesthesia programs in the United States. While these programs differ in various aspects, they generally will last from two to two and a half years and will require the student to be enrolled full-time. Working part-time while in CRNA School is usually technically allowed but not recommended by most nurse anesthesia programs as the CRNA program is very rigorous and demanding. When applying to CRNA School, an RN should be prepared to leave his or her current position in order to focus full-time on schooling. A CRNA program is a commitment for an RN and his or her family as it may require the RN to stop working and to move closer to whichever CRNA program he or she is accepted into.
CRNA Program Application Requirements
In order to be a competitive applicant to a CRNA school, an RN should have the following:
- A relevant Bachelor’s degree
- A current nursing license
- Critical care experience
- Letters of Recommendation
- Completion of the GRE
While some schools may waive or alter some of these specific requirements, they are generally required by most CRNA programs. A current practicing RN who has decided to pursue a CRNA program most likely already has the bachelor’s degree necessary to do so. CRNA programs generally look for applicants with a bachelor’s degree in nursing or in other related fields such as biophysical, biological, or behavioral sciences.
An RN looking to become a CRNA likely also already has a nursing license. In order to become a CRNA it is important that you keep your RN license current and active, as well as free from any suspensions or disciplinary actions.
A practicing RN may or may not already have critical care experience. Generally, CRNA programs are looking for applicants who have had one to two years of experience working in an Intensive Care Unit. RNs can usually fulfill this requirement by working in an adult or pediatric intensive care unit which can include surgical, medical, cardiac, neurological, or pediatric ICUs. While some schools may accept neonatal intensive care unit (NICU) experience, it is usually preferred that acute care experience has been with older children or adults. Some schools may also accept Emergency Room experience, but will likely require that the ER had Level 1 trauma capabilities. Serious pursuit of a CRNA degree may require that some RNs make a job change so that they can acquire the necessary experience to apply for and get into the CRNA program of their choice.
Most RNs practice in an environment where they work closely with other healthcare professionals including doctors, CRNAs, and anesthesiologists. RNs applying to CRNA School will need to have one or more of their colleagues or supervisors write letters of recommendation for them. The length, type, and amount of letters required varies by program, so it is best to check the application requirements for your schools of choice before procuring letters of recommendation.
The Graduate Record Examination (GRE) is not required by all CRNA programs for application, but it may be wise to take the exam as soon as you begin to consider pursuing the CRNA career path because it will be easier to have done it first then to come across this requirement in an application and not have already completed it.
The application process for many CRNA programs is very time-consuming and competitive, but knowing the requirements and beginning to prepare well in advance will make your application process smoother and less stressful once you are ready to apply.
CRNA Certification Requirements
Once you have been accepted into and subsequently graduated from an accredited CRNA program, you are almost a fully certified nurse anesthetist. The final step is taking and passing the National Certification Examination (NCE).
The NCE Exam
The National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) is a corporation which provides the credentialing and licensure examinations for all potential CRNAs as well as CRNAs who need to be re-certified. According to the NBCRNA, the purpose of the exam is to “ensure that nurse anesthetists have the necessary knowledge and skills to practice safely and effectively.” The NBCRNA lists the general eligibility requirements for taking the NCE as follows:
- Submission of a complete examination application ($725 fee)
- A record of academic and clinical experience from an accredited CRNA program
- A current unrestricted RN license
- Color digital photo
- Certification that RN license has never been subject to revocation, restriction, or suspension
- Certification that applicant does not suffer from any condition which might interfere with anesthesia administration or from drug or alcohol addiction.
Once an applicant fulfills the above requirements and submits their application, it is reviewed by the NBCRNA board. If the application is deemed as approved by the board, then the potential CRNA must take and pass the actual examination. The test can be taken year round at official test centers located throughout the United States. It is taken on the computer and contains at least 100 questions with a maximum of 170 questions. The questions will vary in type and could include multiple choice, calculation, and graphics or videos, among other things. The maximum amount of time allowed for testing is three hours. NBCRNA provides a detailed list of potential examination content, but the general categories are Basic Sciences, Equipment Instrumentation and Technology, and Basic and Advanced Principles of Anesthesia. Upon completion of the examination at the testing center, candidates can expect to receive a preliminary pass or fail report, but their final official results will arrive in the mail from the NBCRNA within 2 to 4 weeks.
What do I need to do to be Re-Certified?
According to the American Association of Nurse Anesthetists, in order to be re-certified as a CRNA, you must have a minimum of 40 hours of continuing education every two years, be able to document substantial anesthesia practice, maintain state licensure, and certify that you do not have any underlying conditions that may prevent you from practicing anesthesia.
Of the above requirements, the continuing education requirement is likely to be the most challenging. There are, however, many options available to CRNAs to help them meet their 40 hour requirement. Continuing education opportunities and requirements vary my state, but are usually offered as in-person meetings or seminars, online programs, and self-study options. While completing continuing education credits may seem like a hassle, it is important that those in the medical field stay up-to-date with the latest techniques and practices, and will probably not seem like so much of a challenge once a CRNA has already completed a rigorous CRNA program.