Working as a CRNA in North Dakota

North Dakota is one of the strongest states in the country for CRNA practice due to its independent practice laws and high reliance on advanced anesthesia providers statewide. CRNAs in North Dakota can practice without physician supervision, which provides a high degree of clinical autonomy in both hospital and outpatient settings. Major employers include Sanford Health, Essentia Health, Trinity Health, Altru Health System, and CHI St. Alexius Health, where CRNAs routinely manage anesthesia for general surgery, trauma, obstetrics, and rural health services.

Because many facilities operate in medically underserved regions, CRNAs often play a central role in maintaining local access to surgical and procedural care. Independent practice authority allows CRNAs to provide full anesthesia services, manage patients directly, and collaborate with multidisciplinary teams based on facility policies rather than mandated supervision requirements.

With strong clinical autonomy, significant demand in rural hospitals and critical access facilities, and a stable healthcare infrastructure, North Dakota offers excellent career opportunities for CRNAs seeking independent practice and a wide scope of responsibility.

Education and Certification

• Educational Requirement: CRNAs must complete a doctoral degree from an accredited nurse anesthesia program.
• Certification: After graduation, candidates must pass the National Certification Examination (NCE) administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).

Licensure

• North Dakota License: CRNAs must hold a valid North Dakota Registered Nurse (RN) license and apply for certification through the North Dakota Board of Nursing.
• Renewal: The NBCRNA Recertification Process for All Practicing CRNAs .

Scope of Practice

• Autonomy: CRNAs in North Dakota can practice independently, providing anesthesia care without physician supervision.
• Prescriptive Authority: CRNAs may be authorized to prescribe medications related to anesthesia and patient care.

Collaboration

CRNA-only model, Collaborative Care Model, and Anesthesia Care (ACT) Model.

State Regulations

CRNAs should stay informed about changes in state laws and regulations affecting their practice. For current information, check out the North Dakota Board of Nursing as well as other relevant professional organizations.