Get to know more about Nurse Anesthetists, the profession, and how we work to provide the safest and most effective anesthesia in a majority of all surgical cases in the United States.

History

Certified Registered Nurse Anesthetists (CRNAs) have a legacy spanning more than 150 years. They were the first healthcare professionals to specialize in anesthesia, making nurse anesthesia the first clinical nursing specialty in the United States. This field emerged in the late 1800s when surgeons, often operating in battlefield and frontier settings, needed reliable anesthesia support. Nurses stepped into this critical role and helped formalize the safe administration of anesthetics.

One of the earliest known nurse anesthetists was Sister Mary Bernard in the 1870s, followed by pioneers like Alice Magaw, who safely administered more than 14,000 anesthetics and documented her techniques to improve safety. These early contributions helped establish anesthesia as a specialized practice and laid the foundation for the modern field. CRNAs have continued to lead innovations in anesthesia delivery, pain management, and patient safety across every era—from World Wars to today’s complex operating rooms.

Qualifications

Becoming a CRNA requires an average of 7 to 8 years of rigorous education and hands-on training. The journey includes earning a Bachelor of Science in Nursing (BSN), obtaining licensure as a Registered Nurse (RN), and gaining a minimum of 1–2 years of critical care experience—though most applicants have 3 or more years.

CRNAs are the only anesthesia providers who enter their doctoral programs with extensive ICU experience, making them uniquely qualified in managing life-threatening situations before they even begin their anesthesia training. Admission to an accredited Doctor of Nursing Practice (DNP) or Doctor of Nurse Anesthesia Practice (DNAP) program is highly competitive and includes coursework in advanced physiology, pharmacology, and anesthesia techniques, as well as over 2,500 clinical hours of anesthesia care.

Upon graduation, CRNAs must pass the National Certification Examination (NCE) to become board-certified. They are trained to administer every type of anesthesia—including general, regional, local, and sedation—across every patient population and healthcare setting. CRNAs and anesthesiologists use the same drugs, techniques, and monitoring standards to deliver anesthesia, and both must meet rigorous national standards to ensure patient safety.

Practice

There are currently more than 54,000 CRNAs and student nurse anesthetists practicing in the United States. These advanced practice providers administer over 50 million anesthetics each year, playing a critical role in operating rooms, delivery suites, ambulatory surgical centers, trauma units, and military medical facilities.

In many rural and underserved areas, CRNAs are the sole anesthesia providers, ensuring patients have access to essential surgical and obstetric care. They are also the primary anesthesia professionals in the U.S. military and Veterans Administration health systems, trusted to deliver safe anesthesia in high-pressure and resource-limited environments.

CRNAs can work independently in many states, particularly those that have opted out of the federal physician supervision requirement. In other settings, they collaborate with anesthesiologists in an Anesthesia Care Team (ACT) model. Studies published in peer-reviewed journals, including Health Affairs and the Journal of Nursing Regulation, confirm that anesthesia care is equally safe whether delivered by a CRNA alone, an anesthesiologist alone, or collaboratively. These findings support CRNAs’ essential role in improving access to care without compromising quality or safety.