CRNA Education and History

A legacy of excellence and rigorous academic preparation.

The credential CRNA (Certified Registered Nurse Anesthetist) was established in 1956. Nurses first provided anesthesia on the battlefields of the American Civil War. During WWI, nurse anesthetists became the predominant providers of anesthesia care to wounded soldiers on the front lines; today, CRNAs continue to be the primary providers of anesthesia care to U.S. military personnel on the front lines, aboard navy ships, and on aircraft evacuation teams around the globe.

Legislation passed by Congress in 1986 made nurse anesthetists the first nursing specialty to be accorded direct reimbursement rights under the Medicare program.

In 2001, the Centers for Medicare & Medicaid Services (CMS) changed the federal physician supervision rule for nurse anesthetists to allow state governors to opt-out of this facility reimbursement requirement by meeting three criteria:

  1. Consult the state boards of medicine and nursing about issues related to access to and the quality of anesthesia services in the state.
  2. Determine that opting out is consistent with state law.
  3. Determine that opting out is in the best interests of the state's citizens.

To date, 17 states have opted out of the federal supervision requirement, including Iowa, Nebraska, Idaho, Minnesota, New Hampshire, New Mexico, Kansas, North Dakota, Washington, Alaska, Oregon, Montana, South Dakota, Wisconsin, California, Colorado, and Kentucky. Additional states that do not have supervision requirements in state law are eligible to opt-out, should the governors elect to do so.

Education and Experience

Education and experience required to become a CRNA include:

  • • A baccalaureate or graduate degree in nursing or other appropriate major.
  • • An unencumbered license as a registered professional nurse and/or APRN in the United States or its territories.
  • • A minimum of one-year full-time work experience in a critical care setting (average experience of RNs entering programs is 2.9 years).
  • • Graduation with a minimum of a master’s degree from an accredited nurse anesthesia program. As of 2022, all programs are doctoral-level for entry into practice.
  • • Completion of 24-51 months of intensive clinical and didactic training, with an average of 9,369 hours of clinical experience.

National Certification & Recertification

Graduates must pass the National Certification Examination to become CRNAs. Practicing CRNAs participate in the Continued Professional Certification (CPC) Program through the NBCRNA. This involves 8-year cycles including 60 Class A CE credits, 40 Class B professional development credits, Core Modules in specialized content areas, and a comprehensive examination every eight years.