Who We Are
Certified Registered Nurse Anesthetists (CRNAs) at a Glance
Nurse anesthetists have been providing anesthesia care to patients in the United States for 150 years. The credential CRNA (Certified Registered Nurse Anesthetist) came into existence in 1956. CRNAs are anesthesia professionals who administer more than 50 million anesthetics to patients each year in the United States. CRNAs are the primary providers of anesthesia care in rural America, enabling healthcare facilities in these medically underserved areas to offer obstetrical, surgical, pain management, and trauma stabilization services. In some states, including Oklahoma, CRNAs are the sole providers in nearly 100 percent of the rural hospitals. According to a 1999 report from the Institute of Medicine, anesthesia care is nearly 50 times safer than it was in the early 1980s. Numerous outcomes studies have demonstrated that there is no difference in the quality of care provided by CRNAs and their physician counterparts. CRNAs provide anesthesia in collaboration with surgeons, anesthesiologists, dentists, podiatrists, and other qualified healthcare professionals. When anesthesia is administered by a nurse anesthetist, it is recognized as the practice of nursing; when administered by an anesthesiologist, it is recognized as the practice of medicine. Regardless of whether their educational background is in nursing or medicine, all anesthesia professionals provide anesthesia the same way. CRNAs practice in every setting in which anesthesia is delivered: traditional hospital surgical suites and obstetrical delivery rooms; critical access hospitals; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, plastic surgeons, and pain management specialists; and U.S. military, Public Health Services, and Department of Veterans Affairs healthcare facilities. Nurse anesthetists have been the main providers of anesthesia care to U.S. military personnel on the front lines since WWI, including current conflicts in the Middle East. Nurses first provided anesthesia to wounded soldiers during the Civil War. Managed care plans recognize CRNAs for providing high-quality anesthesia care with reduced expense to patients and insurance companies. The cost-efficiency of CRNAs helps control escalating healthcare costs. 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 (which applies to hospitals and ambulatory surgical centers) 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, and 3) determine that opting out is in the best interests of the state’s citizens. To date, 24 states and Guam have opted out of the federal supervision requirement. On a nationwide basis, the average 2020 malpractice liability insurance premium for self-employed CRNAs was 36 percent less than it was in 1988. When trended for inflation through 2020, the reduction in premium is 71 percent Legislation passed by Congress in 1986 made nurse anesthetists the first nursing specialty to be accorded direct reimbursement rights under the Medicare program. Nearly 61,000 of the nation’s nurse anesthetists (including CRNAs and student registered nurse anesthetists) are members of the AANA. The education and experience required to become a CRNA include:
- Current active license as a Registered Nurse.
- A Bachelor of Science in Nursing (BSN) or other appropriate baccalaureate degree.
- Minimum one year of experience as a registered nurse in an intensive care setting. CRNAs have an average of three and a half years of critical care experience before entering a nurse anesthesia program.
- Graduation with a minimum of a master’s degree from an accredited nurse anesthesia educational program. Masters are no longer offered.
- By 2025, all CRNAs will receive a doctoral degree from a program accredited by the COA.
- Pass the national certification examination following graduation.
- To be recertified, CRNAs must obtain a minimum of 100 hours of approved continuing education every renewal cycle, document substantial anesthesia practice, maintain current state licensure, and certify that they have not developed any conditions that could adversely affect their ability to practice anesthesia.
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