How to become A Nurse Anesthetist

Envision a healthcare setting where anaesthesia needs to be administered during a surgical, therapeutic, diagnostic or obstetric procedure. 

Who is the prized expert that works with surgeons, anesthesiologists, dentists, podiatrists and other medical professionals to deliver anaesthesia-related care before, during and after clinical procedures? 

It is none other than the Nurse Anesthetist.

• Certified Registered Nurse Anesthetist
• Anesthesia Nurse
• Anesthesiologist Nurse

What does a Nurse Anesthetist do?

A Nurse Anesthetist  would typically need to:

• Provide quality anaesthesia care and anaesthesia-related care to individuals across the lifespan, whose health status may range from healthy to immediate, severe or life-threatening injury or illness
• Liaise and communicate with recovery, theatre staff and floor nurses to ensure quality patient care
• Note the patient’s medical history and record their symptoms; perform a physical examination and evaluate the patient
• Provide pre-anaesthetic prep; inform the patient about surgery, recovery and potential side effects of anaesthesia while offering support and reassurance
• Recommend, request and study pertinent diagnostic studies; document pre-anaesthetic evaluation of impactful allergies or illnesses; obtain informed consent for anaesthesia 
• Select, prepare or use equipment, monitors, supplies or drugs for the administration of anaesthetics 
• Administer pre-anaesthetic medications and agents essential for management of anaesthetic care, if necessary
• Provide anaesthesia induction, maintenance, emergence and post-anaesthesia care; insert invasive line catheter/devices
• Manage the patient’s airway or pulmonary status, using endotracheal intubation, mechanical ventilation, pharmacological support, respiratory therapy and extubation
• Provide perianesthetic invasive and non-invasive monitoring according to current standards and techniques; manage the patient’s fluid, blood, electrolyte and acid-base balance
• Respond to abnormal findings with corrective action; recognise and treat cardiac dysrhythmias with the help of perianesthetic electrocardiogram (ECG) monitoring
• Assess the patient’s condition during emergence from anaesthesia; execute pharmacological or supportive treatment to help the patient recover from anaesthesia and ancillary drugs
• Undertake post-anaesthesia follow-up, report and appraisal of the patient’s response to anaesthesia and for potential anaesthetic complications
• Identify and manage emergencies; inform the anesthesiologist- or surgeon-in-charge of any changes in the patient’s condition
• Perform or manage regional anaesthetic techniques such as local, spinal, epidural, caudal, nerve blocks and intravenous blocks
• Ensure the environment is safe; calibrate and test anaesthesia equipment and machinery; disassemble and clean anaesthesia equipment
• Conduct or requisition regular equipment safety checks; clean and sterilise equipment; notify their supervisor of essential equipment adjustments or repairs
• Perform administrative duties such as ordering anaesthesia, training new staff and overseeing department finances

Nurse Anesthetists work in medical care settings where surgeries or procedures are performed, such as operating rooms, emergency rooms and intensive care units. Lithotripsy & MRI units, and cardiac catheterisation labs are other places where one can find these professionals with specialised skills. 

Their work environment usually comprises a clinical environment filled with high-tech equipment. The Nurse Anesthetists work in tandem with other health care professionals such as surgeons, nurses and operating room technicians.

Usually, Nurse Anesthetists spend almost the entire workday on their feet, either administering anaesthesia or walking between the wards, operating rooms and recovery rooms. In addition, the lack of an adequate number of specialised professionals may require them to travel long distances between medical facilities.

Most Nurse Anesthetists work full time in shifts from 6 a.m. to twelve midnight, including weekends and holidays to accommodate the standard workload of the institution. Those who work in critical care or obstetrics may need to be on call.

Finding a new job might seem challenging. Nurse Anesthetists can boost their job search by asking their network for referrals, contacting employers directly, using job search platforms, leveraging social media, and inquiring at staffing agencies.

While most Nurse Anesthetists choose to practice at the bedside, they also have access to administrative jobs that include personnel & resource management, financial management, quality assurance, risk management, department meetings, continuing education and staff development.

They may opt to be employed by healthcare facilities or work with them on an independent contractor basis. They may also choose temporary locum tenens positions offered by practices, hospitals, or healthcare organisations with an unfilled clinical need.

Nurse Anesthetists are generally employed by:

• Medical & Surgical Hospitals
• Critical Access Hospitals
• Mobile Surgery Centres
• Outpatient Care Centers
• Nursing Research Facilities
• Offices of Plastic Surgeons, Dentists, Ophthalmologists and Pain Management Specialists
• Military Medical Facilities
• Government Boards of Nursing
• Food & Drug Administration Agencies

Healthcare associations such as The International Federation of Nurse Anesthetists (IFNA) provide unparalleled networking and educational opportunities. They offer all the certification courses members will need throughout their professional careers.

Affiliated Nurse Anesthetists may attend conventions, seminars, and dinners frequented by peers, mentors, and other industry leaders. The events help them learn about the newest breakthroughs and latest developments in the field, including plum jobs.

• Physically demanding work with extended periods spent standing or walking; high risk of back injuries because of frequent lifting and moving patients
• A work environment that has to be kept cold to reduce bacterial infection
• Emotional stress due to critical decisions that affect a patient’s health and performance of medical procedures such as intubation
• Close contact with infectious diseases, accidental needle sticks and patient outbursts necessitates ready access to masks, gloves, and other personal protective equipment
• Regular experience of live surgical procedures, blood and other bodily fluids and unpleasant smells

Most RNs who wish to pursue nurse anaesthesia educational programs have around three years of experience in an acute care setting. However, the typical requirement is a minimum of one year.

To show their commitment to the long qualifying period, every applicant to a medical program needs work experience in their local hospital, doctor's surgery, nursing home, or mental health trust. It will help them understand some of the physical and emotional demands of a career in medicine.

Some teaching hospitals also offer work experience in their anaesthesia departments, specifically for secondary school students interested in a medical degree and a career as a Nurse Anesthetist. It can be a helpful way to gain insight.

Read about the profession, talk with a high school coun­selor, and interview/job shadow those working in Anesthesia to prove your commitment to course providers and prospective employers.

Be prepared to invest a significant chunk of time, money, and effort to acquire the requisite qualifications to become a Nurse Anesthetist.

You will typically begin with earning an accredited Bachelor of Science in Nursing or a healthcare-related field to qualify for registered nurse (RN) licensure, critical-care registered nurse (CCRN) certification and admission to an accredited nurse anaesthesia program. 

However, be aware that the nurse anaesthesia program requirements may vary across colleges or universities. Many ask for a Master of Science in Nursing (MSN) and will not be satisfied with a BSN.

Also, bear in mind that the prerequisites for qualification as a certified registered nurse anaesthetist (CRNA) will soon include a doctorate in nurse anaesthesia.  The master’s degree that is currently offered by some nurse anaesthesia programs may no longer be valid. Check with course providers and prospective employers to make sure you are on the right track.

The Doctor of Nursing Practice in Anesthesia (DNAP) degree comprises additional knowledge in anaesthesia pharmacology, anaesthesia pathophysiology and anaesthesia biology. It will allow a Nurse Anesthetist to specialise in geriatric, obstetric, neurosurgical, pediatric, dental or cardiovascular anaesthesia services.

Some employers may identify competent RNs working in a perioperative environment or acute care setting. They can offer to fund an online University Advanced Diploma in Anesthetic Practice that will train the RNs to become Nurse Anesthetists.

Applicants need to be employed in a perioperative environment for the course duration and have access to suitable placement opportunities under the supervision of an experienced and registered mentor. 

In addition, prospective students must add a written reference from their supervisor, including the latter’s permission and support, in their application form to the course provider. The employer must also ensure the applicant has undergone adequate (Disclosure and Barring Service) DBS or background checks. 

The course usually lasts around a year, and the time spent in an anaesthetic environment must allow you to achieve its academic and practical aspects. 

Take college preparatory health and life science courses in high school. English and speech classes will help you develop your research, writing, and oral communication skills.

RN licensure requires a BSN degree and passing the board-approved exam. The next step would be to qualify as an Advanced Practice Registered Nurse (APRN), including CCRNs and CRNAs.

Qualified RNs with the requisite number of clinical practice hours and success in the national certifying exam can obtain CCRN certification if they wish to provide direct care to critically ill adult patients.

CCRN positions may require cardiopulmonary resuscitation (CPR), basic life support (BLS) or advanced cardiac life support (ACLS) certification.

License and certification requirements may vary by location. Make sure you get all pertinent details from your course providers and prospective employers.

Qualified Nurse Anesthetists with significant experience and high-performance levels will take on managerial or administrative roles. Those who earn a doctoral degree may go into academia or choose to conduct research independently or as part of an interprofessional research team. 

Candidates with certification in critical care and respiratory care settings who are willing to move to medically underserved areas such as inner cities and rural areas will have the best job prospects. 

This highly specialised position requires ongoing training and continuing professional development (CPD) to renew essential certifications and licenses.

Reflective learning, interaction with peer groups, comprehensive inclusion, workshops, and professional publications educate, influence, support, and foster lifelong enlightenment in all career-grade Nurse Anesthetists.

Doctoral programs will equip professionals with the most advanced skills and knowledge in the field and seek better career options.

New learning objectives, educational methodologies, and novel technological developments, especially in education, management, and IT, will help you move into senior managerial positions with ease.

Interesting Trivia

Anaesthesia means “loss of sensation with or without loss of consciousness.” Medical procedures make use of anaesthesia to prevent patients from feeling pain.

In general, the ratio of male and female Nurse Anesthetists is 41:59.

Prevalent Modes of Medical Practice

In addition to being employed full-time, Nurse Anesthetists may explore other prevalent modes of employment.

Some Nurse Anesthetists work as independent contractors in a solo or group practice; they may share financial responsibility and flexibility in clinical practice but may not be free to make all decisions.

Locum tenens (literally “place holder”) is an alternative to more permanent employment. Locum tenens positions are temporary (up to a year) offered by practices, hospitals, or healthcare organisations with an unfilled clinical need. The compensation rate is generally higher than what the permanent position would suggest. Locum tenens allows Nurse Anesthetists to gauge a specific type of practice or location without committing to long-term employment.

Certified Registered Nurse Anesthetists may be the primary and sole providers of anaesthesia in most rural areas worldwide.

Nurse Anesthetists have to be prepared to make great personal sacrifices throughout their career, but it is well worth it. There is nothing more personally rewarding than knowing that you have a huge role to play in your patient’s safety and comfort when they are very vulnerable.

“Surgery and anaesthesia are all about teamwork, not egos - the only measurement that ever matters - is the safety of our patients.”