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The educational process to become a nurse anesthetist is arguably the most intensive among all advanced practice registered nurses (APRNs). These highly skilled and competent professionals work as independent providers or as part of an anesthesiologist-led team, where they deliver the same level of anesthesia care as their physician counterparts. Recent estimates have nurse anesthetists providing anesthesia care to some 40 million patients every year.
According to the American Association of Nurse Anesthetists (AANA):
- CRNAs must have a minimum of 7 to 8 years of education and training specific to nursing and anesthesiology before they earn state licensure to practice anesthesia.
- RNs must earn a master’s or doctoral degree from a nurse anesthesia program to qualify for national certification as a CRNA and for state licensure.
- By 2025, all anesthesia graduates will likely be expected to earn doctoral degrees.
- Research shows that CRNAs are 85 percent less costly to educate and train than anesthesiologists.
- About 97 percent of employers report a high level of satisfaction with regard to preparedness of CRNA graduates.
Graduate Degrees for Nurse Anesthetists: Course Content and Outcomes
All RNs pursuing graduate studies to become a CRNA must graduate from a nurse anesthesia educational program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). This is an established standard for gaining the requisite national certification and going on to earn advanced practice licensure.
The Master of Science in Nursing (MSN)-Nurse Anesthesia is the minimum degree available with COA accreditation, and the most common degree program for nurse anesthetists.
As of August 2015, there were 115 accredited nurse anesthesia programs in the United States. Thirty-seven of these programs award doctoral degrees for entry into practice.
According to the COA, as of February 2015, there were 94 accredited MSN Nurse Anesthesia programs. Of those programs, 39 were offered in an online format, and 53 programs were offered on a part-time basis.
Online programs offer students the convenience of completing all or most of their coursework requirements through web-based study. In an effort to further accommodate students of these programs, institutions partner with hundreds of clinical sites throughout the U.S., thereby allowing students to complete the clinical component of their MSN program at there current place of employment or at sites close to home.
The three types of graduate-level programs accredited by the COA include:
- Master of Science in Nursing (MSN)
- Post-graduate certificate
- Doctoral degree
All COA-accredited programs range from 24 to 36 months in length, depending on university requirements. The COA requires accredited programs to follow COA standards so as to provide students with a solid foundation on which to build safe clinical practice in anesthesiology.
This includes a basic nurse anesthesia curriculum focused on:
- Pharmacology of anesthetic agents and adjuvant drugs (including concepts in chemistry and biochemistry)
- Anatomy
- Physiology
- Pathophysiology
- Basic and advanced principles of anesthesia practice; including:
- Physics
- Equipment
- Technology
- Pain management
- Research
- Professional aspects of nursing anesthesia practice
- Clinical correlation conferences
Clinical residencies provide students with opportunities to apply their knowledge to clinical problems under the guidance of anesthesiologists and licensed CRNAs.
The AANA’s CRNA Scope of Practice details the competencies nurse anesthetists should possess upon graduating from a nurse anesthesia program:
- Perform and documents pre-anesthetic assessments and evaluations, which include:
- Requesting consultations and diagnostic studies
- Administering pre-anesthetic medications and fluids
- Obtaining informed consent for anesthesia
- Develop and implement an anesthesia plan
- Select the planned anesthetic technique; this may include:
- General anesthesia
- Regional anesthesia
- Local anesthesia
- Intravenous sedation
- Selecting and administering the anesthetics (and adjuvant drugs and fluids) required to maintain the anesthesia
- Apply the appropriate noninvasive or invasive monitoring devices required to collect and interpret patient data
- Manage a patient’s airway and breathing using a number of methods, including:
- Intubation
- Ventilation
- Pharmacological support
- Respiratory therapy
- Extubation
- Manage the emergence and recovery from anesthesia (and provide relief from pain and anesthesia side effects) by administering ventilatory support, medications, and/or fluids
- Discharge patients from post-anesthesia care
- Provide post-anesthesia follow-up evaluations and care, as necessary, including modifying or starting pain relief therapy
- Respond to emergency situations
Nurse anesthetist MSN programs prepare students to successfully pass the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) National Certification Exam (NCE) and earn the CRNA credential, a requirement for CRNA practice throughout the U.S.
Components of an MSN- Nurse Anesthesia Program: Didactic Courses and Clinical Practicum
An MSN-Nurse Anesthesia program consists of two components: the didactic component and the clinical component. Some programs “load” the didactic component at the front of the program, leaving the clinical component for the latter half of the program, while other programs interweave the two so that didactic coursework and clinical sequences are completed concurrently.
The curriculum of an MSN degree program focuses on theoretical nursing, research, and science courses. The clinical practicum of an MSN-Nurse Anesthesia program, which always occurs under the direct supervision of CRNAs and/or anesthesiologists, provides students with the opportunity to apply their knowledge during clinical rotations. Clinical experiences allow students to learn how to administer a variety of anesthetics in primary care settings and in subspecialty settings and patient population foci, such as obstetrics, pediatrics, cardiac, and neurosurgery.
The faculty of a nurse anesthetist MSN program organizes clinical rotations, each of which generally last one to two months. The clinical phase of a nurse anesthetist program may afford students the opportunity to see hundreds of cases. According to the AANA, the average student in a nurse anesthetist program completes nearly 2,500 clinical hours and administers about 850 anesthetics.
Clinical rotations and didactic coursework prepares graduates to:
- Demonstrate the delivery of safe anesthesia with a focus on patient protection and the prevention of complications
- Deliver peri-anesthetic care to patients of all ages and physical conditions
- Possess the skills and knowledge necessary to provide airway and ventilatory management for patients in a variety of settings
- Demonstrate critical thinking during decision-making using research evidence
- Possess the verbal, nonverbal, and written communication skills necessary to effectively communicate with all individuals influencing patient care
- Demonstrate professionalism and integrity as to accept responsibility and accountability in anesthesia practice
Preparing for an MSN Program in Nurse Anesthesia
Institutions offering MSN degrees in Nurse Anesthesia require students to possess a valid and unencumbered RN license, a Bachelor of Science in Nursing (BSN), and at least a few years of experience in critical care settings.
According to the AANA, CRNAs possess an average of 3.5 years of critical care nursing experience before entering a nurse anesthesia program. They are the only anesthesia professionals who possess this level of critical care experience prior to entering an advanced educational program.
Due to the selective nature of these programs, candidates for MSN-Nurse Anesthesia programs must also possess competitive undergraduate GPAs and GRE scores. It is also commonplace for institutions to require admissions interviews in pursuit of candidates:
- Who have displayed leadership attributes
- With a passion for the nursing profession
- Who are highly motivated and driven to succeed
- Who hold advanced certifications and have completed graduate coursework
- Who are actively involved in professional organizations and hospital committees
- Who have demonstrated volunteer efforts through medical missions or have been involved in volunteer activities at the state or local level, providing services to underserved populations
MSN-Nurse Anesthesia Program Delivery Options
MSN programs in nurse anesthesia may be structured in one of three ways, each designed to cater to nursing students from different educational backgrounds:
- Traditional BSN-to-MSN Programs: BSN-to-MSN programs are traditional programs designed for the BSN-prepared RN and constitute the largest number of nurse anesthesia programs.
- RN-to-MSN Programs for ADN-Prepared RNs: RN-to-MSN programs provide RNs that possess an ADN with an education that includes all components of a BSN and MSN, conferring both degrees through one accelerated program.
- Direct-Entry MSN Programs for Bachelor’s Educated Non-Nursing Professionals: Direct-entry MSN programs (also referred to as entry-level MSN programs) allow students with a bachelor’s degree in a field other than nursing to earn their RN, BSN, and MSN in one, combined program.
Many of today’s MSN-Nurse Anesthesia programs offer distance learning and part-time options.