The nurses who administer anesthetics to patients enjoy considerable wages – the highest paid for nurses. This is normal, due to their huge responsibility, as well as the high level of the education and training requirements. Canada doesn’t have such an occupation yet. In the USA, after only a few years of practice, these professionals earn six-figure wages. After a continuous increase in the period 2012~2016, the average nurse anesthetist salary decreased a little last year, from $164,030/year in 2016 to $143,000/year in 2017.
Still, they earn almost as much as the dentists and podiatrists, and more than the pharmacists, optometrists, veterinarians, audiologists and physical therapists, who all need at least a doctoral degree, while the entry level requirement for the NAs it’s only a master’s degree.
Nurse Anesthetist Job Description
Because they involve cutting the patient’s tissues, the surgical procedures are painful. That’s why the patients who will undergo medical operations must be relieved from this pain, through a medical procedure called “anesthesia”. There are two kinds of healthcare specialists who are authorized to perform this procedure:
- the anesthesiologists, who are medical doctors specialized in this field;
- the nurse anesthetists, who are nurses specialized in the administration of anesthesia.
However, there are some countries where this procedure can be carried out only by specialized physicians. One such country is Canada, where the nurses can only assist the physicians who anesthetize patients.
In the United States of America, such a nurse is also known as CRNA – “certified registered nurse anesthetist”, because, in this country, the registration, the certification and the recertifications are mandatory for these healthcare professionals, who must pass some tests every two years. In the USA, the CRNAs are, in fact, APRNs (advanced practice registered nurses), just like the nurse midwives and the nurse practitioners. 
The CRNAs usually work in operating rooms, where they practice together with surgeons and other physicians, but they can also work in the offices of dentists. In some countries, these health practitioners can practice only under the supervision of a specialized medical doctor. The CRNAs practice in public or private hospitals or clinics, in obstetrical or surgical rooms, as well as in the offices of dentists. In other words, they work in any healthcare setting where the patients must get rid of the pain caused by surgical, dental or other medical procedures.
The CRNA, whose name is spelled “nurse anaesthetist“ in British English, administers anesthetic to patients of all ages, from babies to elderly, but only to the patients who can undergo these procedures, which are contraindicated, for example, to those with cardiac problems. The major risks of anesthesia are: death, heart attack and pulmonary embolism. 
The responsibilities of these professionals are very high, because the substances used to prevent or suppress the pain are very powerful and they can threat the patient’s life, if they are not administered properly. This is why these nurses must be educated, trained and tested very well, and they must master this specialty of practice.
This huge responsibility, along with the high level of education and training that are required, justify the huge salaries of the nurse anesthetists.
What Does a Nurse Anesthetist Do?
The CRNAs not only directly administer anesthetics to patients, but they also provide any related care to them, as indicated on bls.gov, the official website of the US Bureau of Labor Statistics . To be more precise, the CRNAs:
- before administering the anesthetics:
- discuss with the patients about any allergies or illnesses that they might have, as well as about any medications they might take, in order to determine whether the anesthesia can be administered to them;
- optionally, depending on the state or hospital regulations, consult with a physician or another highly trained healthcare professional (surgeon, dentist, anesthesiologist) about the pain management service that is the most appropriate to that patient;
- determine the correct anesthetic and dose (quantity), based on the patient’s health status, medical history and physical properties (weight, height, age, etc.);
- tell to the patient (and to his or her family) a few words about the pain management technique that he or she will undergo, how to prepare for it and its risks;
- prepare the medical instruments (syringes, etc.) that enable them to administer the anesthetics;
- during the surgical, dental, therapeutic, diagnostic or obstetrical procedures:
- remain with the patient for monitoring its vital signs and adjusting the anesthesia as necessary;
- after the aforementioned procedures:
- advice and help the patients to recover.
When it comes to giving the anesthetic, the precise medication (substance) that must be administered and the quantity that is necessary might be determined or approved by highly trained physicians, surgeons or dentists. If the substance or the quantity is not appropriate, these risks arise:
- the patient might wake up or recover before the end of the surgery, which would make him or her to feel a terrible pain;
- the patient might wake up or recover too long after the surgery or painful medical procedure;
- the patient might die or have a heart attack, if he or she suffers from any illness that is incompatible with the anesthetic or if he or she is allergic to any of its constituents.
One of the most important nurse anesthetist duties is to self-educate continually, in order to:
- keep up with all the findings in this field;
- be able to deliver excellent services of pain management;
- pass the necessary recertification exams every two years.
How to Become a Nurse Anesthetist
The educational and training path to becoming a nurse anesthetist varies between countries. In the United States, according to bls.gov , the candidates for this profession must be licensed registered nurses who earned at least a master’s degree in anesthesia, from an accredited program, and they must have at least one year of nursing experience in a medical setting. In most states, the certification is mandatory, as well as the recertification, every two years.
In the United Kingdom, the applicants to a CRNA position must become, first of all, registered nurses. Then they have to earn a nursing degree in anesthesia (which requires some experience as RN) and a certification in this specialty.
Nurse Anesthetist Education, Training and Certification
In the USA, the classroom education required for working as a CRNA is gained during these stages:
- high school (four years) – especially during the courses related to the medicine field, like: biology, anatomy, physics, chemistry;
- Bachelor’s or associate’s degree program in nursing (four or two-three years) – includes courses in anatomy, physiology, microbiology, chemistry, nutrition, psychology, social sciences ;
- Master’s or doctoral degree program in nurse anesthesia (two or three years).
The training – the clinical experience – that is necessary for practicing this profession is acquired during the:
- accredited Bachelor’s or associate’s degree program in nursing – which offers clinical experience in both hospital and nonhospital settings;
- minimum one year of full-time experience in a RN position, in an acute or critical care setting ;
- accredited Master’s or doctoral degree program in nurse anesthesia – when the candidate learns and carries out various anesthesia techniques, that are suitable to different surgical or dental procedures.
The license, the registration, the certification and the recertifications are mandatory for the CRNAs in most states of the USA. More precisely, the candidates for this position must:
- be RN – registered nurses;
- earn a RN license in the state where they intend to practice;
- earn a certification for their specialty of practice – which consists in passing a national exam, NCE, organized by the NBCRNA (National Board of Certification and Recertification for Nurse Anesthetists) ;
- recertify every two years, which involves 40 hours of continuing education .
In order to successfully practice this profession, a CRNA must possess the following qualities:
- attention to detail – if they are not administered properly, the substances they use may threat patient’s life;
- ability to work under pressure – sometimes, they must quickly decide on the most appropriate anesthetic procedure and whether they should ask the opinions of other medical professionals;
- good interpersonal and communication skills – they must talk to the patients and their families, for finding out the medical history and for explaining the medical procedures that they must perform, and they also need to communicate with the other members of their teams (physicians, surgeons, dentists, anesthesiologists);
- empathy and compassion – they should understand the difficult situations of the persons whose pain they manage;
- eagerness to learn – they must learn continuously, due to the periodic recertification required.
Pros and Cons of Being a Nurse Anesthetist
Being a CRNA has some important advantages, like enjoying:
- a great degree of satisfaction, for helping the patients to get rid of the pain;
- a lot of professional autonomy, especially in the countries and in the healthcare settings where they administer the anesthetics without being supervised by physicians or dentists;
- a lot of respect, due to the importance of their job, as well as because of the high level of education and training that allows then to legally practice this profession;
- high wages; the nurse anesthetist wage has six figures even from the first years of practice and it is pretty close to the incomes of the physicians and other highly trained medical practitioners.
The main downsides of this occupation are:
- having to work under pressure, especially when practicing in the emergency rooms;
- having to administer powerful medications, which can threat patient’s life, when used inappropriately.
Nurse Anesthetist Job Growth
In the United States, the job prospects for this occupation are good, thanks to:
- the continuous increase in the demand for healthcare services;
- the aging baby-boom population, which is numerous;
- the increasing number of persons who have access to medical services, due to the health insurance reforms.
As indicated on the website of the US Bureau of Labor Statistics , the employment of the nurse anesthetists is projected to grow with 19% – more exactly, with 7,400 jobs – in the decade 2014~2024. In 2014 there were 38,200 CRNAs practicing in the United States, and in 2024 the number of these professionals is expected to grow to 45,600.
The job outlook for this occupation is excellent also because the CRNAs will be in high demand especially in the rural areas, where there have always been a shortage of physicians and highly trained medical professionals, and the NAs have to take on most of the physicians’ responsibilities.
Nurse Anesthetist Salary – How Much Do Nurse Anesthetists Make?
The CRNAs are the best paid nurses, which is right, taking into account the high level of the education required – at least a master’s degree – and also the high level of responsibility they have. These nurses earn six figure wages even in the first years of practice, at least in the United States of America. In fact, their earnings are pretty close to how much physicians make.
The level of the nurse anesthetist salary is determined not only by their knowledge, but also by the country and region where they work, as well as by their level of experience. The employment sector is another essential factor that influences the wages of these professionals – the private sector usually offers higher earnings than the public one.
The employment industry – namely, the type of the healthcare setting where they practice – also affects their income. For example, in the USA, the CRNAs working in outpatient care centers are paid better than those working in hospitals. Other important elements that have an impact on their earnings are represented by the number of hours that they work during a month or year, and the levels of the bonuses that they get.
Nurse Anesthetist Salary in the USA
In 2016, the average salary of a nurse anesthetist working in the USA was $164,030 per year, as indicated on bls.gov, the website of the US Bureau of Labor Statistics. Considering that, during one year, a full-time employee works 2,080 hours, this mean annual wage corresponds to an hourly income of $78.86.  In 2017, the average income of the CRNAs practicing in the United States is estimated to $143,000/year by the website payscale.com .
According to bls.gov, in 2016, the median wage of the CRNAs practicing in the United States was $160,270 per year, or $77.05 per hour. These values indicate that half of the CRNAs working in the USA earned over $160,270/year – namely, their hourly income was above $77.05 – and the other half enjoyed annual wages that were under $160,270. Payscale.com publishes for these professionals a median salary of $138,568 in the year 2017.
In the USA, in 2016, the best paid 10% of these professionals took home over $208,000/year, while the lowest paid 10% of them earned, at most, $107,960/year, namely $51.91/hour, as indicated on bls.gov. .
Most of the nurse anesthetist jobs are in the offices of physicians and in the hospitals. According to bls.gov, in May 2016, the best paying industries for this occupation were:
- outpatient care centers, where the CRNAs earned annually, on average, $181,800;
- specialty hospitals (except the psychiatric and the substance abuse ones), where these professionals were remunerated with $175,800 per year on average;
- general medical and surgical hospitals, which offered a mean annual salary of $174,980 for the CRNAs.
Best Paying States and Areas
In May 2016, the best paying states for this profession were: Montana, Wyoming, California, Oregon and Nevada, where the annual average nurse anesthetist salaries were, respectively: $242,140, $233,400, $215,530, $199,860 and $192,330.
As indicated on bls.gov, the metropolitan areas which provided the highest incomes for these practitioners were:
- San Diego-Carlsbad, CA – $241,670 per year on average;
- San Jose-Sunnyvale-Santa Clara, CA – $238,860/year on average;
- San Francisco-Redwood City-South San Francisco, CA Metropolitan Division – $224,310/yr. on avg.
When it comes to the nonmetropolitan areas, the CRNAs were best paid in South Central Wisconsin ($250,270/yr. on avg.), Panhandle of Idaho ($225,270/yr. on avg.) and Northeast Maine ($219,110/yr. on avg.).
Evolution of Salaries
According to the data published on bls.gov (ref. , , , , ), in the USA, in the period May 2012 ~ May 2016, the wages of the nurse anesthetists have evolved as indicated in the following diagram:
To be more precise, in the USA, from May 2012 until May 2016, both the average (mean) and the median salaries of the CRNAs have continually increased, as follows:
- the average annual pay: from $154,390 in 2012, to $164,030 in 2016;
- the median annual pay: from $148,160 in 2012, to $160,270 in 2016.
|Annual Wages||Evolution of Nurse Anesthetist Wages in the USA
(data from bls.gov)
|May 2012||May 2013||May 2014||May 2015||May 2016|
Nurse Anesthetist Salary in the UK
Those who ask themselves “how much does a nurse anesthetist make in the United Kingdom?” should know that, in the UK, the average pay of these healthcare practitioners is around £71,000 per year, that is about 91,000 US dollars per annum. This mean wage is almost three times higher than the average pay of the registered nurses who work in the UK: £25,000/year, according to payscale.com .
Nurse Anesthetist Salary in Canada
Since in Canada this nursing specialty is at its very beginnings, it has no sense to talk about the wages of these professionals in this country, where, until recently, only the highly trained physicians – anesthesiologists, dentists – were allowed to administer anesthetics to patients. In 2017, it is still not clear whether any nurse can perform this pain management procedure. There are, however, nurses who simply assist the physicians who anesthetize patients.
Nurse Anesthetist Salary in Australia
In Australia, the NAs are paid with something in the region of 173,000 AUD per year, which is equivalent to a mean annual income of approximately 129,000 USD. Just like in any other country, the earnings of these healthcare professionals vary depending on the level of experience, number of hours worked in a month, bonuses received and types of the employment sector and industry.
CRNA Income Compared to Wages of Other Medical Occupations
The wages enjoyed by the CRNAs are, in general, the highest of all the nurses – at least in the United States. The table below compares the annual average wages of the nurse anesthetists with the incomes of other professionals, in the USA, UK, Canada and Australia. The salaries are displayed in descending order of the wages in the USA.
|Occupation||Average Annual Wages in 2017|
|Neurosurgeon||$380,000||£93,000 ($117,000)||C$294,000 ($225,000)||A$135,000 ($100,431)|
|Orthopedic Surgeon||$360,000||£134,000 ($172,000)||C$261,000 ($194,000)||A$210,000 ($156,000)|
|Hematologist||$250,000||£73,000 ($91,000)||C$190,000 ($142,000)||A$125,000 ($94,000)|
|Oncologist||$248,000||£63,000 ($77,000)||C$178,000 ($132,300)||A$163,000 ($124,000)|
|Dermatologist||$240,000||£120,000 ($150,000)||C$115,000 ($87,000)||A$162,000 ($120,500)|
|Cardiologist||$217,000||£109,000 ($136,000)||C$225,000 ($167,239)||A$150,000 ($111,590)|
|Nurse Anesthetist||$143,000||£71,000 ($91,000)||——————||A$173,000 ($129,000)|
|Chiropractor||$70,000||£33,000 ($42,340)||C$65,000 ($50,000)||A$70,000 ($53,000)|
In the USA, for example, the CRNAs earn much more than the chiropractors ($81,210/year on average in 2016 ) and audiologists ($79,290/yr. on avg. in 2016 ), who need a doctoral or professional degree, while the minimum entry level education for the CRNAs is represented by only a master’s degree. Other healthcare practitioners with superior education and training requirements (doctoral or professional degree), but lower earnings, are displayed in the following table:
|Occupation||Average Annual Wage in 2016||References from bls.gov|
The physicians who are specialized in various fields are remunerated much better then the CRNAs: the surgeons – like the neurosurgeon or the orthopedic surgeon – earn, on average, more than two times the mean wage of the NAs; those focused on blood disorders, cancers, skin or heart problems – hematologists, oncologists, dermatologists and cardiologists – also enjoy considerably higher incomes.
Nurse anesthesia is the best paying nursing specialty in (almost) any country where this specialty exists. However, the CRNAs earn less than the physicians and surgeons, but more than many professionals with superior education and training requirements. USA offers six figure wages for the CRNAs after only a few years of practice. Those wondering “how much does a nurse anesthetist make in the USA?” should know that the average annual wage for this occupation is $143,000 in 2017, while in 2016 was $164,030. Canada doesn’t have such an occupation yet.
 Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2016-17 Edition, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners, on the Internet at https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm (visited May 08, 2017).
 https://www.bls.gov/oes/current/oes291151.htm Nurse Anesthetists – Occupational Employment and Wages, May 2016
 Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2016-17 Edition, Registered Nurses, on the Internet at https://www.bls.gov/ooh/healthcare/registered-nurses.htm (visited May 27, 2017).