Certified Registered Nurse Anesthetists (CRNAs) are advanced practice registered nurses (APRNs) licensed as independent practitioners who plan and deliver anesthesia, pain management, and related care to  patients of all health complexities across the lifespan.  As autonomous healthcare professionals, CRNAs collaborate with the patient and a variety of healthcare professionals in order to provide patient-centered high-quality, holistic, evidence-based and cost-effective care.

CRNAs practice in hospitals, nonoperating room anesthetizing areas, ambulatory surgical centers, and office-based settings.  They provide all types of anesthesia-related care for surgical, diagnostic, and therapeutic procedures.  CRNAs provide anesthesia for all specialties including, but not limited to, general, obstetric, trauma, cardiac, orthopedic, gastrointestinal, dental, and plastic surgery.  CRNAs administer anesthesia care to patients in urban, suburban, and rural locations in the U.S., and are often the sole anesthesia professionals delivering care to the military, rural, and medically underserved populations.  CRNAs serve as leaders, clinicians, researchers, educators, mentors, advocates, and administrators.

Before receiving graduate education in anesthesia, CRNAs must be licensed registered nurses with critical care nursing experience.  Building on this critical care foundation, CRNAs successfully complete a comprehensive didactic and clinical practice curriculum at a nurse anesthesia program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs.  Graduates are certified as CRNAs following successful completion of the National Certification Examination.  CRNAs are accountable to the public for professional excellence through lifelong learning and practice, continued certification, continuous engagement in quality improvement and professional development, and compliance with the Standards for Nurse Anesthesia Practice and Code of Ethics for the Certified Registered Nurse Anesthetist.

CRNAs exercise independent, professional judgment within their scope of practice.  They are accountable for their services and actions and for maintaining individual clinical competence.  The scope of an individual CRNA’s practice is determined by education, experience, local, state and federal law, and organization policy.

The practice of anesthesiology is a recognized nursing and medical specialty unified by the same standards of care.  Nurse anesthesia practice may include, but is not limited to, the services in Table 1.

CRNAs provide pivotal healthcare leadership in roles such as chief executive officer, administrator, manager, anesthesia services director, board member, anesthesia practice owner, national and international researcher, educator, mentor, and advocate.  Nurse anesthetists are innovative leaders in the delivery of cost-effective, evidence-based anesthesia and pain management, integrating critical thinking, ethical judgment, quality data, scientific research, and emerging technologies to optimize patient outcomes.

As demand for expert healthcare and anesthesia services accelerates, advocacy activities continue to target supporting the full scope of nurse anesthesia practice.  CRNAs engage in healthcare advocacy and policymaking at the facility, local, state, national, and international level.  They also participate in professional associations focusing on patient access to quality and affordable care.

The CRNA scope of practice evolves to meet the demands of the ever changing healthcare environment and increasing patient and procedure complexity.  As their record of safe, high-quality, cost-effective care demonstrates, CRNAs will continue to lead in the delivery of patient-centered compassionate anesthesia and pain management care.

For additional information and supporting documents, see Clinical Privileges and Other Responsibilities of Certified Registered Nurse Anesthetists, Professional Practice Documents, and Publications and Research.

Scope of Practice Standards for Nurse Anesthesia Practice, American Association of Nurse Anesthetists