Certified Registered Nurse Anesthetist (CRNA) Curriculum: A Comprehensive Overview

The path to becoming a Certified Registered Nurse Anesthetist (CRNA), also sometimes referred to as a nurse anesthesiologist, is a rigorous and demanding one, requiring extensive education, clinical experience, and a commitment to patient safety and well-being. This article provides a comprehensive overview of the CRNA curriculum, encompassing the educational requirements, program structure, and essential skills necessary for success in this advanced nursing specialty.

The Demands of Nurse Anesthesiology

Nurse anesthesiology is physically, mentally, and emotionally demanding. The profession also has one of the highest rates of substance abuse among healthcare fields. Individuals with a history of substance abuse are strongly encouraged to explore alternative nursing pathways. The College recognizes substance abuse as a disease; applicants with such a history may apply but must adhere to professional behavior and ethical standards at all times.

Educational Prerequisites and Application

CRNA/nurse anesthesiologist preparation requires at least 8-8.5 calendar years of education and experience. Every RN and APRN aspiring to become a CRNA/nurse anesthesiologist is encouraged to join AANA to get the inside track on becoming an anesthesia expert. AANA membership does not guarantee admission, but it can give aspiring CRNAs/nurse anesthesiologists an advantage in preparing their application to CRNA/nurse anesthesiology school.

Forty-nine states, the District of Columbia, Puerto Rico and the Virgin Islands require completion of an accredited nurse anesthetist program for practice. (This number includes those states that imply requiring completion of an accredited program by requiring nurse anesthetists to be certified. Graduates from accredited Nurse Anesthesia Programs are eligible to sit for the National Certification Examination administered by the National Board for Certification and Recertification of Nurse Anesthetists (NBCRNA). National certification is conferred by the NBCRNA and this allows the graduate of an accredited program to use the title Certified Registered Nurse Anesthetist (CRNA) or Certified Registered Nurse Anesthesiologist (CRNA).

Doctor of Nurse Anesthesia Practice (DNAP) Degree

To all Nurse Anesthesia student applicants: The Council on Accreditation of Nurse Anesthesia Educational programs requires that we inform all applicants and current students that as of January 1, 2022 - all students matriculating into an accredited program must be enrolled in doctoral study. The University of Pittsburgh Nurse Anesthesia Program transitioned to the BSN to DNP entry program in January 2017 with our first cohort scheduled to graduate December 2019.

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The USC Program of Nurse Anesthesia is a full-time, 36-month professional degree program in nurse anesthesiology with a comprehensive curriculum that leads to the Doctor of Nurse Anesthesia Practice (DNAP) degree and eligibility to sit for the National Certification Examination. The USC Keck School of Medicine confers the DNAP degree upon successful program completion. Graduates are eligible to sit for the National Certification Examination (NCE) administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). The application cycle opens on July 1 and closes on August 31. All application materials must be submitted by the August 31 deadline to be considered for an interview. The USC Program of Nurse Anesthesia is accredited through Spring 2033 by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). The University of Southern California is regionally accredited by the Western Association of Schools and Colleges (WASC).

Essential Skills and Technical Standards

All applicants must meet the technical standards required for safe, competent anesthesia practice, including cognitive, technical, observational, and behavioral skills.

Curriculum Overview

Expert academic and clinical faculty prepare nurse anesthesia trainees in the planning, administration, and evaluation of anesthesia and pain management across the lifespan and perioperative continuum.

The Role of CRNAs/Nurse Anesthesiologists

Nurse anesthetists have provided anesthesia care to patients in the United States for more than 150 years. Nurses first provided anesthesia on the battlefields of the American Civil War. The Certified Registered Nurse Anesthetist (CRNA/nurse anesthesiologist) credential came into existence in 1956 and in 1986 CRNAs/nurse anesthesiologists became the first nursing specialty accorded direct reimbursement rights from Medicare.

CRNAs/nurse anesthesiologists safely administer more than 58.5 million anesthetics to patients each year in the United States. As advanced practice registered nurses, they are among the nation’s most trusted professions according to Gallup. CRNAs/nurse anesthesiologists represent more than 80% of the anesthesia providers in rural counties. Many rural hospitals are critical access hospitals, which often rely on independently practicing CRNAs/nurse anesthesiologists for anesthesia care.

When anesthesia is administered by a nurse anesthetist, it is recognized as the practice of nursing; when administered by a physician anesthesiologist, it is recognized as the practice of medicine. As advanced practice registered nurses, CRNAs/nurse anesthesiologists practice with a high degree of autonomy and professional respect. CRNAs/nurse anesthesiologists are qualified to make independent judgments regarding all aspects of anesthesia care based on their education, licensure, and certification. The all-CRNA model, where anesthesia delivery is staffed and directed by CRNAs/nurse anesthesiologists avoids duplication of services, promotes efficient utilization of anesthesia providers, and reduces cost.

Legislation passed by Congress in 1986 made nurse anesthetists the first nursing specialty to be accorded direct reimbursement rights under the Medicare program and CRNAs/nurse anesthesiologists have billed Medicare directly for 100% of the physician fee schedule amount for services. In 2020, U. S. To date, 25 states and Guam have opted out of the federal physician supervision requirement. On a nationwide basis, the average 2023 malpractice liability insurance premium for self-employed CRNAs/nurse anesthesiologists was 25 percent less than it was in 1996.

Licensure and Recognition

In most states, Nurse Anesthetists hold licensure as registered nurses and/or as an ‘advanced practice registered nurse (APRN)”.

Faculty Profiles: Examples of Expertise

Several faculty members contribute their expertise to nurse anesthesia programs. Here are some examples:

Cheryl Parker, DNP, CRNA, RNC-OB, FAWHONN, FAAN

Cheryl Parker is the Director for the Doctor of Nursing Practice in Nurse Anesthesia Program at the University of Louisville. She is also an actively practicing obstetric anesthetist providing services with Obstetric Anesthesia Consultants at Norton Women’s and Children’s Hospital in Louisville.

Parker earned her BSN from Eastern Kentucky University and her MSN and DNP from Murray State University. She has been a nurse for 28 years, working primarily in the areas of women’s health, specifically: Postpartum, L&D, and NICU. For the last 14 years, her focus has been on Obstetric Anesthesia. She is a member of the AANA (American Association of Nurse Anesthetists), KyANA (Kentucky Anesthesia Nurses Association), SOAP (Society for Obstetric Anesthesia and Perinatology), KyPQC (Kentucky Perinatal Quality Collaborative), and a long-standing member of AWHONN (Association for Women’s Health, Obstetrics, and Neonatal Nursing), where she served 2 years on the Public Policy Committee. In 2020 she was instrumental in the submission and acceptance of KY-HR73; approving legislation to establish January 23rd as Women’s Health Awareness Day; and making Kentucky the 5th state in the nation to inaugurate an MHA resolution.

Parker’s publications include; a case report in JOGNN (Journal of Obstetrics, Gynecology, and Neonatal Nursing), May 2015, entitled: An Innovative Nursing Approach to Caring for an Obstetric Patient with Rape Trauma Syndrome (RTS); in 2019 she served on AWHONN’s Evidence Based Guidelines- Revision Science Team, which produced the evidence-based clinical practice guideline entitled: Analgesia and Anesthesia in the Intrapartum Period, and in Oct 2020, an AWHONN Practice Brief and Podcast entitled: Lower Extremity Nerve Injury in Childbirth.

Zohn Centimole, PhD, CRNA, FAAN

Zohn Centimole joined the School of Nursing as the Assistant Director for the Nurse Anesthesia Program to begin the first nurse anesthesia program housed on a tertiary medical center campus, in the state of Kentucky. Centimole has over 15 years of Certified Registered Nurse Anesthetist (CRNA) practice in the tertiary health care setting. His practice experience spans from outpatient remote anesthetics to major trauma resuscitations, as well as a large volume of complex cancer care. He has also been a didactic assistant professor in the Northern Kentucky University-Nurse Anesthesia Program, teaching courses in pharmacology, chemistry, and physics for nurse anesthetists. He has presented at national meetings and been published in several perianesthesia journals. His most recent article regarding calcinosis universalis is published in the April 2022 edition of the AANA Journal.

His research interests include the effects of anesthesia on cognitive function. In his clinical trial from 2014-2017, he applied the Cambridge Neuropsychological Test Automated Battery-Mild Cognitive Impairment (CANTAB-MCI) computer-based system to the anesthesia population. He actively studies individualized, custom anesthesia, strategies to optimize patient outcomes in vulnerable individuals.

Jennifer Harpe-Bates, DNAP, APRN, CRNA, FAAN

Jennifer Harpe-Bates joined the School of Nursing’s Doctor of Nursing Practice Nurse Anesthesia Program in October 2022 as Assistant Professor. Harpe-Bates has practiced for over 30 years as a Certified Registered Nurse Anesthetist. She was previously Adjunct Faculty for Northern Kentucky University Nurse Anesthesia Program, focusing on Doctoral Projects. Her anesthesia interests include opioid sparing anesthesia techniques that include a regional component. She frequently lectures on Transversus Abdominis Plane blocks at Anesthesia conferences. She is also the Kentucky Association of Nurse Anesthetist Program Committee Chair, providing annual education for the Certified Registered Nurse Anesthetist of Kentucky.

Brett Kendon, DNP, CRNA, ARNP, CHSE-A, DCA

Dr. Brett Kendon is an experienced clinician and Advanced Certified Healthcare Simulation Educator (CHSE-A) in the field of nurse anesthesia. He joins the University of Louisville SON as an Associate Clinical Professor with the Nurse Anesthesia Program as a didactic instructor and simulation specialist.

Throughout his career, Kendon has actively contributed to the advancement of simulation education in nurse anesthesia. He has presented lectures and workshops at various professional meetings, including the Florida Association of Nurse Anesthetists (FANA), Kentucky Association of Nurse Anesthetists (KYANA), and at national anesthesia and international simulation conferences.

He has played a significant leadership role in promoting simulation education within the American Association of Nurse Anesthetists (AANA) and anesthesia education, hosting meetings at the Assembly of School Faculty and National Congress. In conjunction with other educators, he progressed healthcare simulation education through the AANA simulation community, and in 2018 established and for 2 years chaired the initial AANA Simulation Sub-Committee to the Education Committee.

Most recently, his role has been in the design and development of the Northern Kentucky University Nurse Anesthesia Program, and serving as the Assistant Program Director and Director of Simulation for the past 5 years.

Sandy Smalley, CRNA, MSN

Sandy Smalley joined the University of Louisville SON as adjunct faculty with the Nurse Anesthesia Program in the summer of 2023. She has been a CRNA since December 2004, when she graduated from the University of Cincinnati with her MSN in anesthesia. She began practicing at St. Mary and Elizabeth Hospital in Louisville, Ky, where she worked until August 2015. In September 2015, she began her pediatric practice at Norton Children’s Hospital, where she continues to practice today. Pediatrics is where she feels she is truly called to practice.

Sarah Veeneman, DNP, CRNA

Sarah Veeneman joined the University of Louisville SON in October 2023 as the Primary Clinical Site Coordinator for the Nurse Anesthesia Program. Practicing at University of Louisville Hospital since 2016, her anesthesia interests include trauma resuscitation and stabilization, as well as management of complex surgical oncologic patients. A strong proponent of lifelong learning, Veeneman enjoys serving on multiple boards and committees to promote educational advancement. Her doctoral work focused on a workshop intervention for practicing CRNAs that helped to prepare them for success as clinical preceptors to incoming Nurse Anesthesia Residents. Currently, she serves on the UofL Health Advanced Practice Provider Advisory Council, discussing the professional and educational needs of advanced practice providers across the system and working collaboratively to guide quarterly meetings and the annual conference. She recently concluded a five-year term on the National Board of Certification & Recertification for Nurse Anesthetists (NBCRNA) Self-Evaluation Examination (SEE) committee, serving as chair for the last two years of her tenure.

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