CRNA vs. NP: Determining Your Ideal Nursing Career

Two of the most skilled and crucial roles in the medical field are Certified Registered Nurse Anesthetists (CRNAs) and Nurse Practitioners (NPs). These individuals take on some of the most stressful but essential tasks in hospitals, clinics, operating rooms, nursing homes, and doctor's offices.

If you're considering becoming either one, it's important to understand what will be expected of you and how you'll spend a typical day on the job once you've undergone all of the necessary educational and licensure requirements. We've set up this guide to help students make their decision between these two similar but distinct roles and what they can expect along the way.

What is a CRNA?

A Certified Registered Nurse Anesthetist (CRNA) is an advanced practice registered nurse (APRN) who is certified to administer anesthesia. Apart from this highly specialized role, CRNAs also provide care and education to the patient before and after surgery. The full range of duties include:

• Patient Assessment: Conduct comprehensive pre-anesthetic assessments to evaluate patients’ medical histories, current health status, and any potential risks associated with anesthesia.

• Anesthesia Planning: Developing individualized anesthesia care plans based on the patient’s needs, surgical procedures, and medical conditions.

• Anesthesia Administration: Administering various types of anesthesia, including general anesthesia and regional anesthesia, and monitoring anesthesia care using a variety of techniques and medications to ensure patient comfort and safety.

• Monitoring Vital Signs: Continuously monitor patients’ vital signs, such as heart rate, blood pressure, oxygen saturation, and temperature, throughout surgical and medical procedures to detect and respond to any changes or complications promptly.

• Airway Management: Managing patients’ airways, ensuring proper ventilation, and administering medications to support respiratory function during anesthesia.

• Collaboration with Healthcare Team: Collaborating with surgeons, anesthesiologists, nurses, and other healthcare professionals to coordinate patient care, communicate relevant information, and optimize surgical outcomes.

As you can gather from the list above, CRNAs are one of the most essential roles a person can have in the operating room, and they are frequently employed wherever operating rooms are found including hospitals, surgical centers, obstetrical units, and pain management clinics.

This fast-paced role isn't for the faint of heart. On an average day, a CNRA could be briefing a patient on a surgery they have scheduled in the near future or working intensely with the surgical team to save a patient's life or both. 

What is an NP? 

Like CRNAs, nurse practitioners are a type of APRN. In fact, there's really only one major difference between the two – CNRAs are specialized to administer anesthesia. NPs, on the other hand, offer more generalized practice. Their roles typically involve:

• Patient Assessment: Conduct comprehensive health assessments, including physical examinations, medical histories, and diagnostic tests to identify patients’ health status and needs.

• Diagnosis and Treatment: Diagnose acute and chronic illnesses, injuries, and conditions. Develop and implement individualized treatment plans, including prescribing medications, therapies, and other interventions.

• Health Promotion and Disease Prevention: Educate patients about preventive healthcare measures, lifestyle modifications, and disease management strategies to promote overall health and well-being.

• Chronic Disease Management: Manage and monitor patients with chronic conditions such as diabetes, hypertension, asthma, and heart disease to optimize health outcomes and prevent complications.

• Acute Care: Provide immediate and urgent care for patients with acute illnesses, injuries, or exacerbations of chronic conditions.

Another important aspect of nurse practitioner roles is their administrative duties. While their primary role is to treat illnesses and injuries and occasionally prescribe medication depending on the jurisdiction, NPs often maintain accurate and detailed medical records, including patient histories, assessments, treatments, and outcomes, in compliance with healthcare regulations and standards. They also collaborate with other medical professionals when needed and provide patient education.

Skills Needed

Certified Registered Nurse Anesthetist

Nurse anesthetists are one of the highest-paid nursing professions for a good reason – it's an incredibly stressful and immersive role with very little room for error. Above all other skills, a nurse anesthetist must be sharp-witted and able to handle intense and demanding work environments. Being able to make life or death decisions on a moment’s notice is an essential part of the job.

If you're considering becoming a CRNA, you'll also want to brush up on your communication skills. Even if you consider yourself an effective communicator now, it's likely nothing compared to the skills you'll need as a CRNA in the fast-paced operating room. You'll need to understand how to take and give orders when time is not on your side and be able to work efficiently with a team of medical professionals.

Additionally, you'll also have to learn how to communicate clear and informative instructions to your patients. This includes giving them news that they may not want to hear such as needing to get an invasive or risky surgery or that they might be losing a limb. It also means you'll need to communicate with incoherent patients as they're coming off the anesthesia and make sure that they're safely transported to the next location.

Nurse Practitioner

If you want to know what types of skills you'll need to become a nurse practitioner, look no further than another well-known medical role – a physician. Like physicians, nurse practitioners need excellent analytical skills to diagnose diseases and injuries and understand the condition that the patient is suffering from. They'll also need to maintain a working knowledge of these conditions through research and practice.

Apart from a gift for problem-solving, nurse practitioners also need to possess a skill for communication and compassion. As a nurse practitioner, you'll need to maintain close working relationships with not only your colleagues but also your patients. As you've likely observed, nurse practitioners often encounter patients in their most vulnerable and devastated states. This means that nurse practitioners must maintain a compassionate and empathetic demeanor with their patients, even while struggling to maintain their sanity after working a 50-60 hour week.

Lastly, CRNAs and NPs will both need to have a thorough understanding of the technology that they employ. This includes lab and diagnostic tests, anesthesia machines, ultrasounds, and electronic health records.

Path to Become a CRNA vs. NP

Broadly speaking, CRNAs and NPs follow the same educational and career trajectory. The main difference between the two is that CRNAs will obviously specialize in anesthesia whereas an NP will focus on general practice. Here is a typical path to becoming a CRNA or NP:

• BSN Degree: The first step to becoming either a CRNA or NP is to graduate with a bachelor's degree in nursing (BSN).

• Licensure: Once a BSN program has been completed, aspiring CRNAs and NPs will be eligible to take the NCLEX-RN exam and receive RN licensure.

• MSN Degree: Both CRNAs and NPs will need to get their master's degree in nursing (MSN) and fulfill clinical requirements before entering the field.

• Certification: CRNAs typically sit for the National Certification Examination (NCE) to become certified nurse anesthetists. NPs can also choose to become certified or remain general practitioners.

CRNA vs. NP Path

Additionally, CRNAs and NPs can consider leveling up to the doctoral level with a DNP degree if they wish to continue their studies beyond a master's degree.

Remember that every CRNA and NP career pathway will look a little bit different, and the requirements can vary from state to state. Always keep up to date on the most recent NP and CRNA requirements as you research your career path.

Career and Salary Outlook for Nurse Practitioners

The career and salary outlook for nurse practitioners continues to be promising and shows significant growth potential. With an increasing demand for healthcare services due to an aging population, NPs are playing an increasingly vital role in providing primary and specialized care. This demand, coupled with the ongoing shortage of primary care physicians in many areas, has created numerous opportunities for NPs to practice in various healthcare settings, including hospitals, clinics, and private practices.

In terms of salary, nurse practitioners generally enjoy competitive compensation. According to data from the Bureau of Labor Statistics, the median annual wage for NPs was around $128,490 as of 2023, with the highest 10% earning more than $168,030. Factors such as specialization, experience, and geographic location can influence NP salaries, with those working in specialized fields often commanding higher salaries. Additionally, NPs who pursue further education and obtain certifications may also see increased earning potential.

Overall, the future looks bright for nurse practitioners, both in terms of salary and career opportunities. The BLS speculates that the job market for NPs will grow as much as 38% in the next ten years. As the need for nurse practitioners continues, many nurse practitioners who are just starting out in the field find themselves able to move upward as there is plenty of room at the top.

Career and Salary Outlook for Nurse Anesthetists

The career and salary outlook for Nurse Anesthetists (CRNAs) remains highly favorable, reflecting their essential role in the healthcare system. As APRNs specializing in anesthesia, CRNAs administer anesthesia and oversee patient care before, during, and after surgical procedures, obstetrical deliveries, and other medical treatments. The demand for CRNAs is driven by the increasing number of surgeries and procedures performed each year, as well as the emphasis on patient safety and the need for specialized anesthesia care. The BLS speculates that the need for CRNAs will expand to about 38% by 2033.

In terms of salary, Nurse Anesthetists are among the highest-paid nursing professionals. According to data from the BLS, the median annual wage for CRNAs was approximately $183,580 as of 2020, with the top 10% earning more than $208,000. Factors such as experience, location, and the healthcare setting (e.g., hospitals, and surgical centers) can significantly influence CRNA salaries. Additionally, CRNAs who work in metropolitan areas or specialized surgical settings may command higher salaries due to increased demand and complexity of cases.

Conclusion

If you're still on the fence about whether you'd like to become a CRNA or an NP, there's an easy solution – become an NP. Narrowing down your career path to one specialization when you're not fully committed is only going to set your career back. If you change your mind, you have all the necessary education and licensure you'll need to become a CRNA, you'll just need to become certified.

On the other hand, if this information has convinced you to go for a CRNA-focused education, make sure you know what you're getting into. NPs will tell you that their job is incredibly stressful, but few will try and tell you that their job is more intense than that of a nurse anesthetist. What you sacrifice in sanity, however, you'll make back tenfold in salary – that's practically a guarantee.