Medical licensing is a curious thing. For example, you could become a licensed certified registered nurse anesthetist (CRNA) in Illinois and have no trouble finding work in that state. But you might not meet the requirements to work in other states. The thing about medical licensing is that it differs from state to state. At least to that degree, a licensed CRNA cannot necessarily work in just any state.

This does not necessarily mean bad things for CRNAs. Thankfully, states are working harder than ever before to streamline requirements so as to not hinder licensed professionals from one state being licensed in others. Even more important is the fact that dozens of states now allow CRNAs to practice independently.

A State-By-State Issue

Federal regulators do not have the authority to establish licensing requirements for doctors, nurses, etc. So states handle it. But interestingly, states are reluctant to recognize licenses from other states, which seems strange to many of us.

If you get a driver’s license in Florida, for example, you can legally drive in Indiana. Thanks to something known as reciprocity, Indiana recognizes the validity of a Florida license and vice-versus. The same is not true with medical licensing.

Different states have different licensing procedures for CRNAs – and nearly all other licensed medical professionals as well. If you wanted to take a CRNA job in a particular state, you would have to be licensed by that state before you could work inside its borders.


National CRNA Certification

Health Jobs Nationwide, a national jobs board that lists CRNA jobs, says that most states require CRNA certification obtained by passing the National Certification Examination. CRNAs must also be trained in a program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs.

In a nutshell, the majority of states will not license new CRNAs unless they completed their educational program through an accredited institution. They also insist on passing the national certification exam before approving license applications.

This seems pretty straightforward. However, there’s something else to consider: state requirements for registered nursing. In many states, future CRNAs have to work at least one year as registered nurses. What this means is that a young person cannot immediately embark on a CRNA program fresh out of high school.

A young person must first become a registered nurse, then work as an RN before being certified as a CRNA. Only then are CRNA jobs an option. This reality creates yet more confusion in that states have different licensing requirements for RNs as well.

Working Independently as a CRNA

In closing, the American Association of Nurse Anesthetists says there are 31 states where, in addition to the District of Columbia, CRNAs are legally allowed to practice independently. This means they do not have to be supervised by a physician. Though all 31 states are not listed here, they do include:

  • Arizona
  • California
  • Illinois
  • Massachusetts
  • Pensylvania

There has been a long-standing debate over independent practice among CRNAs. Those against it point out that CRNAs do not have the same kind of clinical experience as trained doctors. Proponents site this fact as the only real difference between the two.

If clinical practice hours constitute the primary difference between anesthetist and CRNA, it seems pretty reasonable that CRNAs should be allowed to practice independently after they gain enough clinical hours. Nonetheless, there are now more than three states that allow independent practice.

If you are thinking of becoming a CRNA, you can work in any state. But you have to be licensed in the state where you want to work. That’s it in a nutshell.