For most of human history, surgery brought out tremendous pain.
Before anesthesia, patients were often restrained while surgeons worked as quickly as possible. The speed of the surgeon mattered as much as their skill. Operations that might take hours today were compressed into minutes simply because the human body could not endure more.
Then in 1846, something extraordinary happened inside a Boston operating theater. A dentist named William T.G. Morton demonstrated ether anesthesia at Massachusetts General Hospital. A patient undergoing surgery remained unconscious throughout the procedure. When the operation ended, the surgeon reportedly turned to the crowd and declared that pain-free surgery had arrived.
But a new problem emerged almost immediately. Someone needed to manage the anesthesia. And that responsibility would fall, unexpectedly, to nurses.
The Origins of Nurse Anesthesia in the 1800s
As anesthesia spread across American hospitals in the late 19th century, surgeons discovered something quickly: administering anesthetic agents safely required constant attention. Dosage had to be monitored and breathing had to be observed. A patient could slip from sedation into danger within minutes. Someone needed to stay at the head of the table. In many hospitals, that role fell to nurses.
One of the most remarkable early pioneers was Alice Magaw, a nurse working at St. Mary’s Hospital in Rochester, Minnesota in the late 1800s. Magaw would go on to administer thousands of anesthetics, primarily ether, with extraordinarily low complication rates. At a time when many clinicians viewed anesthesia as unpredictable, she approached it with precision and documentation. She published her results in medical literature, helping establish anesthesia administration as a specialized clinical skill.
Today, Magaw is often referred to as the “Mother of Anesthesia,” and her work is frequently cited in the historical archives of the American Association of Nurse Anesthesiology.
It was an early glimpse of treating anesthesia as a discipline, not just a task.
CRNAs in Wartime Medicine
The next major chapter in the history of CRNAs unfolded not in hospitals, but on battlefields. During World War I and World War II, physician anesthesiologists were in short supply. Thousands of wounded soldiers required surgery, often in field hospitals and mobile surgical units.
Nurse anesthetists stepped in.They delivered anesthesia in military hospitals across Europe and the Pacific, frequently under extreme conditions. Military surgeons quickly recognized their value. Nurse anesthetists were trained, reliable, and capable of delivering anesthesia safely even when equipment and resources were limited.
The legacy of this era still shapes modern anesthesia practice and is frequently documented in military medical histories from institutions like the U.S. Army Medical Department Center of History and Heritage.
The Professionalization of Nurse Anesthesia
By the early 20th century, nurse anesthesia had evolved from a practical hospital role into a defined medical specialty. In 1931, the National Association of Nurse Anesthetists was founded. The organization would later become the American Association of Nurse Anesthesiology (AANA).
This moment marked a turning point. The profession now had structure, standards, and a unified voice. Over the following decades, certification programs were introduced, training standards expanded and academic programs moved into universities.
Modern nurse anesthesia education is accredited through the Council on Accreditation of Nurse Anesthesia Educational Programs and certification is administered by the National Board of Certification and Recertification for Nurse Anesthetists.
Major Milestones in CRNA History
- 1846: Ether anesthesia publicly demonstrated
- Late 1800s: Nurses begin administering anesthesia
- 1931: National Association of Nurse Anesthetists founded
- 1945: National certification program established
- 1956: Credential “CRNA” formally adopted
- 1990s: Graduate-level education becomes standard
- 2020s: Doctoral education becomes the norm
CRNA Jobs and Training Today
Modern CRNAs undergo some of the most rigorous training in advanced nursing practice.
The typical path includes:
Bachelor of Science in Nursing
Several years of ICU experience
Admission to an accredited nurse anesthesia program
Doctoral-level education (DNP or DNAP)
National board certification
Students often complete 2,000+ clinical hours and administer hundreds of anesthetics before graduation. The profession continues to evolve alongside advances in surgical medicine, patient safety protocols, and anesthesia technology.
For clinicians interested in the broader landscape of anesthesia careers, Barton’s locum tenens opportunities for CRNAs explores how the profession is evolving in today’s workforce.
Why CRNAs Are Critical to Healthcare Access
In many parts of the United States, CRNAs are the clinicians who make surgery possible. Today there are roughly 65,000–68,000 Certified Registered Nurse Anesthetists practicing in the United States, collectively delivering tens of millions of anesthetics each year.
Their role becomes even more important outside major metropolitan areas.
Research cited by the American Association of Nurse Anesthesiology shows that CRNAs provide more than 80% of anesthesia services in rural counties, often serving as the primary or sole anesthesia professionals in critical access hospitals. Without them, surgical programs in many communities would disappear. When anesthesia coverage disappears, operating rooms close. Procedures are postponed. Patients travel hours for care that should be available locally.
In that sense, CRNAs do more than administer anesthesia, they protect access to surgery.
Hospitals facing coverage gaps often turn to staffing solutions like CRNA locum tenens assignments to maintain surgical capacity.
Why CRNAs Are Critical to Healthcare Access
Over the past decade, demand for anesthesia providers has accelerated across the United States.
Several forces are driving this shift:
• An aging population requiring more surgical procedures
• Rapid growth of ambulatory surgery centers
• Expanding procedural medicine
• Physician anesthesiologist shortages
According to the U.S. Bureau of Labor Statistics, CRNA employment is projected to grow about 10% between 2023 and 2033, faster than many healthcare professions. At the same time, workforce analyses suggest the U.S. could face a shortage of thousands of anesthesia providers over the next decade as surgical demand rises. This imbalance has made experienced CRNAs one of the most sought-after clinicians in the healthcare workforce.
The Rise of Locum Tenens for CRNAs
As demand has grown, many CRNAs have begun rethinking how they structure their careers. One of the most notable trends in recent years has been the rise of locum tenens anesthesia work.
Locum assignments allow CRNAs to take temporary contracts in hospitals and surgical centers facing staffing shortages. Assignments can last a few weeks or several months depending on facility needs.
For many clinicians, the appeal lies in two things:
Flexibility and earning potential.
Locum CRNAs often earn higher hourly rates than permanent positions, particularly in high-demand regions.
At the same time, the model allows experienced CRNAs to design schedules that prioritize travel, family time, or extended breaks between assignments. What started as a niche staffing solution has increasingly become a strategic career option for anesthesia providers seeking both autonomy and financial upside.
FAQs
When did CRNAs first begin practicing?
Nurse anesthetists began administering anesthesia in the United States in the late 1800s shortly after ether anesthesia was introduced into surgical practice.
Who was the first nurse anesthetist?
Alice Magaw is widely recognized as one of the earliest professional nurse anesthetists and is often referred to as the “Mother of Anesthesia.”
How long have CRNAs existed?
The profession has existed for more than 150 years, dating back to the earliest days of surgical anesthesia.
How many CRNAs practice in the United States today?
There are more than 60,000 CRNAs and student nurse anesthetists practicing nationwide.
Do CRNAs only work in hospitals?
No. CRNAs practice in hospitals, ambulatory surgery centers, military medical units, pain management clinics, and rural healthcare systems.
