By Debra Wood, RN, contributor Aug 26, 2019
With
more complicated cases, more education for advanced practice nurses has taken
hold. By 2025, all new certified registered nurse anesthetists (CRNAs) will
need doctorate degrees.
“The
nurse anesthesia profession has always supported advanced education for nurse
anesthetists,” said Francis Gerbasi, PhD, CRNA, chief executive officer at the
Council on Accreditation of Nurse Anesthesia Educational Programs in Park
Ridge, Illinois.
Gerbasi
indicated that other health care professions, such as pharmacy and physical
therapy, have already moved toward practice doctoral degrees.
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The move to a doctorate for
entry to practice
The
trend toward more education for advanced practice nurses began in 2004, when
the American Academy of Colleges of Nursing (AACN) members published a position
statement advising its member colleges to transition all advanced practice
nursing education to the Doctor of Nursing Practice (DNP) degree.
“The
complexity of health care was changing, the knowledge was growing, and the
knowledge these graduates had and their experience in practice was growing,”
said Joan Stanley, PhD, RN, FAAN, CRNP, CNL, chief academic officer at AACN. “It
warranted a higher degree.”
That action
by AACN “prompted us to take a closer look at moving nurse anesthesia education
to the doctoral level,” Gerbasi explained.
In 2007, the board of directors
of the American Association of Nurse Anesthetists (AANA) approved a position
statement that entry to practice for CRNAs must be a doctorate by 2025. The
organization did not specify the type of doctoral degree.
“The
focus of nurse anesthesia education has been and continues to be ensuring high
quality nurse anesthetists who can provide all types of anesthesia in all types
of settings,” Gerbasi said.
In support of the AANA’s
position statement, the Council on Accreditation of Nurse Anesthesia
Educational Programs (COA) in 2009 voted to require nurse anesthesia educational programs to
transition to a doctoral framework no later than January 1, 2022, Gerbasi said.
So far, 91 of the accredited 121 nurse anesthesia educational programs
have been approved to transition to grant doctoral degrees.
“We are making good progress,”
Gerbasi said.
The transition has required nurse
anesthesia programs to adjust curriculums. However, Gerbasi said many programs
already were teaching classes and requiring credits close to a doctoral degree.
“It made sense to move the education to the doctoral level,” he added.
The two entry-level doctoral
degrees approved by the COA are the Doctor of Nursing Practice and the Doctor
of Nurse Anesthesia Practice (DNAP); the latter is typically offered by nurse
anesthesia programs that are not housed in schools of nursing. Nurse anesthesia
programs are also located in allied health, health sciences and medical colleges.
The minimum length for entry-into-practice
nurse anesthesia programs is 36 months. All of the entry-into-practice programs
require full-time enrollment, but some programs may allow student registered
nurse anesthetists (SRNAs) to work part time as registered nurses.
What do current CRNAs need to
do?
Current
CRNAs are not required to return to school to obtain a doctorate.
“The
decision to go back to school is an individual one, which would be based on
their personal and professional goals and the time they have left in their
careers,” Gerbasi said.
CRNAs who
are early in their careers may want to pursue a doctorate to remain competitive
in the workforce, Gerbasi said. Additionally, he noted that CRNAs could face
regulatory requirements in the future to have a doctoral degree.
Twenty-four
educational programs in the United States currently offer a CRNA completion
degree, enabling nurse anesthetists with a master’s degree to earn a doctorate.
Much of the education takes place using distance education.
“They
are designed so CRNAs can continue to work while getting their degree,” Gerbasi
said.
Will the practice doctorate
change CRNA jobs?
Gerbasi
reports an increase in the number of nurse anesthesia programs and graduates
during the past 10 years, which is also the time period when educators and SRNAs
knew about the requirement for programs to award a doctorate degree for
entry-into-practice by January 1, 2022.
In
2008, there were 110 nurse anesthesia programs and approximately 2,000
graduates in the United States. Ten years later, there are 121 nurse anesthesia
programs, graduating about 2,500 CRNAs.
AACN
also did not approve a position statement advising currently certified and
licensed nurse practitioners (NPs) to go back to school for a doctorate.
However, Stanley reported that many NPs have done that. In the past year, more
than 3,400 NPs with master’s degree enrolled in a post-master’s DNP programs. Additionally,
more than 14,300 are enrolled in BSN-to-DNP programs.
Every
year, the COA surveys the nurse anesthesia programs, asking how many of their
graduates are employed in CRNA jobs, which pay an average annual salary of
$180,000.
“The nurse
anesthesia programs report on average that all of their graduates are employed
within six months of program completion as CRNAs,” Gerbasi said. “The job
market is very good for nurse anesthetists.”
Related:
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CRNA
Scope of Practice: Advancing Anesthesia Safety
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