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Nurse Anesthetist Vs. Anesthesiologist

Scholasticus K
Anesthesia is an indispensable part of surgery. The practice of administering a proper and perfect anesthesia has led to the origination of the separate profession and discipline of anesthesiology. This medical sub-field has two important practitioners, namely, a nurse anesthetist and secondly, an anesthesiologist.
Perfectionist - that's the best word to describe a medical practitioner specializing in anesthesiology. In the pre-surgery medical procedures, the practitioner of anesthesiology, does a very, very important job of administering an appropriate anesthesia to the patient.
The provider studies the current medical condition of the patient, medical history, past and current ailments, allergies, some important facts regarding the patient's health and some day-to-day habits, upon which an appropriate dosage of the anesthesia is administered. The two most important skills of an anesthesia provider are assessment of the patient's physical condition and the judgment with the help of which the anesthesia's dosage is decided and provided.
A nurse anesthetist and an anesthesiologist do almost the same job, often working together as a team. Their career paths, however tend to differ a bit, including experience and educational qualifications. Here's a detailed comparison of nurse anesthetist vs. anesthesiologist.

Nurse Anesthetist

A nurse anesthetist is principally a Certified Registered Nurse Anesthetist (CRNA), who is also an Advanced Practice Registered Nurse (APRN). So basically, a nurse anesthetist is first a nurse who has acquired a lot of experience and the said certification.

Education and Certification

The educational pathway that is undertaken by a nurse anesthetist is quite complex and prolonged. The first primary requirement is a Bachelor's degree in sciences related to medicine and healthcare, followed by a proper certification as a registered nurse that is the Advanced Practice Registered Nurse (APRN).
A minimum one year experience with the Intensive Care Units (Medical or Surgical) is also required so that the nurse becomes eligible to apply for the Certified Registered Nurse Anesthetist educational program.
To get the Certified Registered Nurse Anesthetist (CRNA) certification, nurses can apply to educational institutes, medical colleges or nursing colleges which give the requisite Bachelors, Masters or Doctor's degree, which is a prerequisite as per the Certified Registered Nurse Anesthetist (CRNA) regulations. These programs often have a strict academic criterion and an exhaustive entrance procedure.
The academics are governed by the Council on Accreditation (COA). In the course work that extends for about 24-36 months, nurses are taught the discipline of anesthesiology. The final certification i.e.: CRNA is provided by the National Boards of Certification and Rectification of Nurse Anesthetists (NBCRNA).

Functions and Duties

The function and duties, and also the execution rights of the nurse anesthetist vary significantly from state to state, depending upon the law. As per the license of the CRNA, a nurse is authorized to deliver anesthesia of all kinds.
These clinical privileges are in accordance with the local laws and clinical policies, often depending upon the complexity of the case. In several cases though, when the patient is suffering from severe complications, the approval or even the supervision of a regular anesthesiologist or another surgeon is required.
In the Intensive Care Units, a nurse anesthetist also supervises the administration of anesthesia, sedatives and pre-surgery medications, often continuously reporting to doctors and surgeons. Such nurses who are attached to the Intensive Care Units, and some complicated surgeries, often continuously monitor the health of critical patients, or patients who are experiencing problems due the wearing off effects, after effects and side effects of the anesthesia.
In cases of extreme emergencies, when the patient may go into life-threatening situations, nurse anesthetists have also performed duties without the supervision of a regular anesthesiologist. Note that these instances are, very, very rare and in such cases, highly experienced nurse anesthetist takes charge.


In most of the cases, an anesthesiologist, is the boss of the nurse anesthetist. Unlike, common misconception on the behalf of the public, the anesthesiologist, is not just a supervisor of the nurse anesthetist.
An anesthesiologist commonly approves the assessment done by the nurse anesthetist, and sanctions the pre-surgery medications and the actual anesthesia. This function is usually a double-check to ensure that the anesthesia is sufficient and appropriate.
Giving the appropriate suggestions and modifying dosages and in several cases, supervising the entire pre-surgery, surgery and recovery phases of critical patients is a part of the anesthesiologist's job.

Education and Certification

First off, it must be noted that all anesthesiologist are physicians who are qualified with MD or DO. The academics start with a science based and medical school qualifying graduate degree, which is followed by a regular, medical school and a 4 years residency training.
All these form the basic qualifications for anesthesiology specialization. The course of anesthesiology usually requires, a yearlong surgical internship and a 3 year anesthesiology training.
The certification which qualifies an anesthesiologist to practice is provided and is governed by the American Board of Anesthesiology or the American Osteopathic Board of Anesthesiology (AOBA).

Functions and Duties

The functions and duties of an anesthesiologist are almost parallel and congruent to those of a nurse anesthetist. However from the authority point of view, the anesthesiologist wields more authority as the assistant anesthesiologist and nurse anesthetists or even other surgeons require the approval, consent and suggestions from the anesthesiologist.
A common day in the life of anesthesiologist would include, providing approvals, suggestions and improvements to the nurse anesthetist's recommended medications and anesthesia. Apart from that, diagnosing, assessing and providing medication or anesthesia to patients in the pre-surgery phase is often an important task of the anesthetists.
In some important surgeries, the anesthesiologist actually supervises in the surgery proceedings, and often stays present in the surgery or the Intensive Care Unit till the recovery (wearing off, of the effect of the anesthesia) process of the patient is complete.
Though the actual administering of the medications usually takes a relatively short time, the actual assessment and judgment of the medical case is one very hard task. As mentioned above, it requires intense precision in judgment and assessment.
The functions of both of these medical practitioners, of course involves the practical task of actually administering the anesthesia, talking and interviewing the patient and the patient's family, completing compliance, filling up of medical reports, etc. These two professions and their respective academics are very, very tough, plus the day-to-day functions require the anesthesia providers to be mentally prepared and very sharp.