Where Have all the CRNAs Gone?

Lorraine A. Morandi, MA
Director of Human Resources, Plexus Management Group, Westwood, MA

It doesn’t seem possible to adequately measure the true ramifications of COVID. One thing we all know with certainty is the lasting impact the pandemic has had on the working world and how that has translated into the need for greater resilience, tolerance, flexibility and adaptability to change. The anesthesia marketplace is no exception as it is currently seeing staffing shortages never experienced before, especially as it pertains to Certified Registered Nurse Anesthetists (CRNAs).

According to the Bureau of Labor Statistics, CRNA jobs are ranked eighth among healthcare professionals with approximately 130 accredited programs nationwide. Unfortunately, however, there simply aren’t enough students enrolled in these programs to begin to fill the voids. Across the country, opportunities abound in many capacities (i.e., full-time; parttime; per diem; locum) with compensation and benefits packages reaching an all-time high, some even close enough to resemble or exceed that of an MD package. Still, not a day goes by when one of our clients doesn’t reach out to share their staffing dilemmas and/or asks how Plexus Management Group (Plexus) can assist in finding candidates to fill these critical openings.

The question of why the need for CRNAs so greatly outweighs the supply begs for understanding and explanation, yet there is no easy answer. Aside from the lack of students enrolled in programs, the number of CRNAs reaching retirement age and opting to resign must be considered. We also cannot overlook the intense educational and clinical demands, dedication and years of training (seven to eight years) needed to become a CRNA—clearly, not a profession for everyone. And the requirements are only going to get more involved since it was determined that “effective January 2022, all students enrolled in an accredited program must also be enrolled in a doctoral program. As of January 1st, 2025, all students graduating from an accredited program must be awarded a doctoral degree.”

Once employed, there are a variety of factors contributing towards the decline in CRNA staffing. Among them are on-the-job stress, toxic work cultures, burnout due to long hours amidst staffing shortages, trauma from being immersed in potential life-or-death situations and a lack of reconciliation between personal/professional life otherwise known as “work/life balance.” Another issue highlighted during the pandemic is the struggle for CRNAs to have greater autonomy of practice. As of this writing, approximately 22 states have opted out of the federal physician supervision requirement and others may soon be following suit. The quest for independent practice is far from over.

How then does Plexus HR provide support by sourcing CRNAs for its clients? First, it’s critical to mention that full cycle CRNA recruitment is a lengthy process which starts by identifying where candidates can be found posting their CVs and actively looking for jobs. Gas Works, Indeed (active/passive candidates), LinkedIn, Facebook, the American Association of Nurse Anesthesiology (AANA) and other professional associations are all sites we frequently visit, as well as academic institutions with accredited anesthesia programs and national career fairs. Personal referrals from CRNAs are also something we rely heavily upon. Once we identify a candidate, we review their CV, share it with the client if we think they’ll be a good fit for their practice, conduct a phone screening and, if desired, move them to a live interview either via Zoom or onsite (sometimes both). Assuming the client chooses to move forward with the hire, we assist in offer negotiations, relocations, immigration, draft offer letters, conduct reference and background checks, then introduce them to the provider enrollment and credentialing teams, a process which can easily take three or more months to complete. All totaled, it can feel like a very long time from start to finish for the client and the candidate; but, at the conclusion, there’s great satisfaction that comes from knowing HR helped fill a vital role.

I wish I could tell clients and my team I knew when this job market, along with other post-COVID casualties (think housing, interest rates, etc.) will realize a modicum of stabilization, but that would require superhuman powers, or at the very least, a giant crystal ball. Since Plexus has neither, it will continue searching for an answer to the CRNA staffing crisis.

Lorraine A. Morandi, MA, is Director of Human Resources for Plexus Management Group, LLC (Plexus MG). She brings more than 25 years of HR experience to the leadership team. Ms. Morandi graduated with a Master’s Degree in Counseling Psychology from Boston College. Prior to joining Plexus MG, she worked for nearly 15 years at MarketOne International LLP, where she was Vice President of Human Resources, overseeing staff growth and development in the organization’s domestic and international offices. Ms. Morandi has also held a variety of senior human resources and recruiting positions with the Human Resources Organization (HRO) and the Norfolk District Attorney's Office, Mount Ida College and New Pond Village, all in Massachusetts. Ms. Morandi welcomes inquiries regarding Plexus MG’s HR services for anesthesia groups and can be reached at LMorandi@PlexusMG.com.