CRNA · pathways
Where Certified Registered Nurse Anesthetists practice without a supervising physician, and what it takes
Three groups: full authority from licensure, conditional authority after a defined transition period, and supervision for the life of the practice.
Full practice authority (19)
Independent from licensure. A physician relationship is optional here.
Conditional independence (8)
Authority arrives after a transition period the statute defines. The conditions below are the feed's summary; each state page has the full rule and its source.
| State | Conditions for independent practice |
|---|---|
| Connecticut | ≥3 years licensed and practicing as an APRN; ≥2,000 hours performing advanced-practice nursing activities in collaboration with a physician (§20-87a(3)) |
| Delaware | ≥2 years of collaborative practice; ≥4,000 hours of clinical practice with a physician or experienced APRN |
| Massachusetts | 244 CMR 4.07 lists CRNA among the four APRN categories eligible for the same 2-year-supervised/3-year-prior-independent pathway to independent prescriptive practice as NP/PMHNP/CNM |
| Maine | practicing in a critical access hospital, or a hospital located in a rural area, and acting in accordance with that facility's bylaws/policies — a practice-setting fact rather than an hours/experience threshold |
| Nebraska | Inferred by analogy to the general APRN 2,000-hour transition-to-practice framework created by LB 107 (2015) — NOT independently confirmed against primary statute text specific to CRNAs in this research pass |
| Vermont | ≥2 years and ≥2,400 hours of practice under a collaborative agreement (≥1,600 hours over ≥12 months if adding a second APRN certification) |
| Wisconsin | ≥3,840 hours of professional RN practice over ≥24 months; ≥3,840 hours of advanced practice in the CRNA's Recognized Role while working with a physician or dentist immediately available for consultation, over ≥24 months |
| West Virginia | for prescribing specifically: ≥3 years in a documented collaborative relationship with granted prescriptive authority, then Board of Nursing approval |
Supervision required (25)
No experience- or hours-based pathway. The physician agreement lasts for the life of the practice.