Locum CRNA or Permanent Staff? How to Choose Your Next Anesthesia Role

I have been recruiting clinicians since 2009, and CRNAs rarely regret the rate. They regret the call pattern, the practice model, or the coverage they assumed was included. Locum and permanent work can both be the right next step. They are not the same job with a different paycheck.

The National Board of Certification and Recertification for Nurse Anesthetists (opens in a new tab) is the certifying body for CRNAs, and board certification is required to practice. Everything below assumes you already hold that credential and you are choosing the shape of the work.

What is different about locum work and a staff role?

A staff role means one anesthesia group or hospital, a team that learns how you practice, and a schedule you can describe to your family. A locum role means a defined assignment, a new set of rooms, and more of the logistics sitting with you: credentialing, housing, and the question of who employs you for that stretch of time.

Staff work fits CRNAs who want continuity. You keep the skills you use every week, you know who is on the other side of the drapes, and the unglamorous parts of employment are handled inside the job. Locum work fits CRNAs who want variety, a pause between assignments, or a way to try a region before moving there. It asks more of you between contracts.

Neither one is a holding pattern. I talk to CRNAs who have built a career on staff, and CRNAs who have built one on assignments. The mistake is choosing from the day rate and discovering the model later.

What should you compare before the rate?

Ask each place to put five things in writing. You are comparing jobs, not adjectives.

• Practice model: anesthesia care team, medical direction, or independent practice, and how that shows up case to case.
• Call: how often, in-house or from home, and what "post-call" actually means the next day.
• Case mix: cardiac, obstetrics, pediatrics, regional, and whether you will keep the skills you have spent years building.
• Schedule: start times, late rooms, and how often the day runs past the posted shift.
• Coverage: malpractice, tail, and who handles credentialing.

Scope is part of that list. Supervision rules differ by state, and a group can be more restrictive than the state allows. If you are crossing a state line, ask how that group practices in its own rooms, then confirm the state rules yourself. Our CRNA recruiting page walks through the same comparison.

How do W-2 and 1099 change the offer?

As a W-2 employee, the group withholds taxes and usually provides benefits and malpractice. As a 1099 contractor, you handle your own taxes and you often handle benefits and coverage yourself. Locum work shows up in both forms. A W-2 locum assignment and a 1099 contract can quote similar daily numbers and leave you in very different places at the end of the year.

Ask what is included before you line the rates up. Health coverage, retirement, malpractice, tail, licensure, housing, and travel are either inside the offer or they are costs you carry. A tax professional should look at your specific situation. My job is to make sure the offer says, in plain language, which of those items the group is taking on.

What should call look like in writing?

Call should be describable without a shrug. How many people share it. Whether you sleep in the building or at home. What counts as a callback. What the next day looks like if you were in a room all night. How the group trades or pays for that time.

A permanent job with heavy in-house call and a locum assignment with home call are different lives, even when the headline number looks close. Ask the CRNAs who already take that call, not only the person recruiting you. If the group cannot introduce you to someone who works the schedule, that is information too.

How do you read an offer against the published wage?

The U.S. Bureau of Labor Statistics reports a median annual wage of $236,590 for nurse anesthetists in May 2025. That figure is the nurse anesthetist row, separate from the combined wage for nurse anesthetists, nurse midwives, and nurse practitioners (BLS Occupational Outlook Handbook (opens in a new tab)). The percentile table is on the CRNA salary page. Offers still move with region, practice model, call, and whether you are W-2 or 1099.

Use the median as context, then compare the whole offer. A staff package is usually base pay plus call, extra shifts, and benefits. Locum and contract work is usually a daily or hourly rate, with benefits and malpractice arranged differently. Two CRNAs can be equally well paid and have unequal Tuesdays.

What should be settled before you accept?

You should know who you work for, how long the commitment is, and what happens if the assignment or the permanent seat changes. Credentialing timelines belong in that conversation, especially for locum work, because a start date you cannot make helps no one.

You should also know how orientation works. A staff job that throws you into a full room on the first day, and a locum job that promises a week of orientation and then cancels it, fail in the same way. Ask what the first cases will be.

If you want a wider look at clinical roles around the operating room, the clinical desk, nurse staffing, and the specialist clinician page sit next to this one. For the career conversation itself, start with a confidential call. Healthcare careers is the broader door if you are still naming the specialty. If you want to move without your current employer hearing about it, our confidential search explains how that works.

Related career guides: pelvic floor PT jobs, travel or staff perfusionist roles, remote dosimetrist jobs.

Where do these facts come from?

• U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, nurse anesthetists median annual wage, May 2025: bls.gov/ooh (opens in a new tab)
• National Board of Certification and Recertification for Nurse Anesthetists, the certifying body for CRNAs: nbcrna.com (opens in a new tab)

Frequently Asked Questions

How do I choose between a locum CRNA job and a permanent staff job?

Choose locum work when you want variety and more control over when you work. Choose a staff role when you want one team, a steady case mix, and benefits handled for you. Compare practice model, call, and malpractice coverage before you compare rates.

What is the difference between 1099 and W-2 CRNA work?

A W-2 employer withholds taxes and usually provides benefits and malpractice. A 1099 contractor usually handles taxes, benefits, and coverage. Ask what is included before you compare a daily rate.

What should CRNA call language include?

It should say how often you take call, whether call is in-house or from home, what the next day looks like, and how that time is paid or traded. Ask a CRNA who already works that schedule.

How should I use the published CRNA wage?

The Bureau of Labor Statistics reports a median annual wage of $236,590 for nurse anesthetists in May 2025. Treat it as context. Region, call, practice model, and W-2 versus 1099 all change the offer in front of you.

Can I explore a move without my group finding out?

Yes. The first conversation is confidential. Your current employer is not contacted unless you ask.