Getting Strong Letters
of Recommendation

Letters of recommendation are a required part of most CRNA applications. These letters carry weight because they offer insight into who you are as a nurse, a colleague, and a future CRNA that grades and test scores cannot capture.

Choosing the right people to write your letters and setting them up for success is not something you do last minute. It requires planning, professionalism, and a clear understanding of what programs are actually looking for.

Who should write your letters.

Check each program's specific requirements carefully. Many programs require at least one letter from a direct supervisor, typically your nurse manager. Programs also often seek additional letters from other sources like physicians, charge nurses, professors, or nurse educators, so it is good to build relationships with people in those roles and keep your options open.

The key is choosing people who have worked with you directly and can speak to specific examples of your abilities. Someone who has observed your clinical practice, knows how you handle pressure, and can speak to your growth over time.

Avoid asking people who only know you casually. A letter that says "this person is nice and works hard" is not helpful. Programs want letters that provide real evidence of your readiness for an advanced practice role.

When to ask for letters.

I recommend giving your recommenders at least a month notice if possible. Some applicants let their recommenders know even before the application cycle opens, especially if applying to programs with short application windows or rolling admissions. The goal is to give them enough time to write a thoughtful, detailed letter rather than rushing through it.

Ask in person if possible. Explain that you are applying to CRNA school, share why you think they would be a strong recommender, and ask if they feel comfortable writing a positive letter on your behalf. If they hesitate or seem unsure, take that as a sign to ask someone else. You want recommenders who are genuinely enthusiastic about supporting you.

How to set your recommenders up for success.

Once someone agrees to write your letter, make it as easy as possible for them. I recommend providing them with a copy of your resume so they have a better understanding of who you are. For example, a physician you work with might not know all the committees you are involved in or what you do outside the hospital. Your resume gives them that context.

If you feel comfortable, you can also share your personal statement with them. This helps them understand your goals and why you want to become a CRNA, which can strengthen their letter.

Include details about the programs you are applying to and their deadlines. If the program has specific prompts or requirements for the letter, share those as well. Some programs ask recommenders to address particular qualities like leadership, clinical judgment, or ability to handle stress. Pointing these out helps your recommender tailor their letter appropriately.

A polite reminder email two weeks before the deadline is professional and helpful. People are busy, and a gentle nudge shows you are organized and respectful of their time.

Showing gratitude.

After your recommender submits the letter, I highly recommend sending a thank you note. It does not have to be elaborate, but it should be genuine. A handwritten card is a nice touch, though an email works too if that feels more natural.

If you feel comfortable with your relationship with the person, you might also consider giving a small thank you gift. A coffee gift card, a personalized mug, or even something thoughtful like a stethoscope cuff ring with their initials engraved on it are all appropriate gestures. The gift is not required, but it shows that you recognize the time and effort they put into supporting your goals.

What if you do not have strong relationships with your current managers.

This is a common concern, and it is valid. If you have switched jobs recently, moved to a new unit, or work in an environment where turnover is high, you might not have deep relationships with your current supervisors yet.

In this case, reach out to the programs you are applying to and ask if a letter from a previous manager or supervisor is acceptable. Many programs will accept letters from former supervisors as long as the relationship is recent and relevant to your ICU experience, but policies vary by program. Always verify before asking someone to write a letter.

If you know in advance that you will need letters in the future, start building those relationships now. Check in with your manager during annual reviews. Let them know your career goals. Volunteer for projects and committees where they will see your work. Strong letters come from people who know you well, and that takes time.

What programs are looking for in a letter.

Admissions committees want to see evidence, not platitudes. They want letters that describe specific situations where you demonstrated critical thinking, leadership, professionalism, or composure under pressure.

A strong letter might describe a shift where you managed a rapidly deteriorating patient, communicated effectively with the team, and made sound clinical decisions. It might talk about how you mentored a new nurse through a difficult case or stepped up during a staffing crisis. It should feel real, not generic.

The best letters do not just say you are qualified. They show why you will succeed in a rigorous doctoral program and why you will become an excellent CRNA.