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Advanced Practice Registered Nursing: What Does it Take?
- Learn about the nuances of advanced practice registered nursing.
- Explore the differences between an advanced practice registered nurse and a nurse practitioner.
- Discover which path to take when advancing your nursing career.
Charmaine Robinson
MSN-Ed, BSN, RN
Nurses can work in numerous specialties, fulfill varying roles, and pursue higher degrees. Some have even begun to fulfill the role of primary care providers as advanced practice registered nurses (APRNs) – seeing patients in medical offices, clinics, and urgent care centers.
The terms “advanced practice registered nurse” and “nurse practitioner” (NP) are often used together, but there is a slight difference between the two.
What is Advanced Practice Registered Nursing?
The APRN role is simply an expanded and advanced Registered Nurse (RN) role. RNs must meet specific standards of practice set forth by governing nursing boards. APRNs must do the same, but practice standards differ based on the role and patient population.
There are four nationally recognized APRN types:
- Certified Nurse Practitioner (CNP)
- Clinical Nurse Specialist (CNS)
- Certified Registered Nurse Anesthetist (CRNA)
- Certified Nurse-Midwife (CNM)
APRNs assess, diagnose, order tests, prescribe medications, and manage patient problems. They can work in various settings, including clinics, birth centers, urgent care, doctor’s offices, and hospitals. APRNs hold postgraduate degrees, such as a Masters in Nursing (MSN) and Doctorate of Nursing Practice (DNP).
However, not all RNs with postgraduate degrees are automatically considered APRNs. These include nurse educators, administrators, clinical nurse leaders, informaticists, and researchers. These nursing leaders may hold an MSN or DNP but typically don’t work directly with patients and, therefore, aren’t held to the same standards as an APRN. Advanced-level specialized patient care separates an APRN from an RN with a postgraduate degree.
What is a Nurse Practitioner?
Many APRNs practice as primary care providers and clinicians, such as nurse practitioners (NPs). NPs are APRNs who manage patients in a primary role similar to that of a physician. NPs provide “initial, ongoing, and comprehensive care” to special patient populations. These include family practice, neonatal, pediatric, geriatric, mental health, and women’s health.
The NP role consists of health promotion, disease prevention, care management, education, and counseling. NPs work in inpatient and outpatient settings and can start their own practices (depending on their state).
NPs are required to pass a certification exam and obtain a license to practice. Unlike standard practice RNs – who can work in various fields under one license without specialty certification – NPs must hold certifications in each specialty they choose to work in, which might require them to return to school. For example, a senior nurse practitioner cannot work with pediatric populations without obtaining a new certification. This is why NPs choose a specialty in school, and RNs don’t.
How to Become an APRN
Whether a nurse decides to become an NP, CNS, CRNA, or CNM, the basic education qualifications are generally the same. All four APRN types require a postgraduate degree. The differences primarily lie in licensing and certification requirements.
Qualifications to become an APRN include:
- Hold a registered nurse license
- Gain clinical experience
- Graduate from an APRN program with at least an MSN degree
- Pass a certification exam to be licensed in one of the four APRN types
Qualifications vary based on the state in which an APRN will practice. Nurses who wish to become APRNs should review their state’s nursing board for specific details and updates. For example, nurses who want to become NPs may be required to obtain a DNP instead of an MSN starting in 2025 (although not definitive yet).
While non-APRNs with postgraduate degrees may legally work in their roles without specialty certifications (i.e., nurse educators – who may lawfully teach in a college nursing program without a special teaching license/certification, as their degree is what qualifies them to teach), APRNs are legally required to keep all certifications and licenses up to date to practice.
Why Choose Advanced Practice Registered Nursing?
Nurses who wish to serve patients as leaders in healthcare would benefit from pursuing an APRN degree. Nurses should consider their desires and skills when making a choice. The APRN role might be a great fit if nurses want to serve in primary clinical roles without pursuing a medical degree. Or, if a nurse already works in labor and delivery but desires to assist with the birthing process, becoming a midwife might be a great move.
Rather than go back to school to become an obstetrician, nurses can pursue certification as a CNM by advancing their education for just a few more years. On the same note, if a nurse works in critical care but wants to serve as a hospitalist diagnosing and treating pulmonary illnesses, returning to school to become an acute care NP could be an option. Advanced practice nursing is for the nurse who wants to serve specialized patient populations in a leadership role.
The Bottom Line
Becoming an APRN — whether NP, CNS, CRNA, or CNM — requires additional years of schooling, licensing, certifications, and ultimately more responsibilities. However, APRNs are valuable to the healthcare industry. They serve as resources to patients, nurses, and other healthcare professionals who are highly specialized in their fields. They help provide relief in areas where there are physician shortages. Overall, APRNs are vital for the future of healthcare.
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