Advanced Practice Registered Nurse Career Overview
An advanced practice registered nurse, or APRN, holds a unique position in the world of healthcare, bridging the gap between registered nurses (RNs) and physicians. APRNs have distinct training, independence, responsibilities, and earnings. They are licensed registered nurses who have pursued a master’s degree in nursing within a specific specialization.
This higher level of education equips them with the ability to diagnose and treat medical conditions and even prescribe medications in many cases. It’s important to note that the extent of their independence can vary depending on state regulations, with some requiring them to work under the supervision or in collaboration with a physician. Additionally, APRNs often play a supervisory role over RNs.
Time Required to Become an APRN
To become an APRN, you’ll need to invest approximately 6-8 years in your education and training.
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Job Outlook
The job outlook for APRNs is quite promising, with an anticipated growth of 45% from 2020 to 2030.
Median Earning Potential
In terms of earning potential, APRNs have a median salary of $117,670, making this a financially rewarding career path.
Source: Information derived from the U.S. Bureau of Labor Statistics
What an APRN Does
APRNs have a diverse set of responsibilities and skills, which can be summarized as follows:
Primary Responsibilities
– Acting as a primary care provider and offering patient education
– Managing diseases and conditions, including making diagnoses and prescribing treatment
– Overseeing the work of healthcare staff, including RNs
Key Skills
– Demonstrating empathy towards patients
– Being a continuous learner in the ever-evolving field of healthcare
– Making sound decisions, even under pressure
– Possessing scientific aptitude
– Communicating effectively with patients and colleagues
Work Settings for APRNs
Depending on their specialization, APRNs can find employment in various healthcare settings, such as hospitals, private physician offices, birth centers, surgical centers, clinics, or residential care facilities.
Common Work Settings Include:
Private Practices
APRNs may function as primary care providers, diagnosing and treating medical conditions, and supervising RNs.
Hospitals
In hospitals, advanced practice nurses might be responsible for administering medications, leading nursing departments, and diagnosing and treating health conditions.
Outpatient Care Facilities
In settings like outpatient care facilities and clinics, APRNs, particularly nurse practitioners (NPs), contribute as valuable members of healthcare teams, providing primary care services to patients.
Becoming an Advanced Practice Nurse
To become an Advanced Practice Registered Nurse (APRN), you’ll need to follow these steps:
1. Start by obtaining a Bachelor of Science in Nursing (BSN) degree.
– Some schools offer programs that combine BSN and Master of Science in Nursing (MSN) studies for students who have an associate degree.
2. Next, you must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to become a registered nurse (RN).
– This exam assesses your knowledge and skills in healthcare and takes up to six hours to complete.
3. Gain valuable experience by exploring various nursing specialties and working in clinical settings. Most specialty positions provide on-the-job training, allowing you to learn about different patient populations.
4. Apply to a Master of Science in Nursing (MSN) program or a Doctor of Nursing Practice (DNP) program with a focus on APRN roles. The specific requirements for admission can vary, but many programs prefer candidates with a GPA of at least 3.0, an essay or personal statement, and recommendations.
5. Graduate with either an MSN or a DNP, as these degrees are often necessary to qualify for licensing and certification exams. In some cases, a DNP may be required, especially for academic medical centers and teaching positions.
6. Earn certification from an approved nursing specialty board. Each specialty board has its own set of requirements beyond passing the certification exam. This typically involves holding an unencumbered RN license, completing an application, and submitting academic records. Often, obtaining certification is a prerequisite before applying for an advanced practice nursing license.
7. Apply for state licensure, adhering to your state’s specific requirements. These may include background checks and the verification of your education and clinical hours.
Understanding the Four Types of APRN Roles
There are four main types of APRN roles, each with its own specific requirements and areas of focus:
1. Certified Nurse Practitioner (CNP)
– Educational Requirement: MSN or DNP
– High Demand: These professionals often work in family practice, but some specialize in areas like gerontology, pediatrics, or mental/psychiatric health.
– Salary: The median salary is around $118,040.
– Job Outlook: The field is expected to see a 52% increase in job opportunities from 2020 to 2030.
2. Clinical Nurse Specialist (CNS)
– Educational Requirement: MSN
– Positive Job Outlook: Clinical nurse specialists work in specialized areas like oncology, cardiology, or emergency care.
– Salary: These professionals earn a median salary of about $111,700 (as of April 2022).
3. Certified Nurse Midwife (CNM)
– Educational Requirement: MSN or DNP
– High Demand: Certified nurse midwives focus on the care of pregnant individuals, labor, and childbirth. They have the authority to oversee births, much like physicians.
– Salary: The median salary is approximately $114,210.
– Job Outlook: This field is expected to experience an 11% increase in job opportunities from 2020 to 2030.
4. Certified Registered Nurse Anesthetist (CRNA)
– Educational Requirement: MSN or DNP
– High Demand: CRNAs administer anesthesia and often provide postoperative pain management. They tend to earn the highest salaries among advanced practice nurses.
– Salary: The median salary is approximately $202,470.
– Job Outlook: The job opportunities for CRNAs are expected to increase by 13% from 2020 to 2030.
In summary, these are the essential steps to become an APRN, the four primary APRN roles, and their respective requirements and prospects. It’s important to note that the educational and licensing landscape may vary from state to state, so it’s crucial to research the specific regulations and requirements in your area.
APRN Salary and Demand
APRN salaries can vary significantly based on factors such as specialization, experience, education, and certification. According to the U.S. Bureau of Labor Statistics (BLS), APRN salaries are notably higher than the national average annual salary of $75,330. Nurse anesthetists, in particular, earn the highest average annual salary at $202,470, while nurse practitioners can expect a median salary of $118,040. The median salary for all APRNs stands at $117,670. Furthermore, the demand for advanced practice nurses is on the rise, with the BLS projecting a 45% growth from 2020 to 2030.
Differences Between an APRN and an RN
APRN
– Enjoy high levels of autonomy and can often practice independently, with limited physician supervision in some states.
– Have the authority to make diagnoses and prescribe treatments, including medications.
– Require a minimum of six years of college education, culminating in a master’s degree in nursing.
– Necessitate additional education and certification beyond an RN license.
RN
– Have limited autonomy and independence, typically working under the direct supervision of a physician or an APRN.
– Cannot diagnose medical conditions or prescribe medications but carry out treatment plans provided by physicians or APRNs.
– Attain a minimum of two years of college education, typically earning an associate degree in nursing.
– Are considered entry-level healthcare professionals.
Comparing Advanced Practice Nurse and Nurse Practitioner
A nurse practitioner (NP) is a specific type of APRN. All nurse practitioners are APRNs, but the reverse is not true. Nurse practitioners are highly independent healthcare professionals who often work closely with patients over extended periods. They may specialize in a particular patient population, such as women, infants, or adults throughout their lifespans.
Key Differences Between NPs and APRNs:
Education
– Nurse practitioners are required to hold at least an MSN degree, with a possible future requirement of a Doctor of Nursing Practice (DNP).
– APRNs must have a minimum of a master’s degree to sit for one of the APRN specialization exams.
Typical Duties
– Nurse practitioners take health histories, assess, diagnose, and treat acute and chronic illnesses, often serving as primary care providers, and offer referrals for specialized care.
– Typical APRN duties vary based on their specialization. For example, nurse midwives focus on women’s healthcare, while nurse anesthetists primarily work in surgical settings.
Prescriptive Authority
– Nurse practitioners can prescribe medications, but the types of medicines and the level of supervision are determined by state laws.
– Some APRNs, but not all, have prescriptive authority depending on their specialization and state regulations.
Common Practice Settings
– Nurse practitioners work in a range of healthcare settings, including private practices, ambulatory clinics, long-term care facilities, and community clinics.
– APRNs can work in any healthcare setting, including hospitals, private practice clinics, long-term care facilities, and they may also be involved in educational or healthcare policy settings.
Licensing and Certification
– Nurse practitioners can obtain certification in various specialties through organizations like the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners (AANP). They also need to register with their state board of nursing.
– APRNs may have various certification options depending on their specialization, such as from the National Board of Certification & Recertification for Nurse Anesthetists or the American Midwifery Certification Board.
Continuing Education Requirements
– Nurse practitioners must recertify every five years, which entails accumulating a set number of clinical practice hours and continuing education relevant to their focus.
– The continuing education requirements for APRNs depend on their specialization and may include a combination of clinical and classroom work in their chosen field.
Ultimately, successful APRNs and nurse practitioners share a commitment to providing excellent patient care, strong patient communication skills, empathy, and the ability to handle stress effectively.
Here is a table summarizing the Differences betweens Nursing Practitioners and Advanced Practice Registered Nurses
| Nurse Practitioner | Advanced Nurse Practitioner | |
|---|---|---|
| Education | Currently an MSN is required at minimum. A DNP may be required in the future. | APRNs must have at least a master’s degree to sit for one of the APRN specialization exams. |
| Typical duties |
|
Typical APRN duties vary depending on the nurse’s specialization. Nurse midwives, for example, focus on women’s healthcare, while nurse anesthetists work primarily in surgical settings. |
| Can prescribe medications? | Yes, but the types of medicines and level of supervision is determined by state laws. | Some, but not all, APRNs have prescriptive authority depending on their specialization and the state where they work. |
| Common practice settings |
|
Any healthcare setting including hospitals, private practice clinics, and long-term care facilities. APRNs may also work in educational or healthcare policy settings. |
| Licensing and certification | Certification for nurse practitioners in various specialties is available through both the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners (AANP). Nurses must also register with their state board of nursing in the state where they choose to work. | Certification for nurse practitioners and clinical nurse specialists is available through the American Nurses Credentialing Center. Certification for nurse anesthetists is available from the National Board of Certification & Recertification for Nurse Anesthetists. Certification for nurse midwives is available through the American Midwifery Certification Board. |
| Continuing education requirements | NPs must recertify with AANP every five years. Recertification requires at least 1,000 hours of clinical practice over the past five years and 75 contact hours of continuing education for nurses, relevant to the NP’s role and focus. This means an NP who works in pediatrics must focus their continuing education on that population. ANCC recertification is also required every five years. As of 2018, the ANCC requires 150 continuing education hours, including at least 51% directly related to the NP’s focus and at least 25 hours in pharmacotherapeutics. | The continuing education requirements for APRNs depends on the nurse’s specialization. To recertify in any specialty there will be both clinical and classroom work in that nurse’s specialty. |
| Specialization or population focus |
|
The four main APRN roles are CRNA, certified nurse midwife, clinical nurse specialist, and nurse practitioner. Every NP is an APRN but the opposite is not true. The clinical nurse specialist may specialize like an NP and shares some of the same specializations (pediatric and adult gerontology being the most common). |
| Successful personalities | Like all nurses, NPs are dedicated to patient care. In many states, NPs are free to work without the direct supervision of a physician, meaning the most successful NPs are independent and organized. Patient communication is also integral to an NP’s job. These skills, along with empathy and the ability to interact with a diverse population, are also important. | An APRN must be committed to providing excellent patient care. Some APRNs work in patient-facing positions, and others work in policy or educational settings. In all roles, patient communication skills are essential. This means the ability to consult with a patient and families on sensitive and emotional subjects. APRNs are most successful when they are organized and can handle stress without becoming overwhelmed. |
| Common clinical collaborators | Some NPs must have collaborative agreements with physicians (e.g., medical doctor or doctor of osteopathic medicine) to practice in some states. Whether or not this supervision is required depends on the state in which they practice. | In the hospital setting, APRNs will collaborate with other nurses and physicians as well as hospital administrators. APRNs have more professional autonomy in full-practice authority states. |
Frequently Asked Questions About APRNs
How long does it take to become an APRN?
To become an advanced practice nurse, you should expect to dedicate at least six years to education and training. For those pursuing the Doctor of Nursing Practice (DNP) option, it may take seven years. Some graduate schools and certification boards may require or prefer candidates to have 1-2 years of clinical experience as a registered nurse.
Do APRNs need to earn their doctorate?
A doctorate is not a mandatory requirement for most advanced practice nurse roles. However, to become a Certified Registered Nurse Anesthetist (CRNA), a Doctor of Nurse Anesthesia Practice (DNAP) or a Doctor of Nurse Anesthesia (DNP) degree is necessary. While some practitioners and organizations support making the DNP the minimum academic degree for all advanced practice nurses, this is not universally required.
What is the highest-paying APRN role?
Among APRN roles, nurse anesthetists earn the highest average salary, with a median income of $202,470 annually. Factors influencing APRN salaries include geographical location, experience, and the type of employer.
Is an APRN considered a medical doctor?
No, APRNs hold either a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) degree, which are non-medical degrees. In most healthcare settings, only physicians are referred to as medical doctors.
Resources for APRNs
– The American Nurses Association (ANA) offers professional education, credentials, publications, advocacy for nurses and healthcare reform, and networking opportunities.
– The American Association of Nurse Practitioners (AANP) is the largest professional association for nurse practitioners in the United States, providing professional education, advocacy, and publications.
– The American College of Nurse-Midwives (ACNM) offers professional education, publishes newsletters and journals, promotes midwifery, and engages in advocacy.
– The American Association of Nurse Anesthetists (AANA) serves nurse anesthetists with newsletters, publications, networking opportunities, professional education, and malpractice insurance.
– The National Association of Clinical Nurse Specialists (NACNS) offers publications, clinical resources, scholarships, and conducts research on the profession and clinical nursing standards, in addition to advocacy efforts.
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