Bridging the gap, how APRNs are blurring the line between doctors and nurses
An advanced practice registered nurse (APRN) is a registered nurse (RN) who has completed a graduate-level degree, most commonly a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP), and passed a national certification exam. Four types of nurses are:
- Clinical Nurse Specialist (CNS)
- Certified Nurse Practitioner (CNP)
- Certified Nurse Midwife (CNM)
- Certified Registered Nurse Anesthetist (CRNA)
Competencies and core coursework for APRN professionals
APRN professionals manage patient care, which can include performing comprehensive physical examinations, ordering diagnostic tests, prescribing medications, counseling health promotion and disease prevention, and providing health education. They also consult with and help educate nursing staff and seek to improve the quality of health care by using research to develop and improve policies, procedures, and standards of health care. Some APRN job responsibilities such as prescribing medications are regulated by state boards of nursing and vary by state. Individual states may also have specific licensing requirements.
Some coursework is common to all advanced practice nursing education programs including theoretical, philosophic, and ethical considerations in advanced practice nursing; advanced practice research methods; health systems and policy; advanced assessment, anatomy, biochemistry, pharmacology, and physiology; and professional issues and current trends in nursing and in the APRN specialization.
APRN educational program information
Candidates should make sure that any educational program they are considering is accredited by the governing body for the specific APRN specialty. Admissions to APRN programs varies by school and program but can include a bachelor's degree, preferably in nursing; an RN license; minimum GPA and minimum scores on the Graduate Record Exam; and previous clinical nursing experience.
Portions of some APRN educational programs may be available online although on-site clinical experience is generally required. Some programs also require a comprehensive exam and/or a research or capstone project.
What is a clinical nurse specialist (CNS)?
A CNS professional is extensively trained in direct patient care and case management in a specialty area such as cardiac care, genetics, geriatrics, home health, mental health, neonatal care, occupation health, oncology, or pediatrics. A CNS may also consult with and provide education for other nursing staff.
In addition to generalized APRN core courses, CNS coursework is specific to the area of specialization. For example, an acute/critical care concentration could include a predominance of classes focused on assessment and treatment for acute and critical care.
What is a certified nurse practitioner (CNP)?
A CNP is trained to diagnose and manage acute and chronic health conditions by ordering diagnostic lab work and x-rays, preparing treatment plans, and prescribing medications as well as handling administrative responsibilities. CNP professionals often focus on specific populations - children, adults, or the elderly - or in specialty areas such as diabetes management, mental health, occupational health, or sports medicine. Many states allow CNP professionals to practice independently.
Coursework is specific to a field of interest or particular population. For example, courses for a family nurse practitioner include family health care management and advanced family practice; those for a neonatal nurse practitioner would include fetus and newborn physiology, pharmacotherapeutics for newborns/infants, and assessment and diagnostics of newborns/infants.
What is a certified registered nurse anesthetist (CRNA)?
CRNA professionals are qualified to administer all types of anesthetics including general, regional, and sedation services and can also provide pain management and trauma stabilization services.
Coursework can include principles of anesthesiology; anesthesia management and research; principles of advanced nurse anesthesiology plus extensive practical experience in administering anesthesia under supervision. A comprehensive examination and research project are generally required. Admissions requirements vary by school but most prefer prior experience of at least two years in a critical care area of nursing.
What is a certified nurse midwife (CNM)?
Although this specialty focuses on pregnancy, childbirth, and gynecological and reproductive health, it also covers primary health care throughout a woman's life from adolescence through menopause and beyond. CNM professionals advocate for informed choice, shared decision-making, and the right to self-determination and empowerment of women as partners in health care and promote family-centered care.
Representative coursework can include women's gynecologic health care, diagnosis, and management; care during pregnancy and birth; care of high risk pregnancy; newborn well child care; and primary health care of children. Students must also fulfill a certain number of hours of clinical experience to complete the program.
The future of advanced practice nursing (APN)
Depending on the APN specialty, nursing professionals can work in private practice, hospitals, clinics, operating rooms, emergency rooms, long-term and critical care facilities, educational institutions, birthing centers, and public health offices.
APN is the career path for nurses interested in more responsibility and a wider range of career possibilities.
Kay Easton graduated from the State University of New York with a BA in English Literature. As a freelance and technical writer with more than 20 years experience, she writes articles for the Internet on a variety of topics.
Clinical Nursing Specialist Curriculum
CNS Core Competencies
Core Competencies for Basic Midwifery Practice
Neonatal Nurse Practitioner Curriculum
Role Delineation Study of Nurse Practitioners and Clinical Nurse Specialists
What are APRNs?
Women's Health Nurse Practitioner