What Is an APRN?
Advanced practice registered nurse (APRN) is an umbrella term for nursing professionals who have earned a master’s or doctoral degree to take on advanced roles in health care. According to the National Council of State Boards of Nursing, APRNs include these nurse careers: clinical nurse specialist (CNS), nurse practitioner (NP), certified nurse midwife (CNM) and nurse anesthetist (CRNA).
Registered nurses (RNs) who are looking to advance their careers may consider pursuing a master’s or doctoral degree to work as an APRN. In addition to having more autonomy and an increased scope of practice, nurses may benefit from pursuing an APRN role due to job demand.
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How to Become an APRN
There are multiple steps an individual must take in order to become an APRN, including education, certification and licensure. Before pursuing an advanced nursing career, they must first have an RN license and experience working in the nursing profession.
If those prerequisites have been met, nurses who want to advance their career must take the following steps before they can practice as an APRN:
- Complete an advanced nursing degree. Individuals may choose to complete a Master of Science in Nursing (MSN) program or a Doctor of Nursing Practice (DNP) program depending on their career goals and area of specialization. Online options, such as online MSN programs, are also available.
- Complete clinical hours. Clinical practice experience allows students to apply new knowledge to their practice and gain professional competencies required to fulfill the role of an APRN, according to the American Association of Colleges of Nursing (AACN) Clinical Practice Experiences FAQs.
- Pass a national certification exam. There are multiple national accredited organizations that offer certification for APRNs. Nurses may choose which certification exam to take based on their area of specialization.
- Apply for licensure in their state of practice. In order to practice in your state, APRN graduates must pursue state licensure. Requirements for licensure may vary by the state in which an APRN intends to practice.
Advanced Practice Registered Nurse (APRN) Degrees
Although a master’s of nursing degree (MSN) is most commonly used for nurses pursuing a career as an APRN, some may choose to earn a Doctor of Nursing Practice (DNP). In addition to the level of degree an individual decides to pursue, one must also consider the area of specialty they are interested in. For example, if a nurse is interested in becoming an NP to work in women’s health, they may seek a degree program that focuses on that area of practice.
Examples of programs that focus on an area of specialty include:
- Nurse Practitioner Programs
- Acute Care Nurse Practitioner Programs
- Certified Nurse Midwife Programs
- Women’s Health Nurse Practitioner Programs
- Family Nurse Practitioner Programs
- Psychiatric-Mental Health Nurse Practitioner Programs
- Neonatal Nurse Practitioner Programs
Types of Advanced Practice Registered Nursing (APRN) Specialties
The APRN workforce includes nurses who specialize in four areas: certified nurse midwives (CNM), certified registered nurse anesthetists (CRNA), clinical nurse specialists (CNS) and nurse practitioners (NP).
- Certified nurse midwives (CNMs) work with patients across their lifespan to provide gynecologic and primary health care; however, their main area of focus is reproductive health. CNMs have the skill set to care for women throughout their entire pregnancies, including prenatal, postpartum and childbirth care. They may also help care for newborns during the first weeks of life.
- Certified registered nurse anesthetists (CRNAs) are trained to administer anesthetics during surgery, assist with pain during childbirth and oversee conscious sedation. Depending on where they practice, CRNAs have varying levels of autonomy and may be required to work with a physician present.
- Clinical nurse specialists (CNSs) focus their work on an area of expertise, such as a patient population (e.g., adults) or a type of care (e.g., acute and critical care). CNSs utilize their knowledge base and skills to act as educators and consultants in the health care setting, helping to make decisions about patient care through evidence-based practice. CNSs may also provide recommendations on management of a hospital unit.
- Nurse practitioners (NPs) may focus in primary care or a specialty area such as women’s health. NPs provide direct patient care and have a greater level of autonomy than RNs, including the ability to diagnose illnesses and provide prescriptions.
Nurse Practitioners Sub-Specializations
Working as an APRN allows nurses to specialize in areas of care they are most passionate about. NPs in particular have a wide variety of options for sub-specialization, including:
- Acute Care Nurse Practitioner (ACNP)
- Adult/Gerontology Nurse Practitioner (AGNP)
- Adult/Gerontology Nurse Practitioner—Acute (AGNP-AC)
- Adult/Gerontology Nurse Practitioner—Primary (AGNP-PC)
- Cardiac Nurse Practitioner
- Family Nurse Practitioner (FNP)
- Neonatal Nurse Practitioner (NNP)
- Oncology Nurse Practitioner
- Orthopaedic Nurse Practitioner
- Pediatric Acute Care Nurse Practitioner (PNP-AC)
- Pediatric Nurse Practitioner (PNP)
- Psychiatric and Mental Health Nurse Practitioner (PMHNP)
- Women’s Health Nurse Practitioner (WHNP)
What to Expect as an APRN
According to the National Council of State Boards of Nursing “advanced practice registered nurses (APRN) are a vital part of the health system of the United States.” Their expertise and increased level of autonomy allow them to serve patients and provide additional aid to their team in the workplace.
There are multiple requirements an individual must meet in order to become an APRN. First, an aspiring APRN must have an RN license and experience working as an RN prior to taking next steps. Nurses should also attend additional schooling to complete at least a master’s of nursing degree (MSN). Following the completion of an APRN degree program, individuals must pass a certification exam from an accredited national organization, such as the American Nurses Credentialing Center (ANCC) before they can begin their practice as an APRN. The accreditation organization through which an individual chooses to earn certification may depend on the area of specialization.
Nurses enrolled in APRN programs are expected to participate in both classroom education and clinical experience. Curriculum requirements will vary spending on the APRN program as well as the specialty a nursing student is pursuing. The rigorous coursework required of APRN students generally includes coursework in:
- Advanced health assessment
Additionally, students can also expect to have other coursework related to the APRN role they are pursuing. For example, the course list for an individual studying to become a certified nurse midwife will look different from that of a student in a program for certified registered nurse anesthetists.
Role and Scope of Practice
Advanced Practice Registered Nurse Role
APRNs play an important role in the health care system. Broadly speaking, the role of an APRN may include coordinating patient care, as well as providing primary or specialty health care, according to the BLS. This can include tasks ranging from recording patients’ medical histories, to ordering diagnostic tests and writing prescriptions.
Clinical nurse specialists (CNSs) additionally perform education and leadership duties by working with medical staff as a consultant to improve patient care.
Advanced Practice Registered Nurse Scope of Practice
Depending on their role and the state they work in, an APRN’s scope of practice may vary.
An APRN’s scope of practice may include:
- Evaluating and identifying a patient’s need for care
- Ordering diagnostic tests
- Prescribing medications
- Referring patients for further care
APRNs roles vary depending on specialty, so each APRNs role may differ. CNMs may focus on gynecological care while nurse practitioners may specialize in acute care for children.
To become licensed as an APRN, nurses are required by most states to pass a national certification exam upon completing their master’s degree. There are multiple organizations that provide certification exams for different areas of specialty.
- The National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) offers the National Certification Examination (NCE) for certified registered nurse anesthetists (CRNAs).
- The American Midwifery Certification Board is the “gold standard” for certified nurse-midwives (CNMs).
- There are multiple certifications for those who want to become a nurse practitioner to choose from based on what is required of their specific role. Organizations providing NP certifications include:
The BLS reports that the average salary for certified nurse anesthetists, certified nurse midwives, and nurse practitioners was $117,670 in May 2020. Wages vary across the types of APRN roles, with certified nurse anesthetists earning the highest median salary.
While all APRN roles have their similarities, it is also important to learn more about the specifics of the specialty area an individual is interested in pursuing. The following professional organizations provide professional information and resources that can be helpful to aspiring APRNs and professionals currently working in the field.
- American Association of Nurse Practitioners
- Gerontological Advanced Practice Nurses Association
- Nurse Practitioners in Women’s Health
- National Association of Pediatric Nurse Practitioners
- American Academy of Emergency Nurse Practitioners
- American College of Nurse-Midwives
- American Association of Nurse Anesthetists
What is an APRN-BC?
The designation of BC stands for “board certified.” This may mean that an APRN has completed a certification process to be recognized as a professional in that particular advanced nursing field, such as FNP-BC for Board Certified Family Nurse Practitioner.
Is an APRN considered a doctor?
While APRNs work in tandem with doctors to provide quality care for patients, the roles are different. While some APRNs provide primary medical care, they may be required by their state to do so in collaboration with a licensed physician.
However, APRNs are permitted to complete some tasks that may otherwise be handled by a doctor, such as providing primary care, ordering diagnostic tests, prescribing medication and managing a patient’s overall care.
Can an APRN write prescriptions?
While the level of autonomy may vary depending on the type or specialty, APRNs are generally permitted to prescribe some medication and other treatments to patients. An APRN’s ability to manage patients’ prescriptions can also depend on other factors. For example, nurse practitioners’ prescriptive authority for certain medications may vary by state.
To practice as an APRN in a given state, individuals are required to become licensed, generally by the Board of Nursing for that state. Requirements for nursing licensure vary by state, so it is important for aspiring APRNs to research what standards need to be to obtain and renew a license.
APRN is a term that applies to several advanced nursing roles, including nurse practitioners (NPs). ARNP is a variation of APRN meaning advanced registered nurse practitioner. Some nursing boards still refer to their graduate nurses as ARNPs but they typically have the same roles and responsibilities as their APRN colleagues.
APRNs and PAs both receive a master’s level education in health care. The two careers are certified through different organizations but both must pass a certification exam. APRN education may focus on a patient-centered approach while PA education may focus on a medical model in a particular area of medicine rather than a population.
Which states allow APRNs to work independently?
The level of autonomy for APRNs depends on their specific role. According to the AANP, 25 states and the District of Columbia have approved “full practice” status for NPs, allowing them to work independently. CNMs are permitted to work independently in 28 states, and CRNAs are allowed to practice independently in 19 states.
Last Updated in October 2021