Registered nurses who want to advance their nursing careers can do so by continuing their education to become an advanced practice nurse (APN) or advanced practice registered nurse (APRN). Advanced practice nursing requires a higher level of education, a Master of Science in Nursing (MSN) at the minimum. Through extended education, one can expect to gain a larger skill set, increased assessment abilities, the ability to plan for and implement care, and the competency to offer diagnoses. MSN programs also allow nurses to become an expert in a nursing specialty, so that they can go on to treat specific populations or diseases.

Advanced practice nurses exercise a greater level of autonomy in the areas mentioned above due to their higher level of education and expertise. Advanced practice registered nurses often make more decisions about patient care as they have the knowledge needed to do so. They play an expanded role in managing individual and group care. They also collaborate directly with clients and patients, offering advanced care to maximize positive outcomes. Advanced practice nurses manage physical and labor resources as well as ensure that those working with them are acting ethically and within the boundaries of the law. Advanced practice registered nurses also may apply for prescriptive authority and can administer certain levels of controlled substances depending on what state they are in. They also gain the ability to admit patients into health care facilities.

Advanced Practice Nursing Specialties

In addition to these high-level generalized skill sets, advanced practice nurses have four options for specialization:

Certified Nurse-Midwives

Certified nurse-midwives (CNMs) work with women from adolescence to menopause and provide gynecologic and primary health care. Although CNMs provide primary care for women of all ages, they are mainly focused on reproductive health. CNMs care for women throughout their entire pregnancies, including prenatal and postpartum care and while women are giving birth. They also help care for newborns during the first weeks of life.

Certified Registered Nurse Anesthetists

Certified registered nurse anesthetists (CRNAs), as their name suggests, work with anesthesia and are the highest-paid nurse specialists. CRNAs administer anesthetics during surgery, assist with pain during childbirth and oversee conscious sedation. Depending on where they practice, CRNAs have varying degrees of autonomy and may need a doctor with them as they practice or simply need consent.

Clinical Nurse Specialists

Clinical nurse specialists become experts in a specialty, whether it is a specific population, such as women or adults, or a specific type of care, such as cardiovascular or orthopedic. With their expertise, clinical nurse specialists often act as consultants, managers and leaders and help make decisions about patient care or make recommendations on how a hospital unit should be run.

Nurse Practitioners

Nurse practitioners, which are the most common specialty, also specialize in an area of expertise. Unlike clinical nurse specialists who educate and consult, nurse practitioners are involved in direct patient care. Nurse practitioners have a greater level of autonomy that includes prescriptive authority. Many nurse practitioners have their own primary care practices.

Nurse Practitioner Sub-Specialization

Each of these specialties carries further levels of specialization along with them. Nurse Practitioners have a particularly wide breadth of nursing specialty certifications, sub-specializations for advanced practice nurses to choose from.

Advanced practice nursing is regulated on a state-by-state basis, and Nursing License Map has created a helpful tool for you to navigate the sometimes complicated waters of advanced practice nursing licensure no matter where you live. For additional helpful information, take a look at the Concensus Model APRN Regulation.

Take a look at your state’s specific nursing license requirements: