Advanced Practice Registered Nurse (APRN) Career Guide

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 degree level an individual decides to pursue, one must also consider the area of specialization 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 greater autonomy than RNs, including the ability to diagnose illnesses and prescribe medications.

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 autonomy allow them to serve patients and provide additional support to their team in the workplace.

Requirements

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.

Curriculum

Nurses enrolled in APRN programs are expected to participate in both classroom education and clinical experience. Curriculum requirements will vary depending on the APRN program and the specialty a nursing student is pursuing. The rigorous coursework required of APRN students generally includes coursework in:

• Pharmacology
• Advanced health assessment
• Pathophysiology

Additionally, students can expect 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 differ 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 and 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) also perform educational and leadership duties by serving as consultants to medical staff 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 APRN's role may differ. CNMs may focus on gynecological care, while nurse practitioners may specialize in acute care for children.

APRN Certification

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 offer certification exams in various specialties.

• 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:
  • American Academy of Nurse Practitioners Certification Board (AANPCB)
  • American Nurses Credentialing Center (ANCC)
  • Pediatric Nursing Certification Board (PNCB)

APRN Salaries

The BLS reports that the average salary for certified nurse anesthetists, certified nurse midwives, and nurse practitioners was $132,050 in May 2024. Wages vary across APRN roles, with certified nurse anesthetists earning the highest median salary.

APRN Resources

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