Advanced Practice Nurse Career Guide

The Basics

Since the ages, the field of nursing has dedicated itself towards the survival of generations. When we talk about nursing, one of the names that come to mind is Florence Nightingale. She dedicated herself to provide services for the heroes of Crimean War. This was something that enabled her to go beyond limits. Thus, the return of it was such that today the field of has turned into a diversified field and is respected all over the world.

When we are at our most vulnerable is when we’re sick. When illness or injury strikes, we rely on well-trained medical professionals to give us the care we need to recover and resume living life to its fullest. With so many things that can go wrong with our health, and so many different areas in which medical professionals can specialize, our well-being is often in the hands of an entire team of people, from doctors to nurses to orderlies and everything in between, to ensure that we’re safe and receiving the care we need.

In many situations, you might only see a doctor before or after a surgery, for example, or visit with a specialist like an x-ray technician for a few minutes before entering the radiology room. However, there is a group of medical professionals that is virtually in constant contact with people in need of medical care – nurses.

What is Advanced Practice Nursing?

Advanced practice nursing is a level of medical care provided by nurses that have specialty training and education. Advance practice nursing is not one specific type of care. Instead, it refers to the expanded skills and clinical expertise advanced practice nurses have above the scope of registered nurses.

Typically, advanced practice nursing involves practice in one of four general areas of specialization including work as a clinical nurse specialist, certified nurse-midwife, certified nurse anesthetist, and nurse practitioner.

Advanced practice nursing care allows nurses to have increased autonomy and authority regarding patient care. Nurses in advanced practice have more responsibility and decision making than their registered nursing counterparts. For example, advanced nursing involves diagnosing and treating patients, developing healthcare policies and managing hospital nursing departments.

Currently, advanced practice nursing is a pivotal part of today’s healthcare system, partly because it is cost-effective. In some cases, the nursing care involves functions and duties, which in the past were performed by doctors.

Advanced practice nursing is often implemented in various healthcare settings, such as hospitals, medical practices, and state or local public health agencies.

What is an Advanced Practice Nurse?

An Advanced Practice Nurse (APN) is a nurse who has been educated at the Master’s degree level of education or beyond. APN’s often specialize in a certain patient population or medical practice area, and they are qualified to evaluate, diagnose, order tests and prescribe medications. APNs are responsible for maintaining practice competencies through ongoing continuing education and licensure renewals.

There are four types of specialized APN’s in the United States. Certified Nurse Practitioners (CNP) work in a broad range of practice areas including Primary and Acute care settings. CNPs can work as primary care providers for a broad range of patient populations and address a wide spectrum of medical concerns.  A Clinical Nurse Specialist (CNS) is an APN who specializes in one area of practice. Certified Registered Nurse Anesthesiologists (CRNA) provide anesthesia-related care to patients in various healthcare settings. A Certified Nurse-Midwife (CNM) is an APN who specializes in women’s healthcare across the lifespan.

Advanced practice nurses can be found in settings across the healthcare field, including emergency departments, primary care and urgent care clinics, home health care, specialty medical practices, community clinics, and private offices. Due to their training and competencies, APN’s are in high demand and have extensive opportunities to practice across an array of challenging practice areas.

What Does an Advanced Practice Nurse Do?

Advanced practice nurses are related to the field of registered nurses who may have gained advanced training for expanded clinical practice. Generally, APRNs are at the forefront of providing preventative care to the general public as well as typically primary care suppliers. It is the responsibility of the advance practice nursing to provide facilities of healthcare in collaboration with the healthcare professionals and doctors.

Advanced practice nurses are registered nurses that have a master’s degree and expanded clinical competencies to provide patient care. Each type of advanced practice nurse provides specialized care that goes beyond what a registered nurse does. Different types of advanced practice nurses include nurse practitioners, certified nurse midwives, nurse anesthetists, and clinical nurse specialist.

Nurse Practitioners

Nurse practitioners are licensed clinicians who focus on preventing disease and managing patient’s health conditions. Nurse practitioners may specialize in areas, such as family practice, gynecology, and oncology.

Responsibilities of a nurse practitioner are often similar to a physician. Nurses may assess patients, perform physical exams, and order diagnostic tests. For instance, nurse practitioners may order an echocardiogram to diagnose a heart condition. Nurse practitioners also prescribe treatment, such as medication, physical therapy, and dietary recommendations.

Certified Nurse Midwives

Certified nurse midwives are also considered advanced practices nurses. Certified nurse midwives care for women from preconception through pregnancy and the postpartum period.

Midwives may provide prenatal counseling, pregnancy care, and assistance during labor and delivery. For example, nurses may perform exams and routine prenatal tests, such as ultrasounds and blood work. They may also provide postnatal care including breastfeeding instruction and baby care tips. Some certified nurse midwives also provide routine gynecological care, such as pap tests, breast exams, and provide birth control counseling.

Nurse Anesthetists

Nurse anesthetists are advanced practice nurses that administer anesthesia to people who are undergoing medical procedures, such as surgery. The work of a nurse anesthetist starts before surgery. For example, nurses review a patient’s medical history to check for contraindications for anesthesia. They also provide information to patients on anesthesia side effects.

During surgery, nurse anesthetists administer epidurals, nerve blocks, and other types of anesthesia. They also insert breathing tubes and monitor vital signs during surgery.

Clinical Nurse Specialist

A clinical nurse specialist is an advanced practice nurse that may provide patient care or be involved in research, nurse management, or administration. They typically have an area of expertise, such as working with the elderly or children. They may also specialize in a certain area of medicine, such as cardiology, pain management or pulmonology.

Although they can provide patient care, clinical nurse specialists are often involved in management, research, and education to improve care and patient satisfaction. For example, duties may include researching better ways to control pain in cancer patients or improve quality of life after a stroke. Nurse specialists may also educate nurses on new protocols, which improve patient care.

Why Do We Need Advanced Practice Nurses?

Advanced practice nurses are essential members of the healthcare team for a variety of reasons. Advanced practice nurses have additional education, training, and expertise, which allows them to provide more specialized care than registered nurses. In the past, that specialized care was usually provided by doctors. But there is a growing number of medical specialties that have a shortage of physicians.

The American Association of Medical Colleges expects there will be a shortage of about 90,000 doctors by 2025. Doctors specializing in primary care and family practice are predicted to especially be in short supply.

Fewer doctors may be choosing to specialize in family practice, which may be causing a shortage. There is also an increased demand for healthcare as advances in medicine results in people living longer. Overall, there is an increased need for medical care but fewer doctors available to provide services.

Because advanced practice nurses are more than just registered nurses, they can perform a variety of different services. In some cases, they can provide many of the same services as doctors and fill the void left by a shortage of physicians. Without advanced practice nurses, countless people would not have available healthcare services. The wait time to receive medical care would likely increase.

What are the Requirements to Become an Advanced Practice Nurse?

Educational

The educational requirements to become an advanced practice nurse actually vary widely, simply because there are a variety of types of advanced practice nurses.

For example, some advanced practice nurses become Certified Nurse Practitioners, who might work in a family practice clinic, a women’s clinic, or on a specialty floor at a hospital, like cardiology. Obviously, the training and education required to work in such specialized areas is likewise specialized.

Other advanced practice nurses become Clinical Nurse Specialists. These nurses specialize in a very specific type of medicine, like cancer treatment or psychiatric treatment. Again, depending on the specialization, the educational requirements will vary.

The common thread between all types of advanced practice nurses is the foundational education that’s required. Generally, advanced practice nurses must begin by having a bachelor’s degree in nursing with an RN license in order to meet educational prerequisites. Then, the next step would be to obtain a master’s degree in nursing.

These master’s degree programs usually last between one to three years. Though there are general courses on medical topics like anatomy and physiology, most coursework focuses on the area of desired specialization, as outlined above. So, students that wish to work with geriatric patients would study geriatric medicine, those that wish to work in pediatrics would study pediatric medicine, and so forth.

After graduating with a master’s degree, advanced practice nurses must obtain the proper certification. Again, the type of certification that’s pursued is dependent upon the specific field in which you want to work. The different types of advanced practice nursing certifications can be found here.

You may also opt for an online nursing degree, in case you may not be able to achieve a conventional campus based education. Thus it may also turn out to be fruitful as far as money and time saving is concerned. Thus you may continue with the daily affairs, without disturbing your education.

Licensure

As is the case with most medical-related professions, licensure requirements for advanced practice nurses vary from one state to the next, although there is movement toward a more nationalized licensure model that makes requirements more consistent and licenses portable from one state to the next.

That being said, states are still the authority here, and for specific licensure requirements, it’s best to check with the state licensure board in the state in which you’d like to work.

By and large, licensure has the same basic requirements regardless of the state. This includes having the registered nurse designation and successful completion of a graduate program that focuses on the specific population with which the nurse would like to work. Some states require a period of supervised practice after graduation as well as certification from the National Council of State Boards of Nursing.

What is an Advanced Degree in Nursing?

An advanced degree in nursing typically refers to a master of science in nursing. Like in other fields, graduate studies in nursing give experienced workers an opportunity to build on their existing knowledge, skills, and experience to enhance their capabilities as a medical services provider.

By and large, master’s programs in nursing last anywhere from one to three years because they vary widely in terms of the number of credit hours that are required to complete the program. Naturally, the coursework involved in the master’s program depends on the specialization.

For example, a registered nurse that has a bachelor’s of science in nursing that wants to work exclusively with pediatric patients would undertake coursework that focuses specifically on children’s health issues. Usually, master’s degree programs in nursing require around 500 hours of classroom study with an additional 500-700 hours of supervised clinical experience, but, as noted earlier, this varies from one program to the next.

It should be noted that students wishing to advance their studies in nursing should now be prepared to obtain a doctorate. To achieve that level of education, one must be prepared to attend school for three years full-time, including 1,000 or more hours of supervised clinical practice.

What Does It Take to Become an Advanced Practice Nurse?

Advanced practice nurses provide patient care in primary and specialty settings. As a result, they must possess a wide-range of personal qualities and skills to be successful in their career. That includes:

  • Attention to detail – Advanced practice nurses need to have a strong attention to detail to ensure each patient is diagnosed properly and receives the care they need. Nurses must be able to spot inconsistencies in patient progress, identify potential problems with their care, and pinpoint barriers that might prevent patients from making a recovery.
  • Analytical skills – Many advanced practice nurses are required to conduct assessments with patients ranging from physical examinations to behavioral and psychological evaluations. They must be able to analyze the information they gather, interpret the results, and act upon their findings.
  • Compassion – Advanced practice nurses work in a variety of settings, including schools, clinics, hospitals, and even inpatient and outpatient treatment programs. Regardless of their place of employment, advanced practice nurses must conduct themselves in a way that is comforting to their patients and demonstrates compassion for their situation.
  • Organization – Not only must advanced practice nurses be able to keep track of individual patient progress toward their health goals, but they must also maintain organized patient records, keep individual patient medications separate, and help maintain patient privacy.
  • Willingness to Work as a Team – Advanced practice nurses do not work alone. Instead, they are traditionally part of a larger team of healthcare professionals. Being able to work with others, communicate effectively, and take on additional tasks as needed is crucial.

What is the Career Outlook for Advanced Practice Nurses?

The outlook for advanced practice nurses is excellent. Although the number of job openings may depend on the specific area of practice and geographic location, the demand for advanced practices nurses is projected to be strong national wide. According to the United States Bureau of Labor Statistics, all four advanced practice nurse specialties are expected to grow much faster than average. Nurse practitioners and nurse anesthetists may especially be in demand.

According to the BLS, the field of advanced practice nursing is expected to grow by about 31 percent through 2025. The need for advanced practice nurses is due to an increased emphasis on preventive care. There is also an increased need for healthcare services for the aging population.

As healthcare costs climb, hospitals and other healthcare facilities are developing strategies to decrease costs. Hiring advanced practice nurses instead of physicians can be cost-effective without reducing the quality of care.

What is the Salary for Advanced Practice Nurses?

The scope for advanced practice nurse is not a limited one by any means. It includes handsome salary as well as the job growth. As reported by the Bureau of Labor Statistics, the annual salary for a registered nurse, as of May 2016, is more or less $72,180.

What is the Difference Between an Advanced Practice Nurse and a Physician’s Assistant?

Both advanced practice nurses and physician’s assistants hold advanced degrees in their field and work under the oversight of a fully licensed medical doctor. Both also have much greater autonomy and independence as medical practitioners than other workers in this field.

In fact, in some states, advanced practice nurses and physician’s assistants can see patients and prescribe medicine, much as a doctor would do. What’s more, both advanced practice nurses and physician’s assistants often conduct their day-to-day schedules of seeing patients and offering services without direct supervision by an MD. There are even some states that allow these medical professionals to operate their own clinics with minimal supervision from a medical doctor.

Despite the many commonalities, these two fields of work have many differences as well.

Perhaps the biggest difference between the two is the manner in which patient care is undertaken. Advanced practice nurses are typically trained using a nursing model, which is very patient-centered. That is, nurses tend to examine patients on a holistic level, not just exploring the patient’s physical ailments, but their mental, psychological, and emotional needs as well.

On the other hand, physician’s assistants tend to be trained in the medical model, which is much more disease-centered. That means that physician’s assistants look first at pathology and address patient care by exploring how they can minimize symptoms and improve quality of life by manipulating the anatomical and physiological systems in the body.

Another major difference between these careers is how workers specialize. For example, in graduate school, advanced practice nurses choose a certain type of patient with which to work, such as elderly patients or children. Conversely, physician’s assistants tend to specialize in a certain area of medicine as opposed to a specific population. That means that physician’s assistants will focus on things like family medicine, internal medicine, and so forth.

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