Advanced Practice Registered Nurse (APRNs)

Advanced Practice Registered Nurses (APRNs) are highly trained healthcare professionals who hold a higher education credential such as a master’s or a doctoral degree at least. These nurses take on advanced roles in the field of medicine and have an increased autonomy and greater scope of practice.

In addition to that, the career outlook for this field is highly positive, and the salary potential is quite great. If you want to become a part of this rewarding and lucrative field of medicine, the following guide on Advanced Practice Registered Nurses (APRNs) will provide you with all the information you need about this career.

What is an APRN?

Advanced Practice Registered Nurse (APRN) is a term used to define all nursing professionals who have a master’s or a doctoral degree in medicine and take on advanced roles in the field of healthcare. According to the National Council of State Board of Nursing, there are four types of nurse careers in this category – Clinical Nurse Specialist (CNS), Certified Nurse Midwife (CNM), Nurse Anesthetist (CRNA) and Nurse Practitioner (NP).

An APRN has substantially greater responsibility and more autonomy than registered nurses (RNs), with more comprehensive job duties and more authority in medical decision making. APRNs are trained with advanced clinical and didactic education and are equipped with the latest knowledge and skills.

What Do APRNs Do?

The job duties of an Advanced Practice Registered Nurse (APRN) fall somewhere in between those of a Registered Nurse (RN) and a physician. Their primary responsibilities include provision of medical care, disease management and administration of staff including RNs. APRNs are typically very empathetic and have great communication skills. In addition to that, they are good decision makers in high pressure situations and have an aptitude for science and continuous learning.

Where Do APRNs Work?

APRNs may be able to find work in a variety of healthcare settings, depending on their specialization and personal preferences. Typically, APRNs work in private practices, hospitals, offices of physicians, birth centers, surgical centers and residential care settings. According to the US Bureau of Labor Statistics, APRNs were largely employed by Offices of Physicians, with 47% of these nurses working in this category. This was followed by hospitals that employed 27% of healthcare professionals from this field. It must be noted that APRNs might have to travel long distances to provide medical care to patients in places where there is a lack of qualified healthcare workers.

What are the Differences between an RN and an APRN?

There are several differences between a Registered Nurse (RN) and an Advanced Practice Registered Nurse (APRN) in terms of education required to begin practicing, scope of practice and level of responsibilities. Let’s take a look at some of the differences between these two career levels.

  • Level of Autonomy: APRNs have a high level of autonomy and can practice independently with minor or no supervision in most states. On the other hand, Registered Nurses have limited autonomy and are required to practice under the direct supervision of an APRN or a physician.
  • Scope of Practice:Advanced Practice Registered Nurses have a much wider scope of practice than Registered Nurses. For instance, APRNs can make diagnoses and order relevant treatments. On the other hand, RNs cannot diagnose health conditions or order any kinds of treatment plans. In addition to that, APRNs are qualified enough to prescribe medication, including controlled substances. As opposed to that, RNs cannot prescribe medication.
  • Education Requirements: In order to become an APRN, aspiring nurses will have to complete a minimum of six years of education, with at least a master’s degree in nursing. RNs, on the other hand, need to complete a minimum of two years of education with at least an associate degree in nursing (ADN).
  • Licensure and Certifications: APRNs require licensure and certifications beyond RN, whereas an RN would be eligible to practice after clearing the NCLEX-RN Licensure exam.

How to Become an APRN?

The process for becoming an APRN in the US requires the fulfillment of several requirements, including education, experience and licensing. The following steps to become an APRN shed some light on this comprehensive process.

Step 1: Get a Bachelor of Science in Nursing

A 4-year long Bachelor of Science in Nursing (BSN) is the minimum level of education required to apply for further studies. Common courses at this level of education would include health assessment, family nursing, psychological nursing, public health, nursing management, leadership, medical and surgical care.

Step 2: Get an RN License

Before applying to advanced study programs, aspiring nurses will have to clear the NCLEX-RN exam to become a licensed registered nurse. The exam takes around 6 hours to complete and covers a vast variety of medical topics.

Step 3: Get Experience

Even though students can apply directly to most Master of Science in Nursing (MSN) degrees after getting licensed as a Registered Nurse, it is highly recommended that aspiring nurses get some hands-on experience before going for higher education. With experience, students can learn a number of skills about addressing different kinds of medical dilemmas and can also pick up skills such as working effectively and efficiently in a team. Please note that some graduate degrees might need up to one year of clinical nursing experience as an enrollment requirement.

Step 4: Complete a MSN or a DNP Degree

An MSN degree would typically take 2 years to complete, while a doctoral program would require 3 to 4 years of dedicated studies. Some certifications, such as the CRNA would require a program certified by the board, while others would only need an accredited nursing program. It must be noted that a Master of Science in Nursing (MSN) degree is typically enough to qualify for licensing and certification. However, if you intend to go for a job role in academics, most employers would prefer at least a Doctor of Nursing Practice (DNP) degree.

Step 5: Get Certified

After fulfilling the education and experience requirements, aspiring nurses will have to earn a certification from an approved nursing specialty board. The most common certifying organization for APRNs is the American Nurse Credentialing Center (ANCC). For specialty certifications, each certifying organization would have its own requirements. Certification is often a requirement before applying for the advanced practice nursing licensure.

Step 6: Apply for Licensure

APRNs are required to be licensed in the state where they intend to practice. Common licensing requirements include background checks, and verification of clinical hours and education credentials.

What are the Different Types of APRN Roles?

There are four types of APRN roles identified by the National Council of State Board of Nursing (NCSBN).

  • Certified Nurse Practitioner: This is a high-demand career path that requires an MSN or a DNP degree. Most CNPs work in family practice, though there are many specialized fields also available, such as pediatrics, psychiatrics and gerontology.
  • Clinical Nurse Specialist: These advanced practice nursing professionals require at least an MSN degree for entry level positions. Clinical Nurse Specialists typically work in areas such as cardiology, emergency care and oncology.
  • Certified Nurse Midwife: This career path is also very high in demand and requires at least an MSN degree for entry. These professionals specialize in the care of pregnant women, women in labor and also oversee the entire process of childbirth.
  • Certified Registered Nurse Anesthetist: CRNAs are also high in demand in the US and require at least a 4-year long BSN degree. These medical personnel administer anesthesia and provide pain management solutions to patients with different medical concerns.

How Much Do APRNs Earn?

The earnings and job outlook of an Advanced Practice Registered Nurse (APRN) would vary according to the area of specialization. According to the US Bureau of Labor Statistics, the job outlook for the joint category of Nurse Anesthetists, Nurse Midwives and Nurse Practitioners was an impressive 45%, which is much higher than the 4% average growth for all occupations. Let’s take a look at the salary potential of the different kinds of APRNs.

  • Nurse Anesthetists: Nurse Anesthetists in the US made an annual mean wage of $189,190 in May 2020. The top paying industry for these professionals was Outpatient Care Centers, which paid an annual mean income of $224,810 in May 2020. The top paying state for this category of APRNs was Oregon, paying an annual mean wage of $236,540 in May 2020.
  • Nurse Midwives: These nursing professionals made an annual mean income of $115,540 in May 2020. The top paying industry for Nurse Midwives was the BLS category Local Government, excluding schools and hospitals, paying an annual mean wage of $158,210 in May 2020. The highest paying state for Nurse Midwives was California, with an annual mean wage of $159,590 in May 2020.
  • Nurse Practitioners: Nurse Practitioners made an annual mean income of $114,510 in May 2020. The top paying industry for this category of nurses was the BLS category of Community Food and Housing, and Emergency and Other Relief Services, paying an annual mean wage of $143,480 in May 2020. The top paying state for Nurse Practitioners was California, which paid $145,970 in annual mean wages in May 2020.
  • Please note that all the above salary data, including occupational categories have been extracted from the US Bureau of Labor Statistics for May 2020.