Nurse Practitioner & APRN Education
What do nurse anesthetists, nurse midwives, and nurse practitioners do in their daily routine?
In most states, APRNs can prescribe medications, order medical tests, and diagnose health problems. APRNs may provide primary and preventive care and may specialize in care for certain groups of people, such as children, pregnant women, or patients with mental health disorders. Some APRN job duties are the same as those for registered nurses, including gathering information about a patient's condition and taking action to treat or manage the patient's health.
- Take and record patients' medical histories and symptoms.
- Perform physical exams and observe patients.
- Create patient care plans or contribute to existing plans.
- Perform and order diagnostic tests.
- Operate and monitor medical equipment.
- Diagnose various health problems.
- Analyze test results or changes in a patient's condition, and alter treatment plans, as needed.
- Give patients medicines and treatments.
- Evaluate a patient's response to medicines and treatments.
- Consult with doctors and other healthcare professionals, as needed.
- Counsel and teach patients and their families how to stay healthy or manage their illnesses or injuries.
- Conduct research.
APRNs are trained to perform many additional functions, including ordering and evaluating test results, referring patients to specialists, and diagnosing and treating ailments. APRNs focus on patient-centered care, which means understanding a patient's concerns and lifestyle before choosing a course of action. APRNs also may conduct research or teach staff about new policies or procedures. Others may provide consultation services based on a specific field of knowledge, such as oncology, which is the study of cancer.
The following are types of APRNs:
Nurse anesthetists (CRNAs) provide anesthesia and related care before, during, and after surgical, therapeutic, diagnostic, and obstetrical procedures. They also provide pain management and some emergency services. Before a procedure begins, nurse anesthetists discuss with a patient any medications the patient is taking as well as any allergies or illnesses the patient may have, so that anesthesia can be safely administered. Nurse anesthetists then give a patient general anesthesia to put the patient to sleep so they feel no pain during surgery or administer a regional or local anesthesia to numb an area of the body. They remain with the patient throughout a procedure to monitor vital signs and adjust the anesthesia as necessary.
Nurse midwives (CNMs) provide care to women, including gynecological exams, family planning services, and prenatal care. They deliver babies; manage emergency situations during labor, such as hemorrhaging; repair lacerations; and may provide surgical assistance to physicians during cesarean births. Nurse midwives may act as primary care providers for women and newborns. They also provide wellness care, educating their patients on how to lead healthy lives by discussing topics such as nutrition and disease prevention. Nurse midwives also provide care to their patients' partners for sexual or reproductive health issues.
Nurse practitioners (NPs) serve as primary and specialty care providers, delivering advanced nursing services to patients and their families. They assess patients, determine the best way to improve or manage a patient's health, and discuss ways to integrate health promotion strategies into a patient's life. Nurse practitioners typically care for a certain population of people. For instance, NPs may work in adult and geriatric health, pediatric health, or psychiatric and mental health.
What education is need to become an APRN?
Nurse anesthetists, nurse midwives, and nurse practitioners must earn a master's degree from an accredited program. These programs include both classroom education and clinical experience. Courses in anatomy, physiology, and pharmacology are common as well as coursework specific to the chosen APRN role.
An APRN must have a registered nursing (RN) license before pursuing education in one of the advanced practice roles, and a strong background in science is helpful. Most APRN programs prefer candidates who have a bachelor's degree in nursing. However, some schools offer bridge programs for registered nurses with an associate's degree or diploma in nursing. Graduate-level programs are also available for individuals who did not obtain a bachelor's degree in nursing but in a related health science field.
Prospective nurse anesthetists must have 1 year of clinical experience as a prerequisite for admission to an accredited nurse anesthetist program. Candidates typically have experience working as a registered nurse in an acute care or critical care setting.
Most states recognize all of the APRN roles. In states that recognize some or all of the roles, APRNs must have a registered nursing license, complete an accredited graduate-level program, and pass a national certification exam. Each state's board of nursing can provide details.
The Consensus Model for APRN Regulation, a document developed by a wide variety of professional nursing organizations, including the National Council of State Boards of Nursing, aims to standardize APRN requirements. The model recommends all APRNs to complete a graduate degree from an accredited program, be a licensed registered nurse, pass a national certification exam, and earn a second license specific to one of the APRN roles and to a certain group of patients.
Certification is required in the vast majority of states to use an APRN title. Certification is used to show proficiency in an APRN role and is often a requirement for state licensure. The National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) offers the National Certification Examination (NCE). Certified registered nurse anesthetists (CRNAs) must recertify via the Continued Professional Certification (CPC) Program every 4 years.
The American Midwifery Certification Board offers the Certified Nurse-Midwife (CNM). Individuals with this designation must recertify via the Certificate Maintenance Program every 5 years. There are a number of certification exams for nurse practitioners because of the large number of populations NPs may work with and the number of specialty areas in which they may practice. Certifications are available from a number of professional organizations, including the American Nurses Credentialing Center and the Pediatric Nursing Certification Board.
What salary do nurse anesthetists, nurse midwives, and nurse practitioners earn?
Nurse anesthetists, nurse midwives, and nurse practitioners held about 203,800 jobs in 2017. The median annual wage was $107,460 in May 2017. The lowest 10 percent earned less than $74,300, and the highest 10 percent earned more than $175,170. Most advanced practice registered nurses (APRNs) work full time, although APRNs working in physicians' offices typically work during normal business hours. Those working in hospitals and various other healthcare facilities may work in shifts to provide round-the-clock patient care. Some APRNs, especially those who work in critical care or those who deliver babies, also may be required to be on call.
Overall employment of nurse anesthetists, nurse midwives, and nurse practitioners is projected to grow 30 percent during the coming decade, much faster than the average for all healthcare occupations. Growth will occur because of an increase in the demand for healthcare services. Some APRNs spend much of their day on their feet. They are vulnerable to back injuries because they must lift and move patients. APRN work can also be stressful because they make critical decisions that affect a patient's health. Because of the environments in which they work, APRNs may come in close contact with infectious diseases. Therefore, they must follow strict, standardized guidelines to guard against diseases and other dangers, such as accidental needle sticks or patient outbursts.