Nursing-Specialties

Advanced Practice Nursing is for nurses with masters, post master’s certificate or practice focused DNP degree in one of the specific roles. APRNs get a license to practice through the state board of nursing to provide patient care in their role and population focus. Many states offer APRNs an authority to practice independently and prescribe medication without physician oversight. 

APRN is an advanced registered nursing subset, but most states consider APRN as a separate licensing class from other RN licensure.  Registered nurses, according to the International Council of Nurses are those with expert knowledge, clinical competencies, and complex decision-making skills which are necessary for expanded practice.    

Difference between APRNs and RNs 

APRNs are different from other registered nurses (RNs) because they have skills to take on the more complex cases, handle them with more independence and discretion. Due to the career requirements, APRNs must obtain advanced certification beyond a bachelor’s degree and specialize in a particular area of nursing.  They also get the additional clinical experience that enables them to oversee all aspects of patient medical care. 

The practice APRN   requires more utilization of analytical and organizational skills that relate to the usual bedside care skills while stepping into the role of advanced practice provider.  APRNS, however, do not perform bedside care roles frequently like RNs due to increased responsibilities in the area of coordinating care, team leadership, and medical data analysis.  

APRNs must complete several years of comprehensive graduate-level training to instill skills to solve complex health issues that registered nurses might not have the knowledge to diagnose and treat. For instance, an RN working in a labor ward can perform tasks that support healthy labor and delivery. A certified nurse midwife has advanced training on how to care for a mother throughout the pregnancy, providing care before, during, and after birth.   The transition from an RN to become an APRN requires delegation of responsibilities to other nurses in a team and stepping away from direct caretaker role to some extent. 

 Patients in rural areas with a low number of physicians are increasingly relying on APRNs to meet the demand of their primary and specialty healthcare because they have advanced skills. 

Advanced Practice Nursing (APRN) Education 

 The minimum academic requirement for an APRN license is a master of science in Nursing (MSN). Many programs now combine core courses that will get deeper into the undergraduate courses focusing on a certain specialty.  These include focused patient roles to take care of specific population and educator roles to allow serving other nurses and healthcare professionals. MSN programs also prepare students to work in nursing leadership, education, or administration position or be ground work for a DNP degree. 

A DNP is a practice doctorate. It prepares graduates to use research and findings for influencing nursing practice.  Students at this level can measure outcomes of clinical initiatives on groups of patients or populations. They learn critical skills in focusing on research and reporting efforts to find ways of improving healthcare delivery and systems. Doctoral program graduates can serve as leaders in the healthcare setting by providing scientific research-based knowledge. The beneficiaries of their skills are researchers, healthcare providers, and community leaders. 

 Advanced Practice Nursing Roles  

 APRNs practice in these four main roles. 

1.Nurse Practitioners (NP) 

Nurse practitioners are healthcare providers and leaders with training and expertise to take care of the patients in a similar way to physicians. They can provide direct care and also coordinate care activities. 

The task of an APRN depends on the work settings and specialization, but the standard roles include: 

  • Evaluating the health status of a patient 
  • Evaluating medical history and use it to create a medical care plan  
  • Coordinate discharges and transfers to other units  
  • Directing medical assistant and other nurses in collaborative patient care  
  • Administering the necessary medical treatments and performing procedures  
  • Educating patients about health condition management and disease prevention  

Nurse practitioners usually specialize in offering care to a specific section of the population, such as geriatric patients, families, women, children, or psychiatric patients.  A registered nurse who wants to become a nurse practitioner should earn an MSN or DNP degree and pass a certification examination in the desired specialty. For example, APRNs sit for a certification exam by AANP (American Academy of Nurse Practitioners) or ANCC (the American Nurses Credentialing Center). 

2.Clinical Nurse Specialists (CNS) 

CNS is a nursing practitioner who provides direct care while taking on administrative and leadership roles in improving the systems of healthcare in the settings where they work.  They often specialize in helping a certain sector of the overall patient population, such as psychiatric patients, women, or underserved communities.  Clinical nurse specialists, like nurse practitioners, provide direct care to the patients. Their role, however, takes on more administrative and leadership responsibilities that help in improving care systems at their work settings.  A  CNS specializes in helping a particular segment of the population like women or underserved communities.  CNS after graduating sits for a certification exam before they can start practicing. 

3.Certified Nurse –Midwives (CNM) 

Certified nurse midwives specialize in offering patient care to women during these times. 

  • Before, during and after pregnancy  
  • Labor and delivery  

They also help women to take care of their newborn infants.   CNMs are experts in providing prenatal care, gynecological exams, and family planning services. Certified nurse midwives can also advise women during reproductive years about the way to maintain reproductive health and offer to counsel on the way to take self-care during pregnancy.  Prospective CNMs after earning their graduate degree must pass a certification examination. 

4.Certified Nurse Anesthetists (CNA) 

Certified nurse anesthetists (CNA), also called certified registered nurse anesthetists (CRNA) are those who administer anesthesia to the patients before they undergo surgery. They also administer anesthesia to patients who require palliative care or stabilization during trauma and treatment. It is the CRNAs who develop the anesthesia plan for every patient under the care of their team and informing patients about the procedure before they administer it.  CRNAs get an authority to practice after passing a certification examination. National Board of Certification and Recertification conducts a national certification exam in the United States. 

Despite the differences between RNs and APRNs, nurses at both levels must have the basic qualities of nursing. Each must be empathetic, attentive to patients, good listeners, and critical thinkers. 

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