There are four areas related to advanced practice registered nursing.
These specialties include clinical nurse specialists (CNS), certified nurse-midwives (CNM), certified registered nurse anesthetists (CRNA), and nurse practitioners (NP).
What are the Educational Requirements for each of the APRNs?
The educational requirements vary. The following information states what is required for each specialist.
Clinical Nurse Specialist (CNS)
A clinical nurse specialist is considered advanced in the field of nursing. This is due to the educational requirements for the position.
In order to qualify as a clinical nurse specialist, the individual must first earn a doctoral or master’s degree.
Certified Nurse-Midwives (CNM)
The minimum required for a certified nurse-midwife is an MSN (Master of Science) graduate degree in nursing.
This is generally a two-year program for full-time students.
Once acquired, students have the option to further their education and status by earning a Doctor of Nursing (DNP) degree, which can take up to four years.
Exams, such as the NCLEX-RN and the National CNM Certification test must be passed.
A licensed CNM is eligible to practice in the states plus the District of Columbia.
Certified Registered Nurse Anesthetists (CRNA)
Currently, to become a certified registered nurse anesthetist, individuals must complete either the doctoral degree program (DNP) or the Master of Science in Nursing (MSN) in order to practice.
The requirements are scheduled to change sometime in 2025, with the American Association of Nurse Anesthesiology (AANA) expected to change, requiring students to qualify through the DNP program only.
Nurse Practitioners (NP)
To become a nurse practitioner in any state, an individual must attain a Master of Science in Nursing (MSN) degree.
The requirements for each state are not the same. Some states require a nurse practitioner to also have a Doctor of Nursing degree (DNP).
Without it, the NP would not be able to practice. There are also employers who may require the NP to have a Doctor of Nursing degree, regardless that the state does not have this requirement.
What are the Responsibilities of each APRN Specialist?
Each APRN has specific job responsibilities.
Clinical Nurse Specialist (CNS)
As a clinical nurse specialist, responsibilities are diverse. A CNS uses their knowledge to treat patients, assess issues the patient may be experiencing, and diagnose any issues.
Along with patient examinations and diagnoses, a CNS may treat an issue and order tests to further diagnose an issue.
Clinical nurse specialists also have the authority to prescribe medications necessary for a patient.
Certified Nurse-Midwives (CNM)
A certified nurse-midwife has several responsibilities. A CNM is a primary person for assisting women throughout their pregnancy and during labor and delivery.
A CNM can also assist in gynecological services.
Other responsibilities include the diagnosis and treatment of patients, working in a collaborative manner with the patient’s doctor, administering tests and treatment, and preparing new parents for their role through education.
Certified Registered Nurse Anesthetists (CRNA)
Whenever anesthesia is part of a medical procedure, certified registered nurse anesthetists have the responsibility of conducting an assessment of the patient and educating them about what they should expect in the upcoming surgical procedure and afterward while recovering.
Once the patient is prepared, the CRNA administers the anesthesia and then maintains and monitors it throughout the operation.
After surgery, the CRNA manages the patient while recovering and administers other medications, as needed.
Nurse Practitioner (NP)
Nurse practitioners perform a wide range of duties, which is dependent on the area they have chosen to specialize in, such as acute care or behavioral health.
Some of the general duties and responsibilities include performing examinations, observing patients, ordering diagnostic tests, and administering those same tests, setting up medical equipment, and monitoring equipment.
An NP is also responsible for recording/updating information on a patient’s medical history, and interacting with patients by providing test results, when applicable.
Overall, an NP assists in all areas of patient care.
How Many Years of Training is Required for Each APRN Specialist?
Clinical Nurse Specialist (CNS)
For individuals considering a career as a clinical nurse specialist, plan on at least five years to attain that level.
Part of the time is generally working as an RN (registered nurse).
RNs who plan to advance to become CNS require a master’s degree, which can take two or more years.
Certified Nurse-Midwives (CNM)
Becoming a certified nurse-midwife can take anywhere from six to eight years.
During this time, an individual must earn a Bachelor of Science (BSN) degree in nursing, pass the NCLEX exam, gain experience as an RN (registered nurse), and complete a Nurse-Midwifery program at the graduate level.
Certified Registered Nurse Anesthetists (CRNA)
Those considering a career as a certified registered nurse anesthetist can count on a lengthy process, which can take anywhere from seven to eight years.
In order to qualify to enter a CRNA program, it requires that the candidate has already been licensed as an RN.
The individual must also have clinical experience in acute care.
Nurse Practitioner (NP)
With education and training combined, becoming a licensed nurse practitioner can take six to eight years.
During this time, the individual must become a registered nurse, earn MSN and BSN degrees, obtain clinical experience, and earn passing scores in required examinations.
Overall Summary for APRN Specialists
According to information from the U.S. Bureau of Labor Statistics for 2021, the following are the pay range, work environment, minimum requirements, and job outlook for nurse practitioners, nurse anesthetists, and nurse-midwives.
In the positions of nurse practitioners, nurse anesthetists, and nurse midwives, the basic job description notes that these individuals are responsible for coordinating and providing primary and specialty healthcare services.
The work environment can be in a hospital, a doctor’s office, a healthcare facility, or a medical clinic with most APRNs working in a full-time capacity.
As of May 2021, the median pay range was estimated at $123,780 annually. Pay per hour was estimated at $59.51.
The job outlook for those considering a career is positive, with a projected increase in employment opportunities for nurse midwives, nurse anesthetists, and nurse practitioners by 45 percent.
This increase is expected from 2020 to 2030.
On average, an estimated 29,400 job openings are expected annually for nurse practitioners, nurse anesthetists, and nurse-midwives.
Reasons for the projected increase in job opportunities are due to several reasons, such as people who are retiring, those who have chosen to no longer work in the field, and individuals who have changed to a different career path.
The job outlook for clinical nurse specialists is also expected to grow by at least 31 percent through 2022.
As a CNS, there are many areas available to work those other licensed nurses are not eligible for.
These areas include specialized services, such as lab research, diabetes, oncology, and respiratory care.
A survey conducted by the U.S. Department of Health and Human Services shows that more than 91 percent of the individuals who became licensed clinical nurse specialists are satisfied with their career path.
The estimated average salary for a CNS is $100,000.
To ensure you are following all the guidelines to become an advanced practice registered nurse in your state, always check with the appropriate parties about what is required.
There may be different requirements for becoming licensed, the period for programs may be different, and the pay rate per state may vary.
