NR-500: FOUNDATIONAL CONCEPTS AND
APPLICATIONS
WEEK 2 ASSIGNMENT: ROLES OF ADVANCED
PRACTICE NURSES
CHAMBERLAIN UNIVERSITY
Roles of an Advanced Practice Nurse
With the evolution of the innovation in technology and advancements in healthcare, in
congruence with the United States’ growing baby-boomer population, the demand for
advanced practice roles in nursing is more amplified and growing at a faster rate
compared to the past decades. Something happened during the 2020 Covid-19
Pandemic that made the whole world realize the value of nurses and nursing. At the
same time, the nurses themselves also realized the importance of advancing their
nursing education. The reasons may be because they want to get out of bedside care,
find better ways to improve delivery of patient care, or even just to take it upon
themselves in the current situation of the healthcare system.
There are a lot of ways to choose from when it comes to advanced practice nursing
(APN). There are four different, but also similar in some ways, to take when deciding to
pursue an advanced practice role in nursing: Certified Nurse Practitioner (CNP), Clinical
Nurse Specialist (CNS), Certified Nurse Midwife (CNM), and Certified Registered
Nurse Anesthetist (CRNA). The focus of this paper is to define each role in advanced
practice nursing, describing the role, educational preparations needed, and which work
environments you can find them in. This will also discuss the challenges an RN
transitioning to an APN role faces, and some approach on how to overcome these
challenges. We will also lightly discuss on my personal choice of choosing the CNP role
and my current plans for clinical practice after graduation.
Four APN Roles
Certified Nurse Practitioner
Certified Nurse Practitioners (CNP) assess, diagnose, and treat patients, like that of the
duties and responsibilities of a physician. Most the time, they work with the consultative
supervision of the physician to examine patients, diagnose certain illnesses, and
prescribe medications. The CNPs can provide the patients with direct patient care as
their primary care providers in the inpatient or outpatient setting. CNPs are trained to
manage patients’ health and wellness, chronic conditions, and work towards disease
prevention by performing comprehensive physical examination, ordering diagnostic
screenings, and prescribing appropriate medications to name a few (National Council of
State Boards of Nursing, 2008).
They can also refer or request consultations for patients if the need for a specialized
practice is needed. The scope of practice varies depending on the chose specialized area,
the population being served, and the state where they practice. Currently, CNPs can be
found practicing in hospital inpatients, outpatient clinics, or private group practices. They
can be working autonomously depending on which state they practice, or alongside a
, supervising physician managing acute care, family practice, gerontology, neonatal,
pediatric, psychiatric/mental health, or women’s health.
Prerequisites to be a CNP are a master’s degree and specialized graduate preparation,
and relevant nursing experience, in addition to state licensing and certification.
Clinical Nurse Specialist
Clinical Nurse Specialist (CNS) are often found in leadership, administrative or
educational roles within the clinical setting. CNS practices care within the 3 spheres They
can be providing direct patient care, consulting with the nurse with patient care, and
working with the highest level of an organization to improve healthcare practices and
patient outcomes locally or within a healthcare system (Ko, A, et. al, 2019). A CNS’
main goal within the 3 spheres of influence is to find ways to improve patient outcomes
and healthcare practices utilizing evidence-based practices to educate other nurses and
assist in developing cost-saving strategies in the delivery of care. If they do choose to
work with direct patient care, they are involved in monitoring, and managing symptoms,
and addressing possible issues that might come up to keep patients in the path of recovery
and avoid readmissions in the hospital. CNS can be found working in acute care doing
direct patient care, managing acute specialized care, or supervise nursing staff. CNS
can also practice in a healthcare administration providing acute care consultation,
implementing healthcare evidence-based practices, and as leaders, they can promote and
facilitate change. Another place we can see CNS practice is in nursing education
delivering lectures, instructing nursing courses, designing curriculum, and conducting
research based on best practices. A master’s degree is a requirement to become a Clinical
Nurse Specialist.
Certified Registered Nurse Anesthetist
According to the American Association of Nurse Anesthetist (AANA), nurses first gave
anesthesia to wounded soldiers during the Civil War. A Certified Registered Nurse
Anesthetist (CRNA) are educated and trained in the surgical setting to help administer
general, local, inhaled, or any other forms of anesthesia during a surgery or a procedure
to different populations of patients (Vitale & Lyons, 2021). CRNAs can provide
education to patients and families regarding specific anesthesia and treatments, along
with side effects. CRNAs also maintain pain management, post-operative stabilization,
and monitors patients while they are in recovery. They make sure that the patient is
taken care of all through the surgery process. CRNAs work in hospitals (operating room,
obstetric care, critical care), outpatient surgery centers, dental offices, plastic surgery
centers, and pain management centers. It usually requires a 1 to 2 years of critical care
experience, depending on the school, before being accepted into a CRNA program. In
some states, CRNAs can even practice without a supervising physician. Starting in
2025, instead of only obtaining a master’s degree, the AANA is requiring CRNAs to
hold a doctoral degree.
Certified Nurse Midwife
A Certified Nurse Midwife (CNM) holds a more specific set of responsibilities pertaining
to women’s reproductive health and childbirth. CNMs provide prenatal education, focus
on women during pregnancy and delivery, and postnatal care to the women and assess
and monitor their newborns. They also offer education and counseling in health
promotion, disease prevention, and treating both men and women for sexually
transmitted diseases. A relevant nursing experience in women’s health or labor and
APPLICATIONS
WEEK 2 ASSIGNMENT: ROLES OF ADVANCED
PRACTICE NURSES
CHAMBERLAIN UNIVERSITY
Roles of an Advanced Practice Nurse
With the evolution of the innovation in technology and advancements in healthcare, in
congruence with the United States’ growing baby-boomer population, the demand for
advanced practice roles in nursing is more amplified and growing at a faster rate
compared to the past decades. Something happened during the 2020 Covid-19
Pandemic that made the whole world realize the value of nurses and nursing. At the
same time, the nurses themselves also realized the importance of advancing their
nursing education. The reasons may be because they want to get out of bedside care,
find better ways to improve delivery of patient care, or even just to take it upon
themselves in the current situation of the healthcare system.
There are a lot of ways to choose from when it comes to advanced practice nursing
(APN). There are four different, but also similar in some ways, to take when deciding to
pursue an advanced practice role in nursing: Certified Nurse Practitioner (CNP), Clinical
Nurse Specialist (CNS), Certified Nurse Midwife (CNM), and Certified Registered
Nurse Anesthetist (CRNA). The focus of this paper is to define each role in advanced
practice nursing, describing the role, educational preparations needed, and which work
environments you can find them in. This will also discuss the challenges an RN
transitioning to an APN role faces, and some approach on how to overcome these
challenges. We will also lightly discuss on my personal choice of choosing the CNP role
and my current plans for clinical practice after graduation.
Four APN Roles
Certified Nurse Practitioner
Certified Nurse Practitioners (CNP) assess, diagnose, and treat patients, like that of the
duties and responsibilities of a physician. Most the time, they work with the consultative
supervision of the physician to examine patients, diagnose certain illnesses, and
prescribe medications. The CNPs can provide the patients with direct patient care as
their primary care providers in the inpatient or outpatient setting. CNPs are trained to
manage patients’ health and wellness, chronic conditions, and work towards disease
prevention by performing comprehensive physical examination, ordering diagnostic
screenings, and prescribing appropriate medications to name a few (National Council of
State Boards of Nursing, 2008).
They can also refer or request consultations for patients if the need for a specialized
practice is needed. The scope of practice varies depending on the chose specialized area,
the population being served, and the state where they practice. Currently, CNPs can be
found practicing in hospital inpatients, outpatient clinics, or private group practices. They
can be working autonomously depending on which state they practice, or alongside a
, supervising physician managing acute care, family practice, gerontology, neonatal,
pediatric, psychiatric/mental health, or women’s health.
Prerequisites to be a CNP are a master’s degree and specialized graduate preparation,
and relevant nursing experience, in addition to state licensing and certification.
Clinical Nurse Specialist
Clinical Nurse Specialist (CNS) are often found in leadership, administrative or
educational roles within the clinical setting. CNS practices care within the 3 spheres They
can be providing direct patient care, consulting with the nurse with patient care, and
working with the highest level of an organization to improve healthcare practices and
patient outcomes locally or within a healthcare system (Ko, A, et. al, 2019). A CNS’
main goal within the 3 spheres of influence is to find ways to improve patient outcomes
and healthcare practices utilizing evidence-based practices to educate other nurses and
assist in developing cost-saving strategies in the delivery of care. If they do choose to
work with direct patient care, they are involved in monitoring, and managing symptoms,
and addressing possible issues that might come up to keep patients in the path of recovery
and avoid readmissions in the hospital. CNS can be found working in acute care doing
direct patient care, managing acute specialized care, or supervise nursing staff. CNS
can also practice in a healthcare administration providing acute care consultation,
implementing healthcare evidence-based practices, and as leaders, they can promote and
facilitate change. Another place we can see CNS practice is in nursing education
delivering lectures, instructing nursing courses, designing curriculum, and conducting
research based on best practices. A master’s degree is a requirement to become a Clinical
Nurse Specialist.
Certified Registered Nurse Anesthetist
According to the American Association of Nurse Anesthetist (AANA), nurses first gave
anesthesia to wounded soldiers during the Civil War. A Certified Registered Nurse
Anesthetist (CRNA) are educated and trained in the surgical setting to help administer
general, local, inhaled, or any other forms of anesthesia during a surgery or a procedure
to different populations of patients (Vitale & Lyons, 2021). CRNAs can provide
education to patients and families regarding specific anesthesia and treatments, along
with side effects. CRNAs also maintain pain management, post-operative stabilization,
and monitors patients while they are in recovery. They make sure that the patient is
taken care of all through the surgery process. CRNAs work in hospitals (operating room,
obstetric care, critical care), outpatient surgery centers, dental offices, plastic surgery
centers, and pain management centers. It usually requires a 1 to 2 years of critical care
experience, depending on the school, before being accepted into a CRNA program. In
some states, CRNAs can even practice without a supervising physician. Starting in
2025, instead of only obtaining a master’s degree, the AANA is requiring CRNAs to
hold a doctoral degree.
Certified Nurse Midwife
A Certified Nurse Midwife (CNM) holds a more specific set of responsibilities pertaining
to women’s reproductive health and childbirth. CNMs provide prenatal education, focus
on women during pregnancy and delivery, and postnatal care to the women and assess
and monitor their newborns. They also offer education and counseling in health
promotion, disease prevention, and treating both men and women for sexually
transmitted diseases. A relevant nursing experience in women’s health or labor and
