Nurse anesthetists, nurse midwives, and nurse practitioners, also called advanced practice nurses or advanced practice registered nurses coordinate patient care. They provide primary and specialty healthcare. Each state has its own definition of how these nurses practice.
An advanced practice nurse may have the following job duties:
- 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
Advanced Practice Nurses Focus on Treating the Patient
Advanced practice nurses can work alone or with physicians. In most states, they can prescribe medications, order medical tests, and diagnose health problems.
They 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.
Advanced Practice Nurses vs Registered Nurses
Some advanced practice nurses’ duties are the same as duties for registered nurses, including gathering patient information and treating the patient.
Unlike an RN, APRNs can also order and evaluate test results, refer patients to specialists, and diagnose and treat ailments.
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.
Types of Advanced Practice Nurses
Nurse Anesthetists CRNAs
These advanced practice nurses 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.
Job titles include:
- Certified Registered Nurse Anesthetist CRNA
- Chief Certified Registered Nurse Anesthetist Chief CRNA
- Chief Nurse Anesthetist
- Nurse Anesthetist
- Professor/Nurse Anesthetist
- Senior Certified Registered Nurse Anesthetist (Senior CRNA)
- Staff Certified Registered Nurse Anesthetist (Staff CRNA)
- Staff Certified Registered Nurse Anesthetist
- Anesthesia Service (Staff CRNA, Anesthesia Service)
- Staff Nurse Anesthetist
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Nurse Anesthetists earn a median salary of $174,2790 as of May 2019.
The job requires extensive training and a graduate level degree.
Search for CNRA accredited programs in your area.
Nurse Midwives CNM
Nurse midwives 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.
Job titles include:
- Certified Nurse Midwife
- Certified Nurse-Midwife
- Nurse Midwife
- Senior Instructor, Certified Nurse Midwife
- Staff Certified Nurse Midwife
- Staff Midwife
- Staff Nurse Midwife
- Staff Nurse-Midwife
Nurse Midwives CRM
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A nurse midwife requires at least a masters degree and extensive training.
Get more about education requirements and programs of study near you.
These healthcare professionals earn up to more than $158,990 a year.
Here is the median salary for nurse midwives.
Nurse practitioners NPs
Nurse practitioners 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.
Although the scope of their duties varies some by state, many nurse practitioners work independently, prescribe medications, and order laboratory tests.
All nurse practitioners consult with physicians and other health professionals when needed.
- Acute Care Nurse Practitioner
- Adult Nurse Practitioner
- Advanced Practice Registered Nurse APRN
- Family Nurse Practitioner FNP
- Family Practice Certified Advanced Registered Nurse Practitioner
- Gastroenterology Nurse Practitioner
- Nurse Practitioner
- Nurse Practitioner, Adult
- Pediatric Nurse Practitioner PNP
- Women’s Health Care Nurse Practitioner
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For more information on nurse practitioners and specific area of interest, check out some of these sites.
- American Association of Critical-Care Nurses
- American Nurses Association
- American Public Health Association
- Gerontological Advanced Practice Nurses Association
- National Association of Pediatric Nurse Practitioners
- Occupational Outlook Handbook: Nurse anesthetists, nurse midwives, and nurse practitioners
- Oncology Nursing Society
- Sigma Theta Tau International Honor Society of Nursing
Is Being an Advanced Practice Nurse Stressful?
APRN work can be both physically and emotionally demanding. APRN work can also be stressful because they make critical decisions that affect a patient’s health. Some APRNs spend much of their day on their feet. They are vulnerable to back injuries because they must lift and move patients.
APRNs may be exposed to infectious diseases. They must follow strict, standardized guidelines to guard against diseases and other dangers, such as accidental needle sticks or patient outbursts.
Most APRNs work full time. 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.
They may work nights, weekends, and holidays. Some APRNs, especially those who work in critical care or those who deliver babies, also may be required to be on call.
Education of Advanced Practice Nurses
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. These programs prepare the student for the RN licensure exam in addition to the APRN curriculum.
Although a master’s degree is the most common form of entry-level education, APRNs may choose to earn a Doctor of Nursing Practice (DNP) or a Ph.D.
The specific educational requirements and qualifications for each of the roles are available on professional organizations’ websites.
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.
What Licenses, Certifications, and Registrations Do You Need?
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.
In addition, APRN positions may require certification in cardiopulmonary resuscitation (CPR), basic life support (BLS) certification, and/or advanced cardiac life support (ACLS).
APRN Career Advancement
Some APRNs may take on managerial or administrative roles, while others go into academia. APRNs who earn a doctoral degree may conduct independent research or work in an interprofessional research team.
Advanced practice registered nurses (APRNs) can perform many of the same services as physicians. APRNs will be increasingly utilized in team-based models of care, particularly in hospitals, offices of physicians, clinics, and other ambulatory care settings, where they will be needed to provide preventive and primary care.
APRNs will also be needed to care for the large, aging baby-boom population. As baby boomers age, they will experience ailments and complex conditions that require medical care. APRNs will be needed to keep these patients healthy and to treat the growing number of patients with chronic and acute conditions.
As states change their laws governing APRN practice authority, APRNs are being allowed to perform more services. They are also becoming more widely recognized by the public as a source for primary healthcare.
For more information about nurse anesthetists, including a list of accredited programs, visit
For more information about nurse midwives, including a list of accredited programs, visit
For more information about nurse practitioners, including a list of accredited programs, visit
For more information about registered nurses, including credentialing, visit
For more information about nursing education and being a registered nurse, visit
National League for Nursing
For more information about undergraduate and graduate nursing education, nursing career options, and financial aid, visit
For more information about the Consensus Model and for a list of the states’ Boards of Nursing, visit
For more information about certification, visit
American Nurses Credentialing Center