APN Roles

Introduction –APN Roles

An advanced practice nurse is a specialized professional who performs the tasks traditionally reserved for physicians.Countries enact laws that determine if the advanced nurse collaborates with is supervised by or works independently of a physician. As part of the entry minimum qualification, the advanced practice nurse must hold a postgraduate nursing degree. The high-level education is vital for skills, knowledge, and experience that enable the nurse to perform their roles effectively. Some of the duties of these professionalsare to provide and manage direct care (to client groups and individuals), to administer, and to formulate and implement health policy. Besides assessment and diagnosis, the advanced practice nurse may also, conditional upon the law, prescribe medicine for and treat specific conditions. The advanced practice nurse may even admit clients, make more autonomous decisions, plan, manage human and other resources, and ensure legal and ethical compliance.Different specialities exist for a nurse who intends to move from the Registered Nurse level to the advanced level. They include the Certified Registered Nurse Anesthetist, the Clinical Nurse Specialist, the Nurse Practitioner, and the Certified Nurse Midwife. For a nurse to qualify to practice in any of these specialities, they need a minimum of the Master of Science (Nursing), state licensure, and national certification for the role and the related client population.This paper examines the different advanced practise nursing specialities, the requirements for transitioning into the specific functions, and the reasoning behind choosing a Clinical Nurse Specialist’s role over the other options.

APN Roles

The Clinical Nurse Specialist, Certified Nurse Anesthetist, Nurse Practitioner, and the Certified Nurse Midwife are the different specialities under the advanced practice area. The following is an overview of the educationalrequirements, the work environment, and the roles of the different specialities.

The Clinical Nurse Specialist

Nurses of this category are experts in different speciality areas. They may work among a specific population (such as women and children), in a particular setting (such as the emergency department), against a specific medical problem, and in one specific healthcare area (such as cardiovascular (Greenwood, 2017)).The specialists provide expertise, support (like advising other nurses), and evidence-based care, participate in change and best practices among the organization (Foster & Flanders, 2014). As part of a safe, quality, and cost-effective care, the specialists may conduct research. Since their goal is to find new ways of delivering care, the specialists act as consultants,undergo continuous education, and research. They also serve as the field’s leaders.

The educational requirements for this careerinclude postgraduate degrees–a Master’s or Doctorate. An accredited program is mandatory for the candidateplus a bachelor’s degree which prepares them for doctoral studies. As such, the student must ensure that the school they choose is accredited. It is also necessary for the candidate to complete state licensure examinations– NCLEX-RN certification must accompany the foundational studies. The state board of nursing licensing requirements determine the accreditation body applicant to a specific speciality from which the student must obtain national certification. The various speciality populations include paediatrics, psychiatrists, family, and women health. The scope of practice for specialists in any of the given areas depends on the specific state board. As such, some specialists may acquire the authority to prescribe and offer independent care while others may not.

The Certified Nurse Anesthetist

Professionals in this field administer anaesthesia and monitor clients that have or are about to receive it. They care for patients with scheduled or emergency surgical procedures. The certified nurse anaesthetist works with other specialists –usually anesthesiologists and surgeons. The speciality of the certified nurse anaesthetist involves a variety of roles which includethe following. The administration of the right dose of anaesthesia, assessing how the client responds to it, and examining potential risks for clients who have had anaesthesia are some of the daily duties. The nurses also educate patients before and after receiving the dose. The healthcare setting for the CNAs includes intensive care units, emergency and operating rooms. These places exist in a variety of institutions such as mobile surgery centres, military medical facilities, and medical and surgical hospitals. Beside bedside care, the CNAs may assume management and administrative roles. They can manage finances, people, and risks (nurse.org, n.d.). The CNAcan also develop staff, educate nurses, and plan departmental meetings. Therefore, they are a vital component of the healthcare industry.

The CNA requires, as a minimum, a Master of Science (Nursing) degree. Before earing this certificate, the student should have a bachelor’s degree in the same field and acquired licensure conditional upon demonstrating the right experience. Having worked as a registered nurse for two years with at least one year of experience in an acute care setting are some of the requirements for a CNA. Today, postgraduate programs offer not just the Master’s but also a doctorate. The training and conditions for an advanced practice nurse to attain the CNA level culminate in the National Certification Examination (for nurse anaesthetists).

The Certified Nurse Midwife

Members of this speciality help the mother to deliver safely and naturally. They also provide wellness and health care to women. Their duties include gynaecological checkups, prenatal care, and family planning.In a maternity setting, the CNM helps with labour management and mother-and-baby monitoring.At times, the CNM assists the physician to conduct C-sections. During such a role, the nurse executes the physician’s directions.The healthcare setting of the certified nurse-midwife is diverse and not restricted to the hospital. Some nurses work in private practice, homes, and in collaboration with obstetricians and gynaecologists (nurse.org, n.d.). Like other specialities, the educational path of this career is somewhat lengthy and demanding.

The primary requirement is a Master’s or doctorate. Candidates for this level seek a bachelor’s degree first and some certification before enrolling for the graduate studies. They must also have passed the NCLEX-RN examination. After completing the graduate course successfully, the student must earn the American Midwifery Certification Board’s certification by passing the necessary test. Continuing education is a vital requirement, and it involves taking an examination or regularly attending classes.

The Certified Nurse Practitioner

A member of this careerperforms the roles traditionally reserved for physicians, such as examining the patient, diagnosis, and treatment. They can also prescribe medicine. In quite a large area of the United States (more than twenty states), these individuals can work without physician supervision. The healthcare setting for this career is diverse, and it includes the hospital, long-term care facilities, homes, and healthcare centres. The educational path for this career is also somewhat demanding as it requires a postgraduate certification and licensure.

The rationale for Choosing CNP Role

The demand for advanced practice nurses is currently higher in the US than that of registered nurses (nurse.org, n.d.). More clients preferto have a home-nurse; a primary caregiver whom they can directly interact. At the same time, a significant number of the advanced practice nurses approach retirement, leaving an ample opportunity for students to fill the vacancies. Generally, therefore, the advanced practice nurse field has high job security.The certified nurse practitioner boasts a higher chance of securing a job because this career has the most substantial forecast employment opportunity (nurse.org, n.d.). reasonable to choose the CNP role over the other speciality areas.

Plans for Clinical Practice

My research into the various advanced practice nurse roles has improved my understanding of these roles significantly. One of my primary observations is that the earlier one can enrol for a graduate program, the broader his/her opportunities for an excellent career. I have also learned that the patient population demands the advanced practice nurse more than registered nurses. As such, I will devote to the advanced practice to help those in need of my services while earning my dream salary. Since the certified nurse practitioner has the most exceptional opportunity, I will pursue that role. I intend to work in a state where the advanced practice nurse can perform his/her duties independently. Wyoming and Colorado are some of my targets. I also plan to complete my doctorate within four years of graduation so I can secure enough time to build my private practice. Meanwhile, I will join several networks for nurses to promote my access to information and clinical sharing.

Role Transition

My transition will utilize the knowledge I have gainedfrommy research into advanced practice nursing. The first objective that I want to accomplish is the registered nurse’s licensure. After that,I will focus on expanding my experience as a registered nurse. As such, I will ensure that I have covered all my clinical rotations in good time. I intend to visit different healthcare settings to gain a proper understanding of their requirements. My journey to an advanced practice nurse begins immediately after graduation.I plan to enrol for a Master’s program shortly after graduation.If I get the necessary resources, I will prefer to enrol for a doctorate program too.I will try as much as possible to attain a certified nurse practitioner’s license immediately after completing my graduate studies.

Among the factors that could hinder successful transition areresistance from the professional team (doctors and physicians) and restrictions, such as governmental restrictions about working independently(Torrens et al., 2020). To overcome these barriers, candidates need to strengthen their characteristics such as knowledge, attitudes, and beliefs (Asiimwe, Muwema & Drake, 2019). The student also needs to identify and familiarize with other team members to develop inter- and intra-professional relationships (collaboration)that will enhance acceptance and a smooth transition.


The demand for advanced practice nurseservices is rapidly increasing due to an increasingly ageing population anda high demand for primary care. At the same time, the number of insured patients is gradually rising while the government seeks to bring more people under preventive care. These factors make the advanced practice nurse specialities extremely fruitful. Students need to understand the requirements of these specialities to make an informed choice. This paper examines the various specialities under the advanced practice category. It explains why the certified nurse practitioner boasts a broader opportunity than the other roles and presents a plan for clinical practice and role transition.















Asiimwe, J. B., Muwema, M., & Drake, K. (2019).Factors that influence the transition to advanced roles by RN to BSN nurses, in three selected hospitals of Central-Uganda. BMC nursing18(1), 18.

Foster, J., & Flanders, S. (2014). Challenges in CNS practice and education. OJIN: The Online Journal of Issues in Nursing19(2).

Greenwood, B. (2017). Role of Advanced Practice Nurses. Retrieved 12 March 2020, from https://careertrend.com/role-advanced-practice-nurses-2406.html

nurse.org. Nurse Anesthetist. Retrieved 12 March 2020, from https://nurse.org/resources/nurse-anesthetist/

nurse.org. Nurse Practitioner. Retrieved 12 March 2020, from https://nurse.org/resources/nurse-practitioner/

nursee.org. Certified Nurse Midwife. Retrieved 12 March 2020, from https://nurse.org/resources/certified-nurse-midwife/

Torrens, C., Campbell, P., Hoskins, G., Strachan, H., Wells, M., Cunningham, M., …& Maxwell, M. (2020). Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: a scoping review. International Journal of Nursing Studies104, 103443.

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