NP vs. APRN: Understanding Advanced Nursing Practice Degrees

By Sarah Collins

04/11/2022

  • A nurse practitioner (NP) is an advanced practice registered nurse. Nurse practitioners act in a provider role similar to that of physicians.
  • An advanced practice registered nurse (APRN) is a broad term for nurses with graduate-level education. The APRN degrees include nurse practitioner, certified registered nurse anesthetist, clinical nurse specialist, and certified nurse-midwife.
  • The program requirements and scope of practice are different for each advanced practice area, but all require at least a Master of Science in Nursing (MSN), and some require a Doctor of Nursing Practice (DNP) degree.

Are you looking to go beyond the work of a registered nurse? Nursing is a diverse field with many opportunities to specialize.

Nurse practitioner (NP) is one of the most common advanced practice degrees for nurses. But there are other options to practice as an advanced practice registered nurse (APRN).

Understanding the roles and requirements of each can help you decide the next steps in your nursing career. This guide is expository on the differences between both nursing degrees.

What Is an NP?

A nurse practitioner (NP) works with patients in a provider role similar to a doctor. NPs can act as primary care providers for patients and fill critical gaps in provider care. Often, they practice without a physician’s direct supervision, which is one of the main distinctions between nurse practitioners and physician assistants.

Nurse practitioners’ duties include the following:

  • Ordering and interpreting diagnostic tests
  • Prescribing medications
  • Performing in-depth patient exams to diagnose and treat patient conditions
  • Creating and implementing care plans to treat patients

Nurse practitioners work as part of the healthcare team, and they may consult with specialists and other medical professionals to reach the best possible patient outcomes. Also, they may also oversee other healthcare team members like nurses and certified nurse assistants.

Opportunities to Specialize

As an NP, you have many opportunities to specialize. It all depends on your interests and where you want to work. For example, you can major in the following areas:

  • Family practice and primary care
  • Pediatrics
  • Geriatrics
  • Mental health and psychiatric care
  • Women’s health

As an NP, you can work in acute and non-acute care settings. For example, you can work in the hospital setting or primary care.

What Is an APRN?

An advanced practice registered nurse (APRN) is any nurse that has a graduate degree. Think of APRN as an umbrella term. Many advanced practice nurse degrees are under this category, including nurse practitioners, nurse-midwife, clinical nurse specialists, and nurse anesthetists.

Like an NP, APRN degrees allow for higher autonomy and opportunities to specialize.

How Are NPs and APRNs Different?

APRN is a broad term covering several nursing degrees – the type of certification and degree you get will impact your work and the kind of patients you’ll see. On the other hand, an NP involves specific responsibilities and scope of practice.

 

Also, the educational requirements of each category of degree are different. For example, becoming an NP involves about six years of education covering specific courses and doing a certain number of practice hours. Other advanced practice degrees might require further education — also, they over different courses areas.

Your earning potential is also different between the degrees. For example, you might make more as a nurse anesthetist than you would as a nurse practitioner.

Types of APRN Specialties and Their Duties

There are several APRN specialties, and they all have different responsibilities.

Since we’ve already looked at the duties of an NP, let’s look at some of the responsibilities for three types of APRNs: clinical nurse specialists, certified registered nurse anesthetists, and certified nurse-midwives.

Clinical Nurse Specialist

Clinical Nurse Specialists (CNS) are similar to NPs, and they can specialize in several areas and help a variety of population groups. For example, NPs can specialize in geriatric health, geriatric acute care, or community health.

NPS typically work more indirect patient care, while CNS works more in education and administrative roles. They also act as consultants for patient care and help implement research-based practices.

Certified Registered Nurse Anesthetist

A certified registered nurse anesthetist (CRNA) works with people receiving anesthesia in medical procedures. They tailor their approach to care and give anesthesia based on each patient’s needs. CRNAs can work in various settings, including surgery centers and hospitals.

CRNAs need to understand anesthesia and the overall surgical process thoroughly. They fill a critical role of an anesthesia provider, helping to meet needs in underserved areas and contributing to a cost-effective healthcare system.

Certified Nurse Midwife

A certified nurse-midwife (CNM) works to help expectant mothers through pregnancy, delivery, and the postpartum period. For example, they can help expectant mothers by:

Providing prenatal care, including prenatal examinations

  • Educating new parents
  • Referring mothers to specialists as needed
  • Testing mothers for STDs and providing appropriate treatment
  • Assisting mothers through the labor and delivery process
  • Performing postnatal examinations

Which Nursing Career Is Right for You?

Deciding which type of APRN is right for you can be challenging. But considering your goals and interests can help you determine what degree to get. The following questions will help:

Where Do You Want to Specialize?

Are you interested in specializing with a particular patient population? You can focus your degree on one of these areas. Are you interested in a specific disease process or category of diseases? You can focus your degree based on these interests as well.

What Time Constraints Do You Have?

Are you able to devote the time an APRN degree program requires? It’s a significant time commitment, but the payout can also be high.

What Financial Constraints Do You Have?

While it shouldn’t come down to just money, you should consider the financial impact of pursuing an APRN degree. For example, does your place of employment help with tuition fees and other educational costs? Do you have scholarships available to you? Is the amount of debt going to be less than what you’ll eventually make as an APRN?

How Do You Best Interact With Patients?

Each type of APRN will have different types of patient interactions. For example, NPs often work directly with patients in one-on-one interactions. Nurse anesthetists will have very different patient interactions, seeing patients through the entire anesthesia process. Midwives work with families and individuals to achieve successful deliveries and healthy children.

What Are Your Career Goals?

Do you see yourself in more of an administrative overseer role, or do you see yourself helping more with direct patient interactions? Do you want to work more independently, or do you want to work more with a team?

For example, a clinical nurse specialist might work more in an administrative role, but you might be more independent as a nurse practitioner.

You must know your strengths and weaknesses. You can pursue a degree that best fits your strengths and how you want to help patients. Remember that each degree allows you to help people in highly specialized areas.

How to Become an NP or APRN

Getting a graduate degree in nursing involves several years of education and clinical hours. The specifics will depend on what degree you get and where you plan to specialize. After completing your degree, you may need to get specific certifications before practicing.

Before pursuing any of these degrees, you must first become a registered nurse (RN). To do this, you’ll need to get at least an associate degree in nursing (ADN).

Depending on what APRN program you want to enroll in, you may also have to get your Bachelor of Science in Nursing (BSN) as well. Programs may require additional nursing work experience before you get into the program.

Consider the following coursework related to a clinical nurse specialist, nurse practitioner, nurse midwife, and nurse anesthetist degrees:

Clinical Nurse Specialist Programs

To become a clinical nurse specialist, you can pursue a Master of Science in Nursing (MSN) degree or a Doctor of Nursing Practice (DNP). Coursework can focus on interpreting research and implementing the best possible practices in the healthcare setting.

Coursework to become a clinical nurse specialist may cover the following topics:

  • Organization and management theory
  • Pharmacology
  • Advanced health and physical assessment
  • Ethical and philosophical aspects of nursing
  • Pathophysiology
  • Statistics and reasoning
  • Public policy and the science of healthcare delivery

CNS programs also require several clinical hours as a part of their programs. After completing a program, your specific certification requirements will vary based on your state.

Nationally-recognized groups that offer certifications for clinical nurse specialists are the American Nurses Credentialing Center (ANCC) and the American Association of Critical-Care Nurses (AACN).

Nurse Practitioner Programs

NP programs typically require nurses to get their MSN. Before entering a master’s degree program, you’ll likely need to get your BSN and experience working as a nurse.

Coursework may cover the following topics:

  • Pathophysiology
  • Pharmacology
  • Assessment and diagnostic reasoning
  • Health promotion and disease prevention
  • Caring leadership

The courses you take will also be influenced by where you want to specialize. For example, as a family nurse practitioner, you’ll cover health problems and wellness across multiple age groups, including children and older adults. You’ll also need to complete a certain number of clinical hours to complete the program.

After completing an accredited program, you can get your certification to practice as a nurse practitioner. How you get your certificate will vary between states, but a few different organizations you can look to are the ANCC, The American Association of Nurse Practitioners (AANP), and the National Certification Corporation (NCC)

Certified Nurse-Midwife Programs

In addition to covering core advanced nursing practice concepts like pathophysiology and health assessment, a nurse-midwife program will cover the essential care of expectant mothers.

Courses may cover the following topics:

  • Reproductive and sexual care
  • Gynecologic health and primary care of women
  • Midwifery care during labor and birth, postpartum care, and newborn care
  • Care of the childbearing family

Nurses in a midwife program will also need to complete many practical clinical hours. After completing an accredited program, there are a few different options for certification, but one option is to go through the American Midwifery Certification Board (AMCB).

Certified Registered Nurse Anesthetist Program

Becoming a nurse anesthetist is one of the most extended and rigorous APRN degrees you can get, as it involves extensive clinical hours. According to the American Association of Nurse Anesthesiology (AANA), beginning this year (2022), future nurse anesthetists will need to be enrolled in a doctoral program.

APRN course work cover the following topics

You’ll cover topics similar to other APRN degrees and courses specific to anesthesia. Topics in the coursework may include:

  • Professional aspects of nurse anesthesiology practice
  • Advanced physiology, advanced health assessment, and pharmacology
  • Pharmacology and advanced pathophysiology for nurse anesthesiology
  • Anesthesia equipment and technology
  • Anesthesiology principles
  • Evidence-based practice

You’ll practice as CRNA after you pass the National Certification Examination. You take this exam through the National Board of Certification & Recertification for Nurse Anesthetists (NBCRNA).

Pros and Cons of Being an NP or APRN

As with any nursing degree, becoming an NP or APRN offers both benefits and drawbacks, and it would be best to consider both before deciding to pursue an APRN degree.

Positives of an NP or APRN Degree

APRN degrees allow for higher earning potential. For example, the average annual income among nurse anesthetists, nurse midwives, and nurse practitioners is $117,670 per year and $56.57 per hour.

The job availability for these three APRN specialties is also expected to increase by 45% by 2030 (much faster than the national job growth average). These specialties also allow for more autonomy in nursing practice, and nurses with advanced practice degrees can operate more independently from doctors than registered nurses.

Drawbacks of an NP or APRN Degree

Getting any APRN degree does take a significant amount of time, and this time commitment can be a considerable drawback. While becoming a registered nurse (RN) usually only requires two to three years of schooling, a typical APRN degree can take about six years of training, and it can take even longer.

The cost of the degree is also something to consider. While financial options are available, getting an APRN degree often carries economic costs, and often these costs are higher than getting lower-level degrees like an Associate Degree in Nursing (ADN).

Finally, another major drawback is the level of responsibility. As a registered nurse, you work under the provider’s supervision, but many APRN practitioners can practice independently. This practice scope makes them more responsible for any errors in patient care.

Is an APRN Higher Than an RN?

To be an APRN requires at least a graduate degree like a master’s or doctorate. Becoming a registered nurse typically only requires an associate degree, but many nurses have their bachelor’s degree.

Both fulfill vital roles in the healthcare system, but the scope of practice is different for each. For example, RNs work under physicians or other providers, but many APRN professionals can operate independently of direct physician oversight.
Is an APRN Higher Than an NP?

An NP is an APRN, so some APRN specialties require the same education. Typically, becoming an NP will require you to get at least an MS, and other APRN degrees that also need an MSN degree would rank at about the same level as an NP.

Some APRN specialties require additional education, such as a DNP, and these positions are higher than an NP. But looking at this fashion misses a critical point: it has less to do with rank and more to do with the specialty.

Types of APRN specialties allow nurses to specialize in different areas. People consult with various specialists based on their needs.

For example, you might have a nurse anesthetist work with you during your surgery, but you might see a psychiatric nurse practitioner to help you treat your depression or anxiety.

Get Started With Your APRN Today!

Nursing is a diverse field. Advanced practice degrees in nursing allow you to specialize further and increase the autonomy of your practice.

When deciding which career is right for you, you should consider your interests, how you want to help patients, and where you desire work. Remember, you have lots of options and pathways. And you can get started on the path today!

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