Role of an Advanced Practice Nurse
Advanced practice nurses (APNs) are nurses who have obtained advanced training and certification, often including a master’s degree or a doctorate in nursing. APNs are often referred to as advanced practice registered nurses (APRPs) and are among a group of healthcare provides described as advanced practice providers (APPs). APPs include APNs as well as physician assistants (PAs).
APPs have also been described as physician extenders, and while the term is often used in the healthcare system, some health care professionals feel that it overly emphasizes the physician role in supervision of APPs.
The Roles and Responsibilities of APNs
Because of the additional training required to become an APN, these healthcare providers often have the opportunity to work in a clinical patient care setting with a high degree of independence and responsibility for patient care within the healthcare system. APNs may be certified to see patients without a doctor, to order diagnostic tests, to make a clinical diagnosis, and to make important medical decisions.
However, there are some differences between what a physician, a PA and an APN are authorized and licensed to do. As the healthcare system is changing, you have a higher chance of seeing an APN than ever before. In fact, healthcare systems have considered the increase in APN care to be a strategy for achieving universal healthcare.
According to the American Association of Nurse Practitioners, there are approximately 250,000 nurse practitioners in the United States, and according to the United States Bureau of Labor Statistics there are over 200,000 jobs with a 31 percent anticipated job growth.
APNs can work in a variety of clinical settings, including medical offices, hospitals, and nursing homes. There are special certifications and roles that APNs, can hold, including nurse practitioner (NP), certified nurse midwife, nurse anesthetist, and clinical nurse specialist.
Nurse practitioners (NPs) usually see patients in the outpatient setting. You might see an NP for your preventative care and for your regular medical check-ups. Many patients are assigned to see NPs as their primary care health providers. In this setting, your NP would see you for routine health maintenance and for health problems that may come up from time to time. As part of your preventative care, you may have several diagnostic medical tests. Your primary care provider routinely performs these tests as a part of your regular checkups.
Nurse midwives are nurses who provide prenatal care for expecting mothers throughout pregnancy. In addition to providing prenatal care for mother and baby, nurse midwives often deliver babies as well. Nurse midwives may work in a team composed of both nurse midwives and physicians or they may work in a team of exclusively nurse midwives.
Nurse anesthetists work in the surgical operating room, providing patient care during surgery. This includes administering powerful medication to prevent pain during surgery, administering medication to put a patient to sleep during surgery, and monitoring vital signs during a surgical operation. Often, after a surgical procedure nurse anesthetists are involved in the immediate post-operative care as well.
Clinical Nurse Specialists
Clinical nurse specialists often work as part of a multidisciplinary medical care team. This includes rounding on patients in the hospital and making diagnostic and medical care decisions. Clinical nurse specialists may be general care nurse practitioners, providing a wide range of medical care, or they may be sub-specialized, providing specialized care.
Some clinical nurse specialists see patients post-operatively in the hospital and in postoperative visits after discharge from the hospital. For example, if you have to have a neurosurgical procedure, there is a strong chance that a clinical nurse specialist will be part of your pre-operative care team, managing your pre-operative testing and procedures and explaining what you need to do before surgery. A clinical nurse specialist is also likely to be part of your post-operative care team, explaining what you should expect after surgery, helping evaluate you for post-operative complications, and managing issues such as post-operative medications and rehabilitation arrangement.
There are a number of different types of nursing degrees, and with each of these comes a different type of certification, responsibility, and autonomy. When you are going to get routine medical care, or if you have a medical emergency, you will be cared for by a whole health care team who will work together, each member communicating with the others to get you the heath care you need.
- Bryant-Lukosius D, Valaitis R, Martin-Misener R, Donald F, Peña LM, Brousseau L Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health. Rev Lat Am Enfermagem. 2017 Jan 30;25:e2826. doi: 10.1590/1518-8345.1677.2826.
- United States Department of Labor, Bureau of Labor Statistics, Occupational Outlook Handbook, Nurse anesthetists, nurse midwives, nurse practitioners