What is an Advance Practice Registered Nurse (APRN) in the USA?

By ShiftMed Team//Nursing Profession
APRN Nurse holding clipboard

Nursing is often thought of as a straightforward career, but you can actually gain promotions by pursuing specializations and higher education. You can eventually become an APRN or advanced practice registered nurse with certain degree paths.

APRNs are highly skilled, specialized registered nurses who hold master’s degrees or doctoral degrees. 

While many fulfill similar roles as RNs, APRNs train to work with a specific population and focus on a particular skill set and range of health conditions.

If you are currently a registered nurse looking to grow your career, becoming an APRN might be the next step.

What does APRN mean?

APRN stands for advanced practice registered nurse. An APRN is a registered nurse who has completed additional education and training in a nursing specialty, like Gerontology.

Being an APRN allows you to pursue work with a population you’re especially passionate about. For example, you could pursue a career as a certified nurse midwife (CNM), certified registered nurse anesthetist (CRNA), or become a clinical nurse specialist (CNS).

An APRN can also be an NP, or nurse practitioner. These are the highest level of APRNs next to CRNAs. They can examine and diagnose their own patients.

What is the difference between an APRN and a registered nurse (RN)?

Advanced practice registered nurses are registered nurses with additional education and skills training in a specific branch of medicine. They can perform all the duties of a registered nurse, in addition to advanced procedures related to their specialty. 

Some APRNs can operate almost independently, such as CRNAs. In some states, a CRNA can provide the same level of treatment as an anesthesiologist.

Being an APRN allows you to home in on a particular branch of medicine you love, whether women’s health, pediatrics, gerontology, or family health care. 

What qualifications does an APRN Nurse need?

The requirements to be an APRN vary based on your specialty, but all advanced practice registered nurses must have at least a master’s degree. Your master’s degree in nursing (MSN) will have a concentration in the medical specialty you want to pursue. 

For example, an aspiring family nurse practitioner (FNP) would need to complete a nurse practitioner master’s degree program as well as clinical hours. They will then have to pass a certifying exam from an accrediting organization. 

Some APRNs decide to pursue doctoral degrees as well. These nurses focus more on nursing research, academia, and administration than direct patient care. However, you can still treat patients if you decide to go this route after earning your master’s. 

What work does an APRN nurse do day to day?

The tasks of an APRN vary among specialties. Nurse practitioners will see their own patients, perform routine examinations, order lab work for diagnostics, and create treatment plans. CRNAs, on the other hand, consult with patients and families before surgical procedures, develop anesthesia plans, administer anesthesia, and monitor patients during surgery. 

Every APRN's day looks different depending on what they choose to specialize in. One of the most appealing aspects of this career is the ability to shape your work environment to suit your preferences.

Where do APRN Nurses work?

APRNs can work in hospitals, or they can work in more laid-back clinics or physician’s offices. Depending on their discipline, they also tend to have more flexible schedules than RNs. Some APRNs work for government organizations, including Veterans Affairs clinics or the military. 

In some states, APRNs can work independently and manage their own practices. 

What is it like to be an APRN Nurse?

With a more advanced skill set, APRNs have greater responsibility, too. They have more comprehensive relationships with their patients because they are often responsible for developing care plans.

In addition to making diagnoses, APRNs work with other nurses, physicians, and members of their patients’ healthcare teams. 

Due to the increased work responsibility, you can be busy as an APRN, sometimes even more so than an RN. 

But an APRN position opens the door, in many cases, to build ongoing relationships with your patients. You play an integral role in their healthcare, often developing plans for treatment entirely on your own.

Some APRNs also like to become teachers, guiding the next generation of nurses into the field. They can either serve as APRN teachers or instruct undergraduates in nursing school.

How much do APRN Nurses make?

There are different salaries for APRNs depending on their job title. For example, the average nurse practitioner's salary is $116,438.80, and the average CRNA's salary is $140,357.71. Both of these are significantly higher than the median RN salary of $76,944.90; this increase comes from the fact that APRNs are nurse specialists and have knowledge and skill sets in high demand. 

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Are there different specialties of APRN nurses?

Absolutely! You can become a nurse practitioner (NP) and choose to specialize in family health care, women’s health, mental health, pediatrics, emergency care, or gerontology.

CRNAs, or certified registered nurse anesthetists, are part of the operative team and work with other CRNAs under an anesthesiologist. 

Clinical nurse specialists (CNSs) focus on treating vulnerable populations, disease management, healthcare policies, research, and education. 

Certified nurse midwives, or CNMs, care for women throughout their lives, providing support for reproductive health, infertility, pregnancy, labor and childbirth, and postnatal care. 

APRNs can continue to develop their skill sets by taking continuing education courses and earning advanced certifications in additional fields. For example, an APRN may want to specialize in cardiac vascular nursing, diabetes, immunology,  or oncology. 

Advantages and disadvantages of choosing a career as an APRN nurse

There are a few downsides to becoming an advanced practice registered nurse. You have more control over your career, a higher salary, and more growth opportunities. However, there are some stark differences between working as an APRN specialist and practicing as a registered nurse.

Before you start your studies and dedicate yourself to this career path, here are some of the benefits and disadvantages of being an APRN. These are relative, of course, and you might find that what some consider a negative doesn’t affect your view.

That being said, keeping an open mind and developing a full picture of a career is helpful to ensure it’s the right path for you.

Advantages of choosing a career as an APRN nurse

1) Specialize in a type of nursing

You can become a family nurse practitioner (FNP), work in pediatrics, become a vital part of the anesthesia team, and perform many other specialized roles as an advanced practice registered nurse. 

Being an APRN gives RNs the greatest level of specialization possible. If you are highly passionate about a certain field, then the best way to develop an advanced education and skill set is to become an APRN.

2) Treat more complex patients

While many RNs are experts in complex patient care, there are still limitations on what they can do for them. APRNs take on greater responsibility in healthcare; they collaborate with physicians and treat patients independently. 

With a higher degree level and clinical experience, APRNs prepare to handle patients with specialized needs.

3) Different work environments

Some APRNs work in hospitals, but many work in doctor’s offices and medical clinics. In certain parts of the country, nurse practitioners can even hold their own practices. Being an APRN provides you with immense flexibility in where you work as well as your shifts.

Another great facet of APRN nursing is that this career is always in demand. There will never be a lack of need for specialized nurses with advanced clinical skill sets. So, whether you want to relocate or have greater job security, you can rest assured that APRNs are needed everywhere. 

4) Build long-term relationships with your patients

For many APRNs, patient care is an ongoing process. They perform initial assessments and intake, write care plans, and perform routine follow-ups with their patients. Some nurse practitioners become primary care providers for patients of all ages.

Building long-lasting relationships with your patients are rewarding, and it’s wonderful to see the difference your care plans and treatments can make in their lives.

5) Higher salary than an RN

One of the biggest perks of furthering your education as a registered nurse is increasing your earning potential. APRNs take home six figures regularly, and these specialists are qualified for greater starting salaries than registered nurses.

Disadvantages of choosing a career as an APRN nurse

1) Heavier workload

APRNs take on the highest level of nursing in patient care. In many cases, their role is indistinguishable from a physician’s. Being solely responsible for a patient’s health plan means taking on far more responsibility than you do as an RN.

Instead of being given orders by a physician, you are the one in charge. RNs will look to your diagnosis and recommendations when giving care. While this can be a great part of the job, it also means each patient comes with significantly more responsibility. 

2) Legal consequences

APRNs assume a great deal of responsibility in healthcare. Their ability to diagnose patients and, in some roles, prescribe medication puts them at a higher risk of liability. They can face jail time or lose their license if they are sued for malpractice, accidental injury, or even death. 

3) Lengthy education requirements

It takes at least two years to earn a master’s degree if you already hold a bachelor’s in nursing. Additionally, most APRN degree programs require a background in nursing and at least 1 to 2 years of clinical experience. 

In addition to earning their master’s degree, APRNs must perform hundreds to thousands of hours in clinical rounds before becoming certified. The certification exam is taken through a recognized board in their specialization, and it is not the same as the NCLEX. They must still continue their education and regularly renew their RN license. 

4) Difficulty maintaining work-life balance

Balancing work with personal time is one of the hardest parts of being an APRN. You are often on-call, work 8 to 12 hours per shift, and may have to work rotating shifts in some settings. Overtime is also common, so you may spend more time away from home than expected. 

While long hours are an issue for some APRNs, they aren’t always the case. There are many nurse practitioners who work 8 hours a day and have fewer demands than RNs in hospitals.

How to become an APRN nurse

Every APRN nurse starts their career in nursing school. If you aspire to become an APRN, you will need to earn a bachelor of science in nursing (BSN), then a master of science in nursing (MSN). Your MSN program must focus on your APRN specialty, like a nurse practitioner. 

Alternatively, you can apply for a doctorate of nursing practice (DNP) program instead of an MSN. Many schools do not require an MSN to apply for a DNP; instead, you must demonstrate clinical experience and perform more extensive rotations and training. DNP degrees usually last around three years, whereas MSN programs last two years.

After completing your master’s degree, you must pass an exam through the certifying board of your specialization. If you want to become a CRNA, that would be the American Association of Nurse Anesthesiology.

Recommended Reading - How To Become An Advanced Practice Registered Nurse (APRN) In The USA

Frequently asked questions about APRN nurses

How long does it take to become an APRN nurse?

On average, it takes between 6 to 10 years to become an APRN. This depends on your starting level of education, the type of advanced nursing degree you pursue, and your area of specialty. 

Is an APRN the same as a nurse practitioner?

All nurse practitioners are APRNs, but not all APRNs are nurse practitioners. They can pursue other specialty areas and become CRNAs, CNSs, or CNMs. 

Is an APRN higher than a PA?

Neither career ranks higher than the other because they have separate roles and requirements. A nurse practitioner and physician’s assistant can both assess and diagnose patients, but there are different restrictions and regulations based on their location.

For example, some states allow NPs to operate independently, but PAs must always work under a physician’s supervision.

How do you address an APRN?

APRNs are addressed by their title, which is “Nurse (name).” Some are comfortable working with their patients on a first-name basis. All APRNs must introduce themselves by their name, followed by their title. It is a felony in some states and illegal in all of them for APRNs to call themselves doctors.

Is becoming an APRN worth it?

According to the Bureau of Labor Statistics, the demand for APRNs is high. The BLS projects career growth for nurse practitioners, nurse anesthetists, and nurse midwives to increase by 40% through 2030. Between 2021 and 2031, 118,600 new jobs will appear in the United States.