Pros and Cons of an Advanced Practice Nurse Career
Advanced practice nurses (APNs) are registered nurses who have graduate-level education and may act as primary care providers. Check out these pros and cons to see if becoming an advanced practice nurse is the right career for you:
| Pros of an Advanced Practice Nurse Career |
|---|
| Higher than average salary ($66,640 in May 2014)* |
| High growth field (16% increase from 2014-2024)* |
| Specialization options in nursing available* |
| Satisfaction of providing primary care* |
| Cons of an Advanced Practice Nurse Career |
|---|
| Minimum six years of education* |
| Licensing requirements* |
| Possible on-call, evening or weekend hours* |
| Potential physical stress and hazard exposure* |
Sources: *U.S. Bureau of Labor Statistics.
Essential Career Info
Advanced practice nurses are registered nurses (RNs) who have gone on to complete education and training at the graduate level in a post-graduate certificate or master's degree program. APNs can choose to specialize in certain diseases, age groups or biological systems. There are four categories of APNs that include nurse practitioners (NPs), clinical nurse specialists, nurse midwives and nurse anesthetists.
Nurse practitioners function similarly to primary care doctors, performing physical examinations, diagnosing illnesses and prescribing medications. They often specialize in healthcare categories, such as women's health, pediatrics or mental health. In some states, NPs can work independently of a physician and may even have their own practices.
Clinical nurse specialists work in a certain field of healthcare to provide acute care. They could have specializations in cardiac, neonatal, gynecological or psychiatric medicine, among others. Nurse anesthetists administer anesthesia to patients undergoing surgical procedures. Nurse midwives provide care to pregnant women, monitoring prenatal conditions, delivering babies and supervising postpartum care.
Advanced practice nurses work in many different healthcare settings according to their specializations and roles. They could work in hospitals, clinics, private practices, nursing care facilities, universities and government agencies. Some APNs go on to teach the next generation of nursing staff. APNs may need the physical strength to lift or help move patients. As with many healthcare roles, there is a risk of exposure to biological hazards, though proper safety practices can diminish this risk.
Salary and Job Prospects
Your salary may vary based on your area of specialty. For example, Salary.com reported in February 2016 that nurse practitioners made a median annual salary of $99,326, while nurse midwives earned $99,954 in the same year. The U.S. Bureau of Labor Statistics (BLS) projected a 16% increase in employment of all registered nurses, which includes advanced practice nurses, in the decade from 2014-2024 (www.bls.gov).
This faster-than-average growth may be due to an aging population that will require more care as well as technological advances that allow for previously unavailable treatments. In 2010, the American Association of Colleges of Nursing noted that there was a nursing shortage in the United States, which is further compounded by an increasing lack of nursing faculty (www.aacn.org).
Education and Licensing Requirements
To become a registered nurse, you need to complete a diploma or degree program, as well as pass the National Council Licensure Examination for Registered Nurses. If you want to become an advanced practice nurse, you might consider enrolling in a Bachelor of Science in Nursing (BSN) program in order to have the proper prerequisites for admission to a graduate program.
After completing a BSN program and gaining licensure, you can choose to spend a few years working as a nurse or continue directly to graduate school. The National League for Nursing Accrediting Commission accredits nursing program at all levels, including the master's and doctoral levels. Master of Science in Nursing (MSN) programs usually offer a few specialties, so you'll need to find a school that offers coursework in the field you want to study.
Licensing
Many states require advanced practice nurses to be licensed and some advanced practice nurses need certification. Each state's board of nursing has specific certification and licensing requirements. The National Board of Certification and Recertification for Nurse Anesthetists offers the Certified Registered Nurse Anesthetist credential, which is an entry-level requirement.
The American Midwifery Certification Board offers the Certified Nurse Midwife designation which some states use as licensure. Certifications and licenses may require maintenance with a certain number of continuing education credit hours each year.
What Employers are Looking for
In job postings, employers mention that candidates must have the appropriate licenses. Some employers require certification, or require you to seek certification within one year of hire. Check out these summaries of job postings open in March 2012:
- A cancer center in Michigan was looking to hire a clinical nurse specialist who had registered nurse licensure, a master's degree in nursing and two years of experience.
- A university in Illinois was searching for a nurse practitioner with an advanced degree, an APN license, two years of experience and teaching skills.
- A behavioral healthcare center in New Jersey wanted to hire an advanced practice nurse who specialized in gerontological psychology, as well as had APN licensure and certification in gerontological psychology.
How to Stand out in the Field
Get Certified
If the advanced practice pathway you choose doesn't require certification, you may still want to seek a professional credential in order to demonstrate your advanced and specialized knowledge and abilities. The American Nurse Credentialing Center and the American Academy of Nurse Practitioners are two large certifying organizations, though more specific groups offer certifications as well. Generally, in order to be eligible to take a certification exam, you need to have a current, active RN license and an advanced degree from an accredited program. Most certifications require maintenance through continuing education credits and renewal every few years.
Gain Teaching Skills
Part of the nursing shortage problem is a lack of faculty to teach new nursing staff, so your educational services may be in demand. If you work at a university hospital or a hospital with a nursing program, you may have an opportunity to teach in addition to your nursing duties. As an APN, you will have attended many years of classes and have seen effective teaching methods.
Other Careers to Consider
If you'd like to work as a nurse but don't want to undergo extensive schooling, you could work as a registered nurse. After attending a nursing program and gaining licensure, you can begin work in a variety of healthcare settings and even specialize in a specific area of healthcare. Salary.com reported in April 2012 that registered nurses made a median annual wage of $66,000.
If you want to provide a high level of care but aren't sure about the comprehensive role of the advanced practice nurse, consider becoming a physician assistant (PA). PAs work closely with a supervising physician and practice within that physician's specialty, whether it's primary care or psychiatry. PAs attend 2-year master's programs after earning their bachelor's degree. The BLS reported in May 2011 that physician assistants made a median annual wage of $89,000.
