How to Become an Advanced Practice Nurse (APN or APRN)
An advanced practice registered nurse (APN or APRN) is a nurse who has received specialized training at the post-graduate level. APNs have knowledge, skills and clinical responsibilities that go beyond those of a traditional registered nurse (RN). As an APN, you can choose 1 of 4 general specialization fields, including nurse practitioner (NP), clinical nurse specialist (CNS), nurse midwife (CNM) and nurse anesthetist (CRNA).
Although the specific educational and licensing requirements differ for each type of APN, all 4 of these specializations usually require nurses to first complete a Bachelor of Science in Nursing (BSN). In addition, all APNs must also hold an RN license before they can begin their advanced education at the masters or doctorate level and earn an APN certification.
Advance practice nurse jobs are available in almost every type of healthcare setting, and these specialized nurses often have much more professional freedom than RNs. Additionally, their advanced knowledge and skills make them more valuable on the job market, and the average APN salary is significantly higher than the average RN’s income.
All advance practice nurse programs are offered by colleges and universities at the masters degree or doctorate level. Before you can begin your advanced practice nurse degree, you must first complete all of the same undergraduate educational requirements as a traditional RN. For the majority of APNs, this means that you must first earn a BSN at a 4-year university and then take the NCLEX-RN exam to earn your registered nurse license.
After you successfully complete your BSN and earn your RN license, you are eligible to enroll in a graduate-level nursing program. Although all advanced practice nursing students may begin in an APN program on the same campus, once you begin your program you must select a specialization.
Each of the 4 general APN specialization fields has its own unique educational track. However, all of them require about 2 years of full-time study at the masters degree level or 3 to 5 years at the doctorate level. Some schools advertise APN accelerated nursing degree programs, but these are usually special RN to MSN or BSN to DNP programs, and do not actually require less time to complete.
In the past, almost all advanced practice nurse schools trained APN nurses at the masters degree level. However, in 2004 the American Association of Colleges of Nursing (AACN) and the National Council of State Boards of Nursing (NCSBN) recommended that the entry-level degree for all APN nurses be changed to the Doctor of Nursing Practice (DNP) by the year 2015.
As a result, almost all masters-level APN programs have started to change their degree plans to the new standard, and there are already many more brick-and-mortar and online DNP programs available than there were only a few years ago. However, the AACN has stated that after 2015 it will still allow all working APNs who already hold a masters degree in nursing to continue to practice with their existing degree.
Licensing and Certification Requirements
After you have finished your APN degree, there are 2 more important requirements that you must fulfill before you can begin to work as an advanced practice nurse. You must earn your APN license as well as a certification in your specialty field.
An APN license is awarded by the board of nursing or health in the state where you want to practice, and gives you the legal authority to practice in the state. In addition, your advance practice nurse certification in your specialty area must be earned through 1 of several national, nonprofit professional organizations. The exact APN certificate that you must earn will depend on what kind of APN nursing you want to pursue.
In most states, the APN licensing process is fairly simple and does not require additional testing. Instead, every state requires you to first earn your APN specialty certification before you can apply for your APN license. For each type of APN specialization, your state’s board of nursing website will tell you which certification you need and which professional organizations award it.
You must typically pay an application fee between $100 to several hundred dollars when you apply for your APN license. Many states also require you to provide documentation that you have completed a certain number of clinical practice hours in your advanced specialty field. However, this is usually only a formality because the organization that awards your certification typically requires you to have the same number of clinical practice hours.
APN certifications are awarded by nonprofit associations that set specific standards of practice and educational requirements for your specialty field. Each of the 4 APN specialization fields has at least 1 or more agencies that are responsible for awarding certifications.
The specific requirements that you must fulfill to earn your APN certification depend on your specialization and the association (or associations) that award certifications in that subfield. However, all certifying organizations require applicants to have an MSN or DNP degree in addition to a certain number of clinical practice hours.
Before you are eligible for certification, you must also take and pass a certification exam that is specific to your area of practice. These exams typically cost several hundred dollars and must be taken at official testing centers. Additionally, all APN certifications must be renewed once every 2 years. To find out about the specific certification requirements for your APN specialization, visit the websites of the associations that certify in your field.
Some of the main associations that offer APN certifications include the American Nurses Association, the National Board of Certification & Recertification for Nurse Anesthetists, the American Academy of Nurse Practitioners and the American Midwifery Certification Board.
Earning Your APN Training Online
There are hybrid online APN programs at both the MSN and DNP levels. Hybrid programs allow you to complete some or all of your traditional classroom coursework requirements in an online format. Most of the top-ranked online APN degree programs are offered by brick-and-mortar universities that have created distance learning versions of their traditional MSN or DNP programs.
However, it is important to remember that even the best online APN degree programs will require you to complete your clinical hours on site in a healthcare setting. Therefore, beware of Internet websites that promise to help you earn your APN education fully online. Because nursing is a practical field, you cannot learn necessary job skills if you attend a fully online training or educational program.
In addition, professional nursing associations do not award APN certifications online, and require you to take your certification exam at an official testing center. However, most of these organizations provide a variety of online training resources to help you prepare for your APN certification or recertification exam. To find these online resources, simply visit the main website of your certifying association and look for a tab called “education” or “certification preparation.”
Jobs Within Advanced Practice Registered Nursing Fields
The type of APN job that you will have depends on your specialization. However, the role and importance of advanced practice nurses in healthcare has grown significantly in recent years, and APN jobs can now be found in almost every type of clinical setting. Because they do not need the supervision of a physician in order to practice, many APNs work as contractors and may travel to visit patients in hospitals, clinics and nursing homes.
There is little difference in advance practice nurse salaries between the different types of specializations. On average, CNSs, NPs, CNMs and CRNAs all earn an annual advanced practice nurse salary between $60,000 and $105,000.
Like every job, your APN pay will depend largely on both the region where you practice as well as your type of employer. However, because APNs often work independently and are in high demand, these professionals typically increase their advanced practice registered nurse salary by simply choosing to work more hours.