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Advanced Practice Registered Nurse Career Overview

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What is an advanced practice registered nurse or APRN? An APRN is a clinician with a registered nurse (RN) license who has also earned a master’s in nursing in one of the following specialities: certified registered nurse anesthetist (CRNA), certified nurse midwife, clinical nurse specialist, or nurse practitioner.

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What Does an APRN Do?

MSN required
certification optional


The role of an advanced practice nurse falls between an RN and a physician in such areas as training, autonomy, responsibilities, and compensation.

For instance, advanced practice nurses have considerable autonomy since they can diagnose and treat conditions and prescribe medications. In some states, they must work under the supervision of or in collaboration with a physician. They often supervise RNs.

Advanced practice nurses typically hold these key skills and responsibilities:

Primary Responsibilities

  • Acting as a primary care provider
  • Disease and condition management (making diagnoses and ordering treatment)
  • Oversight of staff, including RNs

Key Skills

  • Empathy
  • Continual learner
  • Good decision-making under pressure
  • Scientific aptitude
  • Communication skills

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Where Do APRNs Work?

Depending on their speciality, advanced practice nurses may work in hospitals, private physicians’ offices, birth centers, surgical centers, clinics, or residential care settings.

NNPs might find work in these common settings:

Private Practices
APRNs can act as a primary care provider, diagnose and treat health conditions, and supervise RNs.
Hospitals
Advanced practice nurses might administer medication, lead nursing departments, and diagnose and treat health conditions.
Birth Centers
APRNs oversee births, involve physicians or transfer to a hospital as needed, and educate pregnant women and parents on caring for a newborn.

What Is the Difference Between an APRN and RN?

APRN

  • High levels of autonomy; can practice independently in most states with limited physician supervision in others
  • Can make diagnoses and order treatments
  • Can prescribe medications, including controlled substances
  • Minimum six years of college with master’s degree in nursing
  • Requires education and certification beyond RN

RN

  • Limited autonomy and independence; must practice under direct supervision of a physician or an APRN
  • Cannot diagnose conditions or prescribe medications; carries out physician or APRN treatment plans
  • Minimum two years of college with an associate degree in nursing (ADN)
  • Requires RN license
  • Can be an entry-level position

How to Become an APRN

Advanced practice nurses must have an RN license, a graduate degree in nursing, and, in the majority of states, national or state certification. Most graduate schools require RN nursing experience before admission. Specific requirements vary by state and the certifying board.

Graduate with a bachelor of science in nursing (BSN).
Some graduate schools offer bridge programs that combine BSN and master of science in nursing (MSN) studies for students with an ADN.

Pass the NCLEX-RN exam to receive RN licensure.
The National Council Licensure Examination for RNs (NCLEX-RN) takes up to six hours and covers clinical and other healthcare situations nurses are likely to encounter.

Explore different nursing specialty areas while gaining clinical experience.
Most specialty nursing entry-level positions include on the job training for that area. Clinical experience introduces nurses to work in specialties with different populations. Many graduate school programs require or prefer at least one year of clinical nursing experience.

Apply to an MSN-APRN or doctoral nursing program.
APRN programs typically take two years for a master’s degree or 3-4 years for a doctor of nursing practice (DNP). Some specialties, such as the CRNA, require a board-certified program, while others require only an accredited program. Admission requirements usually include a GPA of at least 3.0, an essay or personal statement, and recommendations.

Graduate with an MSN or a DNP.
As far as degree level, only the MSN is required to become an advanced practice nurse and qualify for licensing and certification exams, but academic medical centers and teaching jobs often require or prefer a DNP.

Earn certification from an approved nursing specialty board.
Each board has its own requirements beyond passing the certification exam. These typically include an unencumbered RN license, application, and a submission of academic records. Often, earning certification is required before applying for the advanced practice nursing license.

Apply for state licensure.
State advanced practice nurse requirements may include background checks and verification of education and required clinical hours.

The Four Types of APRN Roles

msn or dnp Required
High Demand

Certified Nurse Practitioner

Most certified nurse practitioners work in family practice, but others specialize in fields such as gerontology, pediatrics, or mental/psychiatric health.
Salary $109,820
Job Outlook 52% increase from 2019-2029
Learn More About Certified Nurse Practitioners

msn Required

Clinical Nurse Specialist

Clinical nurse specialists are advanced practice nurses who work in a specialty area such as oncology, cardiology, or emergency care.
Salary $91,300
Job Outlook Positive job outlook in coming years
Learn More About Clinical Nurse Specialists

msn Required
High Demand

Certified Nurse Midwife

Certified nurse midwives are advanced practice nurses who specialize in the care of pregnant women, labor, and birth. Like physicians, they are authorized to oversee births.
Salary $105,030
Job Outlook 12% increase from 2019-2029
Learn More About Certified Nurse Midwives

bsn Required
High Demand

Certified Registered Nurse Anesthetist

CRNAs administer anesthesia and often treat patients for postoperative pain. They generally earn the highest advanced practice nurse salaries.
Salary $174,790
Job Outlook 45% increase from 2019-2029
Learn More About Certified Registered Nurse Anesthetists

How Much Do APRNs Make?

Advanced practice nurse salaries are considerably above the national median annual salary of $39,810. The highest paid APRN specialization is nurse anesthetist with a median annual salary of $174,790 and the lowest paid is clinical nurse specialist at an average $91,300 annual salary. The median salary for most APRNs is $115,800 and 90% earn between $82,460-$184,180.

Demand for advanced practice nurses is growing; the BLS projects 45% growth between 2019 and 2029 — a total of 117,770 new jobs.

Frequently Asked Questions

  • How long does it take to become an APRN?

    It takes at least six years of education to become an advanced practice nurse and seven for the DNP option. Some graduate schools and certification boards require or prefer at least one or two years of clinical experience as an RN. A DNP typically requires three years, whereas an MSN takes two.

  • Do APRNs need to earn their doctorate?

    A doctorate is not a degree requirement for any advanced practice nurse role. Some practitioners and organizations advocate for making the DNP the minimum academic degree for advanced practice nurses, but others fear this will further limit the number of APRNs, specifically nurse practitioners, and unnecessarily raise the cost of becoming an advanced practice nurse.

  • What is the highest paying APRN role?

    Nurse anesthetists earn the highest advanced practice nurse salary at a median $174,790 annually. Other than the speciality, factors that affect advanced practice nurse salaries include geography, experience, and type of employer.

  • Is an APRN considered a medical doctor?

    No, APRNs hold either an MSN or a DNP which are nonmedical degrees. An advanced practice nurse with a DNP degree is a doctor of nursing practice but not a medical doctor or physician. In many healthcare settings, only physicians are referred to as doctors.

Resources for APRNs


  • American Nurses Association ANA offers professional education; issues credentials; publishes books, journals, and newsletters; engages in advocacy for nurses and healthcare reform in general; and offers networking opportunities. Full membership is open to RNs, and students and others can join as subscribers.

  • American Association of Nurse Practitioners At 118,000 members, the AANP is the largest professional association for NPs in the United States. It offers professional education, including an annual conference, engages in advocacy, and issues scholarly journals, newsletters, and other publications. Membership is open to NPs, students, retirees, and affiliate members.

  • American College of Nurse-Midwives The ACNM provides professional education, including a conference, publishes newsletters and a journal, promotes the profession of midwifery, and conducts advocacy. Certified midwives and nurse midwives can be full members; students and others can join as nonvoting members.

  • American Association of Nurse Anesthetists The AANA serves approximately 54,000 nurse anesthetists with newsletters and scholarly publications, networking opportunities, professional education in multiple formats, recognition programs, and malpractice insurance offerings. Membership is open to nurse anesthetists and students.

  • National Association of Clinical Nurse Specialists The NACNS offers publications, toolkits, and clinical resources; provides scholarship and awards programs; conducts research on the profession and clinical nursing standards; and engages in advocacy. Membership is open to individuals and institutions.

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Portrait of Nicole Galan, RN, MSN

Nicole Galan, RN, MSN


Nicole Galan, RN, MSN is a registered nurse who started in a general medical/surgical care unit and then moved to infertility care where she worked for almost 10 years. She has also worked for over 13 years as a freelance writer specializing in consumer health sites and educational materials for nursing students. Galan currently works as a full-time freelancer and recently earned her master’s degree in nursing education from Capella University.

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