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Roles in Advanced Nurse Practice

Introduction

Advanced Practice Nursing (APN) are registered nurses who have advanced degrees
allowing them to practice in various nursing specialties. Thanks to their training, they are able to
provide both specialized and primary care to patients. When a registered nurses transitions to
advanced practice nursing, there are four roles they can specialize in. The exact role that one
chooses to specialize in is dependent on many factors such their previous experience and
passion. The transition to advanced nurse practitioner is often challenging but with the right
strategies, it can be done in a smooth manner. This paper looks at the four roles of advanced
nursing practice, why a nurse may choose one of the roles over others, factors affecting the
smoothness of transition, and my plans for clinical practice.
Advance Practice Nurse Roles

There are four advance practice nurse roles. These are Certified Nurse Practitioner
(CNP), Certified Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), and
Certified Nurse Midwife (CNM) (Grant, 2017). All these four roles require one to have, in
addition to a Bachelor’s Degree in Nursing, a Master’s of Science in Nursing or more advanced
education.
Certified Nurse Practitioner (CNP)
These nurses can provide speciality care as well as primary care to patients (Zaccagnini et
al., 2019). Their high level of training means that they can comfortably practice independently
(Zaccagnini et al., 2019). However, when dealing with very complex cases they can collaborate
with doctors to get the best results for the patients.

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They are trained to perform physical examinations, prescribe therapeutic medications and
treatments, order diagnostic tests, and manage various common health conditions (Zaccagnini et
al., 2019). A certified nurse practitioner may choose to provide family health care. Alternatively,
they limit their nursing practice to a given population group such as children or the elderly
(Zaccagnini et al., 2019).
Certified Nurse Midwife (CNW)
CNWs are registered nurses who possess graduate level training in gynecology and
obstetrics (Grant, 2017). Their main focus in training is childbirth. As part of their practice, they
provide to women both prenatal and postpartum care. They also provide labor and delivery
services as well as services related to general primary healthcare of women (Grant, 2017). Their
training also allows them to provide gynecological examinations, preconception care, and family
planning. Their high level of training means that they can independently provide patients with
the needed care. However, when circumstances are unusual, they may consult with a physician to
ensure effective care during pregnancy and safe delivery (Grant, 2017).
Certified Registered Nurse Anesthetist (CRNA)
Anaesthesia is a common practice that millions of patients undergo each year in the U.S.
when they undergo various medical procedures. CRNA’s role is to administer anesthesia which is
a pain management procedure that helps patients undergo otherwise unbearable medical
procedures (Grant, 2017). In addition to administering anesthesia, CRNAs closely monitor
patients from the beginning to the end of the medical procedure so that any complications that
the patient develops are dealt with in a timely manner. Thus, generally CRNAs care for patients
not just before and during medical procedures, but also after the procedures.

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To become a Certified Registered Nurse Anesthetist, one needs to possess a masters
degree obtained from a nurse anesthesia educational program. The program must be accredited
by the council of the accreditation of nurse anesthesia educational programs (Grant, 2017).
Clinical Nurse Specialist (CNS)
CNS’ mainly focus on research, consulting, and education (Zaccagnini et al., 2019).
Using their research, they may advocate for various strategies that may increase quality of care
while reducing costs. They are mainly experts in specific fields of nursing. For instance, they
may be experts in emergency room care or in a particular health condition such as diabetes
management. Apart from dealing with individual patients, they also handle various patient
populations and seek to understand unique factors that act as barriers to effective care for a given
population with a view to addressing it (Zaccagnini et al., 2019). They may perform some basic
nursing practices but generally that is not what they usually do. To become a CNS one needs to
have a minimum of Masters of Science in Nursing (Grant, 2017).
Rationale for Choosing CNP Role

Of the four roles discussed, my choice is Certified Nurse Practitioner (CNP). I choose
CNP because it will allow me to diagnose and treat patients as well as manage various health
conditions of patients. CNM and CRNA perform very specific functions, midwifing in the case
of CNM and anesthetic administration in the case of CRNA. Thus, choosing them will not allow
me to treat different patients and offer them primary care that I would love to. As for CNS, it is
more research and advocacy-oriented rather than general patient treatment. Thus, given my
passion and nursing goals, I believe that CNP best suits me because I want to work directly with
patients suffering from all manner of health conditions.

Plans for Clinical Practice After Graduation

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After graduation I plan to be a family nurse practitioner. I plan to provide both
specialized and primary care for patients from different demographics. Apart from conducting
patient health examinations, I will be diagnosing various patient illnesses and prescribing
medications. Additionally, I plan to be active in providing general health education to various
individuals and population groups. Since CNPs can have private practice, I plan to open my own
facility where I will be carrying out my nursing practice.
Role Transition

Transitioning from a registered nurse (RN) to an advanced nurse practitioner (NP) is
often a difficult step to make. The main factors that determine the smoothness of the transition
are previous RN practice and formal orientation (Barnes, 2015). With regards to RN practice, the
amount of practice does not have much impact on the smoothness of the transition. Instead, it is
the type of the experience. Studies have shown that nurses whose previous RN experience is
similar to their NP practice have a much easier time transitioning than nurses whose previous RN
experience is different from that of their NP practice (Barnes, 2015).
The second factor is formal orientation. It has been found that when nurses are formally
oriented, they experience a quicker and easier transition. Additionally, they achieve more
satisfaction in their new nursing role (Barnes, 2015).
Given these factors, my strategy to ensure that I have smooth transition to NP is to go to a
healthcare facility that practices formal orientation for nurses transitioning from RN to NP.
Secondly, I will specialize in an NP role whose functions closely mirror my RN experience.

Conclusion

Advanced practice nurses play an important role in providing quality healthcare to
patients thanks to their extensive training and education. Many, however, find the transition

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process from an RN to an APN challenging and stressful. With the suggested strategies, the
transition can be smooth and easily manageable.

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References

Barnes, H. (2015). Exploring the factors that influence nurse practitioner role transition. The
Journal for Nurse Practitioners, 11(2), 178-183.
Grant, P. D. (2017). Advanced Practice Nursing. Law for Nurse Leaders, 35.
Zaccagnini, M., & Pechacek, J. M. (2019). The doctor of nursing practice essentials: A new
model for advanced practice nursing. Jones & Bartlett Publishers.