The four types of Advanced Practice Registered Nurses (APRN), roles, and specialties

Pursuing a career as an advanced practice nurse is fulfilling as you’ll find that APRNs genuinely make a difference in the lives of individuals and their loved ones. The different types of advanced practice nurses are assets to our health care system – providing options, affordability, and lowering wait times for appointments and emergency care. In this role, you support individuals on their health journeys through diagnostics, treatments, and wellness plans for diverse health issues and injuries.

  • NP vs. APRN: Understanding the difference
  • The four types of Advanced Practice Nurses
  • APRN careers at Children’s Minnesota

What is an advanced practice registered nurse? An APRN can provide much of the same patient care as a physician. While there are many APRN types, overall APRN responsibilities include diagnosis, treatment plans, research, and education – and that’s just a start. Depending on their specialization, an advanced practice nurse may treat patients in all life stages, from newborns to elderly adults.

What is an APRN?

What is an APRN in nursing? APRNs have many responsibilities depending on their specialty. Advanced Nurse Practitioners generally diagnose and create a treatment plan for their patients. These may include diagnostic tests, prescribing medications, and follow-up visits.

They work in various settings, from family practices to specialty clinics and hospitals. While researching how to become an APRN, you’ll find multiple specializations, each serving an essential role in the healthcare system.

How to get APRN from RN? An RN requires a bachelor’s degree, whereas an APRN needs graduate-level education such as a master’s degree or doctorate. In addition to an advanced degree, certifications and licensing are required, which may vary from state to state.

Why are advanced practice nurses important – and what does an advanced practice nurse do? The role of an advanced practice nurse is to treat many of the same illnesses and injuries as a primary care physician. This service dramatically improves healthcare access and availability for patients of all ages, from infancy to the elderly, as it reduces overall wait times.

NP vs. APRN: Understanding the difference

What is an advanced practice registered nurse versus a nurse practitioner? Advanced practice registered nurses and nurse practitioners are similar but different healthcare professions. The two terms are often considered interchangeably.

Both are valued in healthcare and assume several responsibilities in treating their patients. Completing nursing school and holding a graduate degree are prerequisites for both. Additionally, both require certifications and additional licensing through the state where the APRN or NP will practice.

But, what exactly are the differences?

  • Nurse Practitioner: A Nurse Practitioner is a type of APRN. NPs typically are primary caregivers and work in health care clinics.
  • Advanced Practice Registered Nurse: There are four specializations in which an APRN may work. APRNs may work in hospitals but can also work as primary healthcare providers.

The Graduate Medical Education team at Children’s Minnesota offers continuing education programs for APRNs, physicians, and assistants.

The four types of Advanced Practice Nurses

How many types of APRNs are there? There are four types of Advanced Practice Nurses.

  1. Nurse Practitioners (NP)
  2. Certified Nurse-Midwives (CNM)
  3. Clinical Nurse Specialists (CNS)
  4. Certified Registered Nurse Anesthetists (CRNA)

Each specialization may have varying job duties, but the advanced practice registered nurse job description generally includes technical and soft skills. These technical skills include education and certifications, not just the equipment and tools used for diagnosis and treatment. Soft skills include clear communication, critical thinking, and decision-making.

Advanced practice nurse roles require several years of APRN schooling regardless of the type. An advanced nursing degree program such as a Master of Science or a Doctor of Nursing Practice is necessary. Once you’ve earned your degree, you’ll move on to the certification exam in your specialization, followed by any license requirements in your state before becoming an APRN.

Nurse Practitioners (NP)

What is advanced practice nursing? The role and responsibilities of advanced practice nurses can vary based on their certification. There are several types of advanced practice nurses:

  • Pediatric Nurse Practitioner (PNP)
  • Neonatal Nurse Practitioner (NNP)
  • Emergency Nurse Practitioner (ENP)
  • Family Nurse Practitioner (FNP)
  • Psychiatric-Mental Health Nurse Practitioner (PMHNP)
  • Adult-Gerontology Nurse Practitioner (AGNP)

One reason APRN roles are attractive is the independence APRNs have in caring for their patients. Many NPs can diagnose and treat patients without the observation of a physician, though this can vary by specialty and state. Let’s take a closer look at each NP specialty.

Pediatric Nurse Practitioner (PNP)

Pediatric nurse practitioners treat infants to young adults. They treat illnesses, conduct physicals, and monitor child development to ensure the child meets age milestones expectations. They also play a crucial role in educating parents on at-home care for illness and injury.

Neonatal Nurse Practitioner (NNP)

Neonatal Nurse Practitioners treat infants at risk due to complications from being premature, heart issues, and many other conditions. Due to the high-risk conditions treated there, most NNPs work in hospitals and outpatient clinics for continuing treatment. In addition, they provide support to parents as they navigate caring for a high-risk child while they’re in inpatient treatment and eventually back at home.

Emergency Nurse Practitioner (ENP)

ENPs work in emergency rooms and urgent care settings, treating minor and traumatic illnesses and injuries. They often work collaboratively with other staff to stabilize and treat patients. Emergency nurse practitioners work in fast-paced and often stressful environments. Due to this, they must be excellent multi-taskers and able to prioritize.

Family Nurse Practitioner (FNP)

FNPs are certified to treat patients of all ages, from children to adults. Much of what family nurse practitioners treat is the same as physicians, from routine physicals to illnesses and injuries. They can write prescriptions and run diagnostics with little to no physician oversight depending on the procedure and varying state laws. FNPs may work in healthcare centers such as doctors’ offices and emergency rooms.

Psychiatric-Mental Health Nurse Practitioner (PMHNP)

A psychiatric mental health nurse practitioner, or PMHNP, treats patients suffering from mental disorders, mental illnesses, and even addiction. In addition, they treat and provide advice to patients with mental afflictions, including depression, anxiety, PTSD, eating disorders, and schizophrenia.

Children’s Minnesota has begun a partnership to provide additional mental health services and support, opening several opportunities for mental health professionals.

Adult-Gerontology Nurse Practitioner (AGNP)

AGNPs work with adults of all ages, but most often, geriatric patients, primarily in outpatient clinics, nursing homes, and hospitals. They treat and educate their patients on chronic health issues like diabetes, heart disease, and arthritis. Their focus is on minimizing the pain and discomfort their patients may experience. Adult-Gerontology Nurse Practitioners often work with their patients long-term and will assist in tasks such as bathing and walking.

Certified Nurse-Midwives (CNM)

Certified nurse-midwives improve the quality and access to women’s healthcare during pregnancy by educating women on family planning and nutrition and providing healthcare and support throughout all stages of pregnancy. Advanced nurse practitioner roles and responsibilities include checkups, prenatal care, and providing support during labor and delivery.

To become a CNM, you must have an advanced degree from a midwifery program and pass the required certification exams. In addition, CNMs impact the lives of their patients through research and education, for example, in Children’s Minnesota’s Children’s Home Application based Monitoring Program.

Clinical Nurse Specialist (CNS)

Clinical Nurse Specialists (CNS) pursue an advanced nursing program, typically a doctoral degree or master’s, and they must become an APRN by passing the required exams. CNSs have a versatile skill set ranging from treating patients to process improvements. Like many APRN roles, they diagnose and treat patients.

Additionally, clinical nurse specialists often use training, consultation, and analysis skills. It isn’t uncommon for a CNS to provide indirect care by contributing to research and improving cost reduction and patient satisfaction in treatment and hospital stays.

Pediatric Clinical Nurse Specialist (PCNS)

A Pediatric Clinical Nurse Specialist focuses primarily on children. They diagnose and treat their young patients while educating and working closely with parents on a treatment plan. Like many other CNS roles, PCNSs’ will take on additional management tasks such as training and identifying areas where hospitals may need process improvement.

Neonatal Clinical Nurse Specialist (NCNS)

Similar to a neonatal APRN role, a neonatal CNS specializes in treating infants that have or are at risk of complications from being premature. However, unlike neonatal nurse practitioners, neonatal clinical nurse specialists contribute to making significant process changes, such as reducing the length of hospital stays and improving treatment plans.

Adult-Gerontology Clinical Nurse Specialist (AGCNS)

An adult-gerontology clinical nurse specialist, or AGCNS, is an advanced practice nurse who cares for adults, particularly aging adults. These specialists treat patients suffering from or at the beginning stages of chronic illness through diagnosis, consultation, and education. Adult-Gerontology Clinical Nurse Specialists will typically work in hospitals and senior living facilities.

To become a CNM, you must have an advanced degree from a midwifery program and pass the required certification exams. In addition, CNMs impact the lives of their patients through research and education, for example, in Children’s Minnesota’s Children’s Home Application based Monitoring Program.

Certified Registered Nurse Anesthetists (CNRA)

Certified Registered Nurse Anesthetists are one of the many advanced nursing specialties. CNRAs are one of the primary anesthesia providers within the United States, particularly in rural areas. Certified Registered Nurse Anesthetists specialize in giving anesthesia to patients in a trauma condition or going into surgery. In this role, they create and advise on an anesthesia plan for each patient.

Learn more about the benefits to working at Children’s Minnesota

Children’s Minnesota, which serves more than 130,000 patients annually, is committed to providing everyone the care and attention they need to be successful in health and in life. We want all who engage with us — patients, families, employees, vendors and community partners — to feel valued, respected and supported.

We know that taking care of the most amazing people starts with taking care of ourselves. Children’s Minnesota offers comprehensive benefits for our employees and their families. Ready to join the team of kid experts?

Liz Burwell