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A Day in the Life of An Advanced Practice Registered Nurse

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A Day in the Life of an Advanced Practice Registered Nurse (APRN)

Who Are Advanced Practice Registered Nurses? (https://www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf)

Career Profiles

Job descriptions from https://www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf

Certified Registered Nurse Anesthetist

  • Short job descript: Provide anesthesia to patients for pain management during medical operations
  • Long job descript: “The Certified Registered Nurse Anesthetist is prepared to provide the full spectrum of patients’ anesthesia care and anesthesia related care for individuals across the lifespan, whose health status may range from healthy through all recognized levels of acuity, including persons with immediate, severe, or life-threatening illnesses or injury. This care is provided in diverse settings, including hospital surgical suites and obstetrical delivery rooms; critical access hospitals; acute care; pain management centers; ambulatory surgical centers; and the offices of dentists, podiatrists, ophthalmologists, and plastic surgeons”
  • Pay: $91,000 – $181,000 a year (http://www.payscale.com/research/US/Certification=Certified_Registered_Nurse_Anesthetist_%28CRNA%29/Salary)
  • Employment: 35,430 (http://www.bls.gov/oes/current/oes291151.htm)

Certified Nurse Midwife

  • Short job descript: Assist women throughout the course of a pregnancy, from conception to childbirth
  • Long job descript: “The certified nurse-midwife provides a full range of primary health care services to women throughout the lifespan, including gynecologic care, family planning services, preconception care, prenatal and postpartum care, childbirth, and care of the newborn. The practice includes treating the male partner of their female clients for sexually transmitted disease and reproductive health. This care is provided in diverse settings, which may include home, hospital, birth center, and a variety of ambulatory care settings including private offices and community and public health clinics”
  • Pay: $51,000 – $109,000 (http://www.payscale.com/research/US/Job=Nurse_Midwife/Salary)
  • Employment: 5,460 (http://www.bls.gov/oes/current/oes291161.htm)

Clinical Nurse Specialist

  • Short job descript: Promote health and prevent illness at an advanced level
  • Long job descript: “The CNS has a unique APRN role to integrate care across the continuum and through three spheres of influence: patient, nurse, system. The three spheres are overlapping and interrelated but each sphere possesses a distinctive focus. In each of the spheres of influence, the primary goal of the CNS is continuous improvement of patient outcomes and nursing care. Key elements of CNS practice are to create environments through mentoring and system changes that empower registered nurses to develop caring, evidence-based practices to alleviate patient distress, facilitate ethical decision-making, and respond to diversity. The CNS is responsible and accountable for diagnosis and treatment of health/illness states, disease management, health promotion, and prevention of illness and risk behaviors among individuals, families, groups, and communities.”
  • Pay: $62,000 – $111,000 (http://www.payscale.com/research/US/Job=Clinical_Nurse_Specialist_%28CNS%29/Salary)
  • Employment: 69,017 (http://www.nacns.org/html/cns-faqs1.php as part of http://www.nacns.org/html/cns-faqs.php) **NOTE: I’m not a fan of this resource, but the BLS lumps CNS workers with RNs, making the stats over 2.6 million and highly inaccurate

Certified Nurse Practitioner

  • Short job descript: Provide advanced healthcare servants to patients, like diagnosing illnesses or prescribing medication
  • Long job descript: “For the certified nurse practitioner (CNP), care along the wellness-illness continuum is a dynamic process in which direct primary and acute care is provided across settings. CNPs are members of the health delivery system, practicing autonomously in areas as diverse as family practice, pediatrics, internal medicine, geriatrics, and women’s health care. CNPs are prepared to diagnose and treat patients with undifferentiated symptoms as well as those with established diagnoses. Both primary and acute care CNPs provide initial, ongoing, and comprehensive care, includes taking comprehensive histories, providing physical examinations and other health assessment and screening activities, and diagnosing, treating, and managing patients with acute and chronic illnesses and diseases. This includes ordering, performing, supervising, and interpreting laboratory and imaging studies; prescribing medication and durable medical equipment; and making appropriate referrals for patients and families. Clinical CNP care includes health promotion, disease prevention, health education, and counseling, as well as the diagnosis and management of acute and chronic diseases. Certified nurse practitioners are prepared to practice as primary care CNPs and acute care CNPs, which have separate national consensus-based competencies and separate certification processes”
  • Pay: $63,000 – $102,000 (http://www.payscale.com/research/US/Job=Nurse_Practitioner_%28NP%29/Salary)
  • Employment: 113,370 (http://www.bls.gov/oes/current/oes291171.htm)

Percentages (calculated by adding employment totals from above and dividing for each career – total = 223,277)

  • Nurse practitioner = 51%
  • Clinical nurse specialist = 31%
  • Nurse anesthetist = 16%
  • Nurse midwife = 2%

Specialties (https://www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf)

Introduce it with something along the lines of “Explore your options…”

  • Adult-Gerontology
  • Family Nursing
  • Pediatrics
  • Neonatal
  • Women’s Health
  • Mental Health

Career Training + Cost of Education

  • Master of Science in Nursing or Doctorate of Nursing Practice
  • 2-6 years of graduate-level education
  • Up to 10 years total education (including bachelor’s degree)
  • Average cost of graduate tuition and fees = $14,537 (http://nces.ed.gov/programs/digest/d10/tables/dt10_348.asp)
  • Using the number above, a master’s degree in nursing would cost $29,074, and a doctorate would cost up to $87,222
  • If you want to add in the bachelor’s degree price for those, use $19,339 per year (http://nces.ed.gov/fastfacts/display.asp?id=76). Over four years, that would add $77,356 to your total

GOOD FACTS TO TIE INTO THIS

  • The average doctoral graduate in the country earns twice as much as someone with an associate’s degree ($777 per week vs. $1623 = 209%)
  • Someone with a master’s degree is likely to earn nearly 20% more than someone with a bachelor’s degree (1108 per week vs. 1329 = 119.9%)
  • People with doctorates earn 3 1/2 times what people with just a high school diploma earn (472 vs 1623 = 344%)

Job Outlook (http://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm#tab-6)

  • Overall, APRNs are supposed to grow by 31% between 2012 and 2022
  • Nurse practitioners are projected to grow by 34%
  • Nurse midwives, 29%
  • Nurse anesthetists, 25%

Number of APRN Licenses in the Country (https://www.ncsbn.org/14_2012_2013_NCLEXExamStats_vol61.pdf)

***NOTE: This is not active employees, just active licenses

  • Nurse midwife: 8,125
  • Nurse anesthetist: 48,196
  • Nurse specialist: 14,400
  • Nurse practitioner: 173,865
  • TOTAL: 245,606

States with the Most Nurse Practitioners (http://www.bls.gov/oes/current/oes291171.htm)

  • New York: 9,610
  • California: 9,200
  • Texas: 6,690
  • Florida: 6,240
  • Massachusetts: 4,700

States with the Best Pay Rates for NPs (http://www.bls.gov/oes/current/oes291171.htm)

  • Alaska: $53.75 hour, $111,800 year
  • California: $53.17 hour, $110,590 year
  • Oregon: $51.71 hour, $107,560
  • Hawaii: $51.33 hour, $106,770
  • Massachusetts: $50.48, $105,010

States with most Doctorate of Nursing Practice Programs (http://www.nln.org/researchgrants/slides/pdf/AS1112_T02.pdf)

  • Pennsylvania: 30
  • New York: 27
  • Texas: 22
  • Massachusetts: 22
  • Illinois: 21
  • TOTAL FOR ALL STATES: 447 doctorates, 504 master’s