Choosing your advanced practice nursing specialty

Nurse practitioners, nurse midwives and nurse anesthetists, also referred to as advanced practice registered nurses (APRNs), are registered nurses prepared with at least a master’s-level education and certified by a nationally accredited exam to provide primary or specialty care for a specific population.

This powerful and growing force in the U.S. health system is educated and certified to assess, diagnose and treat illnesses and injuries; order and interpret diagnostic tests; educate patients and families on preventive care and health issues; coordinate care to ensure the best outcomes for patients and, in some states, prescribe medications.

With many options available, how do you choose the advanced-practice nursing specialty that’s right for you? Here are three things to consider to help narrow your choices.

Do you want to work with adults, children or both? Do you want to work mostly with women or with infants? Do you want to focus on treating patients with mental health and addiction disorders? Your answers to these questions offer pivotal insight into determining which advanced-practice specialty would provide the best career path for you.

APRNs focus their education and clinical preparation on one of six populations:

• Adult-gerontology (age 13 through end of life)
  
• Family (birth through end of life)
  
• Neonatal
• Pediatrics
• Psychiatric mental-health
• Women's health/gender-related

If you know you don’t want to work with patients younger than 13, for instance, you can eliminate the family, neonatal and pediatric populations, which require clinical experience with children or infants to maintain certification in the field.

Do you want to work in a hospital setting, especially in an emergency department or intensive care unit (ICU), treating patients with severe illness, injury or trauma? Or, would you rather work in a primary-care focused setting? Determining where you want to work also serves as an important factor in your decision.

Adult-gerontology acute care, pediatric acute care and neonatal nurse practitioners and certified nurse anesthetists, typically work in hospital-based settings or hospital outpatient clinics and are prepared to provide critical care procedures. Adult-gerontology acute care nurse practitioners, for example, can perform suturing, lumbar punctures, establish emergency airways and place chest tubes and central lines.

By contrast, family, adult-gerontology primary care and women’s health nurse practitioners and nurse midwives typically work in community-based settings, such as physician practices. Additional settings based on specialty and population focus include retail clinics, long-term care facilities, dermatology, oncology or women’s health specialty clinics that do not provide critical care. These APRNs diagnose and manage common and complex conditions and focus on disease prevention and education.

It’s important to note that, while some hospitals still hire primary care nurse practitioners, namely to work in emergency department settings, many organizations require nurses to obtain acute care nurse practitioner certifications. This is because primary care nurse practitioners are not certified to perform life-saving procedures that acute care nurse practitioners can perform.

APRNs must receive graduate-level education and training by earning a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP), the terminal or highest-level practice-focused degree, in their specialty.

Master’s-prepared advanced-practice nurses receive fully adequate education and hands-on experience in their specialty to offer the kind of safe, quality, affordable and accessible care that’s in high demand across the nation. The DNP builds on traditional master’s programs to include instruction in evidence-based practice, quality improvement and systems leadership.

What benefits does a DNP offer? It allows nurses to more easily move up in health care administration and opens doors to academic positions at all levels of nursing education. It also serves to differentiate nurses in larger job markets.

On a broader level, other health professions – medicine, dentistry, pharmacy, psychology, physical therapy, audiology – require doctoral-level education, and nursing continues to move in this direction, which means the DNP could soon become the standard for advanced-practice nurses.

Take this short quiz to point you to the right advanced practice nursing specialty program for you at the University of Cincinnati College of Nursing.

Though nurse anesthetists are considered advanced-practice nurses, our Nurse Anesthesia DNP program is not included in this quiz. To learn about the nurse anesthesia specialty, visit our Nurse Anesthesia program page.