What Is an Advanced Practice Nurse?

Advanced practice nurses (APN) are experienced nurses who have obtained advanced training and certification, often including a master’s degree or a doctorate in nursing. Consequently, APNs often have the opportunity to work in a clinical patient care setting with a high degree of independence and responsibility for patient care within the healthcare system. APNs are often certified to see patients without a doctor, to order diagnostic tests, to make a clinical diagnosis, and to make important medical decisions.

As the healthcare system is changing, more patients are seeing APNs than ever before. According to the American Association of Nurse Practitioners, there are 205,000 nurse practitioners in the United States.

While APNs can work in a variety of clinical settings (including medical offices, hospitals, and nursing homes), most generally practice in one of the following four broad areas:

  • Nurse practitioner (for instance, as primary care practitioners)
    • Nurse practitioners usually see patients in the outpatient setting. You might see a nurse practitioner for your preventative care and for your regular medical check ups. Many patients are assigned to see nurse practitioners as their primary care health providers and many patients prefer to have nurse practitioners as their primary care provider. In this setting, your nurse practitioner health care provider would see you for routine health maintenance and for health problems that may come up from time to time. As part of your preventative care, you will have several medical examination tests. Learn about the different medical tests that assess your stroke-risk. Your primary care provider routinely performs these tests as a part of your regular check ups.
  • Certified nurse-midwives
    • Nurse midwives are nurses who provide prenatal care for expecting mothers throughout pregnancy. In addition to providing prenatal care for mother and baby, nurse midwives often deliver babies as well. Nurse midwives may work in a team composed of both nurse midwives and physicians or they may work in a team of exclusively nurse midwives.
  • Nurse anesthetists
    • Nurse anesthetists work in the surgical operating room, providing patient care during surgery. This includes administering powerful medication to prevent pain during surgery, administering medication to put a patient to sleep during surgery and monitoring vital signs during a surgical operation. Often, after a surgical procedure nurse anesthetists are involved in the immediate post-operative care as well.
  • Clinical nurse specialists
    • Clinical nurse specialists often work as part of a multidisciplinary medical care team. this includes rounding on patients in the hospital and making diagnostic and medical care decisions. Clinical nurse specialists may be general care nurse practitioners, providing a wide range of medical care, or they may be sub-specialized, providing specialized care. Some clinical nurse specialists see patients post operatively in the hospital and in post operative visits after discharge from the hospital. For example, if you have to have a neurosurgical procedure, there is a strong chance that a clinical nurse specialist will be part of your pre operative care team, managing your pre operative testing and procedures and explaining what you need to do before surgery to you and your family. A clinical nurse specialist is also likely to be part of your post operative care team, explaining what you should expect after surgery, helping evaluate you for post operative complications and managing issues such as post operative medications and rehabilitation arrangements.

    If you have a stroke or any other medical problem, there is a strong likelihood that you will see an advanced practice nurse as the lead of your healthcare team or that an advanced practice nurse will be a part of your healthcare team. Indeed, in many leading stroke centers, advanced practice nurses often establish and monitor the clinical processes and procedures that make stroke care efficient and effective. For instance, they often drive the procedures for rapidly identifying a possible stroke victim in the emergency room, begin the process of making a rapid diagnosis, quickly mobilizing the acute stroke care team,  and then assuring that you get the kind of rehabilitation and education you need to recover as fully as possible, and coordinating your care after you go home.

    Edited by Heidi Moawad MD

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