Advice for Nurses Considering an APRN Career

ACNO of Advanced Practice Nursing offers recommendations

By Meredith Lahl-Foxx, MBA, MSN, APRN, PCNS-BC, PPCNP-BC, CPON

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Earlier this year, Cleveland Clinic’s Stanley Shalom Zielony Institute for Nursing Excellence hosted an “Advanced Practice Nursing 101” webchat to educate nurses on the ins and outs of advanced practice nursing.

The chat was tailored to those considering a career path as an advanced practice registered nurse (APRN), and the unique learning opportunity brought about great discussion from participants. Topics included what defines an APRN, APRN roles, licensing and certification, clinical practice and types of jobs available.

Throughout the chat, several specific areas of interest emerged. Participants wanted to know more about:

  • How to choose a program type
  • Graduate program considerations
  • What to do after graduation

The following offers nurses who are considering an APRN career guidance and recommendations on these three common areas of interest.

How to choose a program type

Throughout healthcare, there are opportunities for APRNs in every specialty area imaginable – from emergency and acute care to family medicine or primary care. According to a 2015 Ohio Board of Nursing APRN Workforce Data Summary, some of the most popular APRN specialties are anesthesiology (CRNA), general family practice or primary care, internal medicine, psychiatry, general pediatrics, obstetrics and gynecology, and cardiology. Cleveland Clinic is currently experiencing a growing need for nurse practitioners specializing in acute and express care and a future need in primary care.

Your most important consideration should be selecting an APRN specialty based on the type of patients you enjoy taking care of most. Your specialty should be your passion – the practice area that excites you and allows you to truly excel and be at your best.

Every nurse has had at least one moment in their careers when the pieces just fell in place and all seemed right and comfortable. Every nurse has also had at least one moment when nothing seemed to fit. Before you decide on a specialty area, think about your career experiences and make a list of those that really stand out as positive as well as those that stand out as negative. Look for patterns in your lists and focus your energy on the areas that correlate with your most positive experiences.

Too often, nurses choose an APRN specialty based on factors like work schedules or pay. While these things are certainly important, they likely aren’t the reasons you entered the nursing profession. Chances are, you became a nurse because you have a passion for taking care of people – and your chosen specialty area should reflect that passion.

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Graduate program considerations

Higher education advanced practice nursing programs can be found throughout the U.S. Many are available in traditional as well as online formats and offer various academic points of entry, including options for RN-, BSN-, and MSN-prepared nurses. To date, DNP degrees aren’t required for APRN practice and MSN degrees are the current preferred standard. Most MSN programs require a 2-year commitment, and in that time you will earn your graduate degree and be trained in your APRN specialty.

When looking at graduate programs, first and foremost, only look at programs that are accredited. Attending an accredited nursing school can present numerous added benefits. For example, accredited schools can be a gateway for study in federally funded and state entitlement programs. Additionally, earning a degree from an accredited school allows further education at other accredited schools.

The accrediting body for nurse practitioner programs is the Commission on Collegiate Nursing Education (CCNE), which is recognized by the U.S. Secretary of Education as a national accreditation agency. Another accrediting body is the Accreditation Commission for Education in Nursing (ACEN).

Second, look at program details like flexibility, expected completion timelines, support for clinical placements, and faculty expertise. You will want to ensure that you have the option to attend as a full-time or a part-time student. You never know when your professional or personal course might change so having this added flexibility is important. It’s also helpful if the program provides a roadmap and accompanying expectation for completion so you can prepare, plan and meet your goals as efficiently as possible.

Another key detail to consider is the program’s support of clinical placements. Make sure you know, first, if it supports clinical placements and, second, how it supports them. You’d be surprised at how clinical rotations vary from school to school. To get the most out of your experience and best prepare for your new career, you need comprehensive training. Similarly, you should research program faculty members to determine if they are experienced in their practice areas. For example, has the faculty member teaching the pediatrics course actually worked as a pediatric nurse practitioner?

Another consideration is to look at your undergraduate school – you are already familiar with the school and the teaching style so it might be a good fit. And finally, don’t choose a program simply because it looks like it will be the easiest. Truly consider the quality of the program and how prepared you will be when you graduate and begin independently caring for patients.

What to do after graduation

Most new APRN graduates won’t get their dream job immediately upon graduating. During this transitional time, patience is key. It may be difficult, but if you are able, resist the urge to immediately accept a position just to get a job. Carefully consider where you want to be, the type of workplace you enjoy and what you want to do.

Just like when you graduated from your undergraduate program, keep in mind that the relationships you made throughout your schooling – every clinical experience, every encounter with preceptors and so on – could get you one step closer to landing a great job.

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Also, while you are searching for an ideal job, there are several ways you can prepare for the launch of your new career, including obtaining your national certification and state APRN license.

The American Academy of Nurse Practitioners Certification Program (AANPCP) and the American Nurses Credentialing Center (ANCC) offer nationally recognized certification programs for Certified Nurse Practitioners (CNPs) and Clinical Nurse Specialists (CNSs). Through AANPCP’s exam, CNPs can become certified in adult, family and adult-gerontology specialties. The ANCC exam certifies CNPs and CNSs in roughly 15 specialties, like acute care, adult gerontology, adult psychiatric care, family care and pediatric primary care.

Additionally, certification for Certified Registered Nurse Anesthetists (CRNAs) is available through the National Board of Certification and Recertification for Nurse Anesthetists NBCRNA), and certification for Certified Nurse Midwives can be earned through the American Midwifery Certification Board.

After completing and passing your certification exam, you can apply for your APRN license by following your state’s guidelines for application.

When you do land that first job, keep in mind that feedback a gift. Ask for feedback on your assessments, histories, differential diagnoses and demeanor with patients. Ask those teaching you how you are doing and ask for constructive ways to improve. Feedback will make you a better, stronger and smarter practitioner.

Meredith Lahl-Foxx is the executive director and associate chief nursing officer for advanced practice nursing at Cleveland Clinic.