APRN Career Overview

How long to become: 6 to 8 years Median annual wage: $132,050 (BLS, May 2024) Job outlook (2024 to 2034): 35% growth (BLS)

What Does an APRN Do?

An advanced practice registered nurse (APRN) sits between an RN and a physician in training, autonomy, responsibility, and pay. The role requires an MSN, and certification is required in most states.

APRNs diagnose and treat conditions and prescribe medications. In some states they must work under or in collaboration with a physician. They often supervise RNs.

Primary responsibilities:

• Serving as a primary care provider and educating patients
• Diagnosing conditions, ordering treatment, and managing disease
• Overseeing staff, including RNs

Key skills: empathy, a habit of continual learning, sound decisions under pressure, scientific aptitude, and strong communication.

Where Do APRNs Work?

Depending on specialty, APRNs work in hospitals, private physician offices, birth centers, surgical centers, clinics, or residential care.

Private practices: acting as a primary care provider, diagnosing and treating conditions, and supervising RNs.

Hospitals: administering medication, leading nursing departments, and diagnosing and treating conditions.

Outpatient facilities: providing primary care services as part of the healthcare team.

How to Become an APRN

You need an RN license, a graduate nursing degree, and, in most states, national or state certification. Most graduate programs want RN experience first. Specifics vary by state and certifying board.

1. Earn a BSN. Some graduate schools offer bridge programs combining BSN and MSN study for ADN holders.
2. Pass the NCLEX-RN for RN licensure. The exam takes up to six hours and covers the clinical situations nurses encounter.
3. Gain clinical experience while exploring specialties. Entry-level specialty roles usually include on-the-job training, and many graduate programs prefer at least one year of clinical experience.
4. Apply to an MSN-APRN or doctoral program. Master's programs run about two years; a doctor of nursing practice (DNP) runs three to four. Some specialties, such as certified registered nurse anesthetist (CRNA), require a board-certified program. Admission usually wants a GPA of at least 3.0, a personal statement, and recommendations.
5. Graduate with an MSN or DNP. Only the MSN is required to sit for licensing and certification exams, but academic medical centers and teaching jobs often prefer a DNP.
6. Earn certification from an approved specialty board. Requirements typically include an unencumbered RN license, an application, and academic records. Certification is often required before you apply for the APRN license.
7. Apply for state licensure. This may include background checks and verification of education and clinical hours.

What Is the Average APRN Salary?

APRN pay varies by specialization, experience, education, and certification, and it runs well above the national average annual wage of $49,500. The highest-paid specialization is nurse anesthetist, averaging $223,210 a year. Nurse practitioners average $129,210. The median for all APRNs is $132,050 (BLS, May 2024).

Demand is climbing: BLS projects 35% growth for the APRN occupation between 2024 and 2034.

APRN versus RN

APRN:

• High autonomy; practices independently in most states, with limited physician supervision in others
• Diagnoses conditions and orders treatment
• Prescribes medications, including controlled substances
• Minimum six years of college with a master's in nursing
• Requires education and certification beyond the RN

RN:

• Limited autonomy; practices under a physician or APRN
• Cannot diagnose or prescribe; carries out the treatment plan
• Minimum two years of college with an associate degree
• Requires an RN license; can be entry-level

APRN versus Nurse Practitioner

A nurse practitioner is one type of APRN. An APRN holds at least an MSN in an APRN specialty. The four main roles are nurse practitioner, certified nurse midwife, certified registered nurse anesthetist, and clinical nurse specialist. Every NP is an APRN, but not every APRN is an NP.

NPs are independent and organized, and often work closely with the same patients and families for years. Many specialize further by population, such as women, infants, or adults across the lifespan.

	Nurse Practitioner	Advanced Practice Nurse (APRN)
Education	MSN required now; a DNP may be required in the future.	At least a master's degree to sit for an APRN specialization exam.
Typical duties	Take health histories; assess, diagnose, and treat acute and chronic illness, often as primary care provider; refer for specialized care.	Vary by specialization. Nurse midwives focus on women's health; nurse anesthetists work mainly in surgical settings.
Prescribing	Yes, with medication types and supervision set by state law.	Some, not all, depending on specialization and state.
Common settings	Private practice, ambulatory clinics, long-term care, community clinics.	Any setting, including hospitals, private practice, and long-term care, plus education and policy roles.
Licensing and certification	Available through the ANCC and the AANP. Nurses must also register with their state board.	NP and clinical nurse specialist certification through the ANCC; nurse anesthetists through the NBCRNA; nurse midwives through the American Midwifery Certification Board.
Continuing education	AANP recertification every five years requires 1,000 clinical hours and 75 contact hours relevant to the NP's focus. ANCC recertification every five years requires 150 continuing education hours, with at least 51% related to focus and at least 25 hours in pharmacotherapeutics.	Depends on specialization; recertification involves clinical and classroom work in that specialty.
Population focus	Adult-gerontology acute and primary care, psychiatric mental health, family health, neonatal, pediatric acute and primary care, women's health.	Four main roles: CRNA, certified nurse midwife, clinical nurse specialist, and NP. Clinical nurse specialists often focus on pediatric or adult-gerontology populations.
Collaboration	Some states require collaborative agreements with physicians; depends on state.	Collaborate with nurses, physicians, and administrators; have more autonomy in full-practice-authority states.

Resources for APRNs

The American Nurses Association (ANA) offers professional education, credentials, publications, advocacy, and networking. Full membership is open to RNs; students can join as subscribers.

The American Association of Nurse Practitioners (AANP), at 118,000 members, is the largest NP association in the country, offering education, an annual conference, advocacy, and publications.

The American College of Nurse-Midwives (ACNM) provides education, a conference, publications, and advocacy for the midwifery profession.

The American Association of Nurse Anesthesiology (AANA) serves around 54,000 nurse anesthetists with publications, networking, education, recognition programs, and malpractice insurance.

The National Association of Clinical Nurse Specialists (NACNS) offers publications, toolkits, clinical resources, scholarships, research, and advocacy.

Frequently Asked Questions

How long does it take? At least six years, and seven for the DNP route. Many programs prefer one to two years of RN experience first.

DNP versus MSN timeline? A DNP typically takes three years; an MSN takes two.

Is a doctorate required? Not for most APRN roles. The exception is nurse anesthesia, where the minimum is a DNP or doctor of nurse anesthesia practice. Some groups support making the DNP the minimum for all APRNs, though others worry that would limit the supply of NPs and raise the cost of entry.

Which APRN earns the most? Nurse anesthetists, at a median of $183,580 a year. Beyond specialty, geography, experience, and employer type drive pay.

Are APRNs doctors? No. An APRN holds an MSN or DNP, which are nonmedical degrees. A DNP holder is a doctor of nursing practice, not a physician.