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The Advanced Practice Nursing: Main Roles


The medical field provides clear and concise career paths for nurses that wish to aspire to become better at their jobs by acquiring knowledge and skills necessary to help people in the most complicated of health nurses. The next step from being an RN to becoming an APN involves choosing one of the four main roles that allow for further specialization and excellence. The transition from RN to APN takes time and effort, as well as additional education. The nurse is expected to acquire a master’s degree in the chosen field as well as pass-through rigorous tests to ensure their capability to practice different aspects of specialized medicine. This paper will first cover the four APN roles, the demands for their educational qualifications, and the work environments. It will be followed by my reasoning for choosing the CNP role over others and plans for further clinical practice. Finally, the paper will conclude with the transitioning paragraph from an RN to an APN role.

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Overview of the Four APN Roles

There are four main roles in advanced practice nursing, which include Certified Nurse Practitioners (CNP), Certified Nurse-Midwives (CNM), Clinical Nurse Specialists (CNS), and Certified Registered Nurse Anesthetists (CRNA) (Phillips, 2016). CNPs provide different types of care (primary, acute, specialized) to patients and perform the assessment, diagnosis, and treatment of illnesses and injuries. They can be found in hospitals as well as primary and tertiary care facilities (Phillips, 2016). CNMs specialize in reproductive and gynecological healthcare, as well as primary care for patients (Phillips, 2016). Their work environment constitutes facilities that concern themselves with sexual health and reproduction. CNSs occupy a plethora of different roles in healthcare facilities, ranging from diagnosticians and ongoing treatment managers to organizational and research roles, and are trained to apply evidence-based practices to enhance patient outcomes (Phillips, 2016). They typically find employment in hospitals and similar facilities that allow them to practice EBP. Finally, CRNAs offer specialized anesthetic and pain management skills in treating patients (Phillips, 2016). Their working environment constitutes operation rooms, post-operative care, geriatric facilities, and end-of-life care, among others.

All APNs follow a similar educational preparation, with a specialization towards their chosen role. They have to possess an RN (registered nurse) education and license, must achieve an advanced nursing degree in their chosen specialty, complete a number of clinical hours to put their knowledge into practice, and pass a national certification exam (Phillips, 2016). To practice in different states, APNs need a license from the respective state they work in (Phillips, 2016). The conditions of receiving such vary but typically involve a different exam.

Rationale for Choosing the CNP Role

I have chosen the CNP role for several reasons. First, it is the most ubiquitous role and can fill a variety of positions in almost any organization that specializes in health. That way, I will be able to find employment quicker and closer to home. In comparison, a role like CNM would restrict me to birthing centers and gynecological facilities at a hospital, making many potential work environments unavailable (Phillips, 2016). The second reason is that CNPs get to work closely with the local populations and assist them throughout their lifetime. I feel that continuous and preventative care would allow preventing people from developing serious health issues (Phillips, 2016). A CNM, while considering itself as an important asset of human health, is a more specialized role without the same overall impact. Finally, being a CNP will allow me to help fill the availability gap, as in some regions of the country, qualified healthcare specialists are rare, and isolated communities require a well-rounded specialist (Phillips, 2016). That is something a CNM role could not provide.

Plans for Clinical Practice

After researching the four ANP roles, I realized that NP practice is just the first step of the way and that there is still much room to grow in order to provide patients with the best possible standard of care. A role of an NP is that of a generalist, which can then be molded into one of the four more specialized roles. My plans for clinical practice after graduation would involve working in my chosen field of expertise (CNP) and aspire to increase my skills and knowledge of the field. I may consider applying for a DNP (Doctorate of Nursing Practice). I understand that such a motion would mean a significant commitment, both in terms of time and resources, so I will first work as an ANP for several years in order to prepare myself for that. The reason why I wish to pursue a DNP is that it is a position of great responsibility as well as an influence (Phillips, 2016). I will be able to affect the medical field not only through my medical skills but also through research, advocacy, and networking. Finally, DNP will offer me a degree of expertise that no other course could match.

Transition from RN to ANP

The transition from the RN role to the NP role will likely be difficult, as it will involve switching from a relatively experienced and familiar position of the RN to that of an ANP novice. A couple of negative factors that may impact my transition would be the potential loss of confidence in my abilities as well as issues associated with the autonomous practice. According to Barnes (2015), these are some of the most frequent issues experienced by RNs when transitioning to the NP role. The strategies I will use to ensure a successful transition would involve finding support and learning opportunities in the nursing community and working closely with the instructors at the university to overcome the hurdles of autonomous practice (Barnes 2015). The former will enable me to strengthen my psychological fortitude through positive support and assistance, whereas the latter will offer me the experienced advice of individuals meant to help me deal with the issues of transition.


This paper provided an overview of the 4 ANP roles, which include CNP, CNM, CNS, and CRNA. My rationale for choosing CNP over CNM was because of the opportunities and the greater good that is provided for the populace. The transition from an RN to a CNP will involve taking a master’s degree, acquiring additional hospital hours, and passing various exams. Some of the issues in transition that I foresee include the loss of confidence and problems with autonomous practice, which I plan to overcome using the community resources available to me. After achieving my goal and becoming a CNP, I plan to work for a few years before aspiring for a DNP.

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Barnes, H. (2015). Exploring the factors that influence nurse practitioner role transition. The Journal for Nurse Practitioners, 11(2), 178-183.

Phillips, S. J. (2016). 28th annual APRN legislative update: advancements continue for APRN practice. The Nurse Practitioner, 41(1), 21-48.

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