2017 Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners
Median Pay: US$104,740
Entry Level: Master's degree
Summary
Nurse anesthetists, nurse midwives, and nurse practitioners, also referred to as advanced practice registered nurses (APRNs), coordinate patient care and may provide primary and specialty healthcare. The scope of practice varies from state to state.
Duties

Advanced practice registered nurses typically do the following:

  • Take and record patients' medical histories and symptoms
  • Perform physical exams and observe patients
  • Create plans for patients' care or contribute to existing plans
  • Perform and order diagnostic tests
  • Operate and monitor medical equipment
  • Diagnose various health problems
  • Analyze test results or changes in a patient's condition, and alter treatment plans, as needed
  • Give patients medicines and treatments
  • Evaluate a patient's response to medicines and treatments
  • Consult with doctors and other healthcare professionals, as needed
  • Counsel and teach patients and their families how to stay healthy or manage their illnesses or injuries
  • Conduct research

APRNs work independently or in collaboration with physicians. In most states, they can prescribe medications, order medical tests, and diagnose health problems. They may provide primary and preventive care and may specialize in care for certain groups of people, such as children, pregnant women, or patients with mental health disorders.

Some APRN duties are the same as those for registered nurses, including gathering information about a patient's condition and taking action to treat or manage the patient's health. However, APRNs are trained to perform many additional functions, including ordering and evaluating test results, referring patients to specialists, and diagnosing and treating ailments. APRNs focus on patient-centered care, which means understanding a patient's concerns and lifestyle before choosing a course of action.

APRNs also may conduct research or teach staff about new policies or procedures. Others may provide consultation services based on a specific field of knowledge, such as oncology, which is the study of cancer.

The following are types of APRNs:

Nurse anesthetists (CRNAs) provide anesthesia and related care before, during, and after surgical, therapeutic, diagnostic, and obstetrical procedures. They also provide pain management and some emergency services. Before a procedure begins, nurse anesthetists discuss with a patient any medications the patient is taking as well as any allergies or illnesses the patient may have, so that anesthesia can be safely administered. Nurse anesthetists then give a patient general anesthesia to put the patient to sleep so they feel no pain during surgery or administer a regional or local anesthesia to numb an area of the body. They remain with the patient throughout a procedure to monitor vital signs and adjust the anesthesia as necessary.

Nurse midwives (CNMs) provide care to women, including gynecological exams, family planning services, and prenatal care. They deliver babies; manage emergency situations during labor, such as hemorrhaging; repair lacerations; and may provide surgical assistance to physicians during cesarean births. They may act as primary care providers for women and newborns. Nurse midwives also provide wellness care, educating their patients on how to lead healthy lives by discussing topics such as nutrition and disease prevention. Nurse midwives also provide care to their patients' partners for sexual or reproductive health issues.

Nurse practitioners (NPs) serve as primary and specialty care providers, delivering advanced nursing services to patients and their families. NPs assess patients, determine the best way to improve or manage a patient's health, and discuss ways to integrate health promotion strategies into a patient's life. They typically care for a certain population of people. For instance, NPs may work in adult and geriatric health, pediatric health, or psychiatric and mental health.

Although the scope of their duties varies some by state, many nurse practitioners work independently, prescribe medications, and order laboratory tests. All nurse practitioners consult with physicians and other health professionals when needed.

See the profile on registered nurses for more information on clinical nurse specialists (CNSs), also considered to be a type of APRN.

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