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Advanced Specializations in Nursing

When it comes to nursing, one size certainly does not fit all. Nurses can pursue different types of advanced studies and programs that allow them to specialize in a number of different topic areas.

Advanced practice registered nurses (APRNs) undergo intensive training and perform many of the same duties as physicians and registered nurses (RNs). State licensure boards credential four types of nurses as APRNs: nurse anesthetists (CRNAs), nurse midwives (CNMs), nurse practitioners (NPs), and clinical nurse specialists (CNSs). APRNs need a master of science in nursing (MSN) or higher, along with an RN license. Most states require national certification in a specialty area.

CRNAs anesthetize patients prior to surgery and procedures. They also provide care during and after surgery, such as managing pain and monitoring vital signs. CNMs care for women throughout pregnancy and labor, often as primary maternity services providers. NPs function as primary and specialty care providers for a particular patient population. NP specialties include gerontology, pediatrics, and psychiatric health. CNSs also specialize and provide direct patient care. They may educate and advise other nurses and medical professionals.

To learn more about APRNs, visit this website.


Accrediting Bodies for APRN SpecializationsAPRN Specialties
Frequently Asked QuestionsTypes of Nurse Practitioners

Accrediting Bodies for APRN Specializations

See below for professional organizations that confer accreditation according to APRN educational fields. Accreditation signifies that a nursing program adheres to quality standards. Graduates from unaccredited schools cannot take the exam to become licensed RNs.

Council on Accreditation of Nurse Anesthesia Educational ProgramsRecognized by the U.S. Department of Education (ED) and the Council for Higher Education Accreditation (CHEA), COA accredits graduate programs in nurse anesthesia. COA also accredits postgraduate fellowships for CRNAs and maintains a searchable database of its accredited programs. COA posts position papers and FAQs relevant to students.

Accreditation Commission for Midwifery EducationRecognized by the ED, ACME assures that the programs it accredits prepare students to take the American Midwifery Certification Board (AMCB) exam and to become CNMs. ACME also provides accreditation resources for midwives and midwifery students, including training webinars and online workshops. Its affiliate, American College of Nurse-Midwives, offers continuing education (CE) and advocacy.

Commission on Collegiate Nursing EducationCCNE accredits nursing programs at all levels, including programs relevant to APRNs. These consist of master’s and doctoral programs, postgraduate certificates, and postgraduate residencies. Recognized by the ED, CCNE provides accreditation information, such as webinars and videos, along with a database of accredited programs.

Accreditation Commission for Education in NursingACEN accredits nursing education at all levels, including transition-to-practice programs. The commission hosts an annual conference for nursing administrators, faculty, and students with networking opportunities and information on contemporary nursing education. The group also sponsors a lifetime achievement award for nursing education, practice, or accreditation.

American Association of Nurse PractitionersAANP accredits NP CE activities with the designation as an AANP-Approved Provider. Approved individuals or groups demonstrate competency in creating and administering CE activities. AANP’s website lists its approved providers and offers educational, networking, and professional development opportunities for NPs and students in NP programs.

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Frequently Asked Questions about Advanced Practice Nurses

  • What is an advanced practice nurse (APN)?

    APNs work as CNMs, CNSs, CRNAs, and NPs. They hold state licenses as APRNs and national certification in their APRN specialties. These medical professionals undergo rigorous education and training programs and often perform the same duties as physicians.

  • Can APRNs prescribe medication?

    Yes. All states allow APRNs to prescribe medication, but their prescriptive authority varies by state. Some states allow full authority, while others restrict or reduce the ability to prescribe. In most restricted and reduced authority states, APRNs can only prescribe medication under a collaborative agreement with their supervising physician.

  • How much do APRNs make?

    Nurse practitioners, anesthetists, and midwives earned a median annual wage of $113,930 in 2018, according to the Bureau of Labor Statistics. CRNAs brought in significantly more money ($167,950) than other APRN specialties. CNS median salaries average $71,730, with CNSs in California earning the most with an annual mean wage of $106,950.

  • What is an APRN versus a physician assistant (PA)?

    While APRNs and PAs often work side by side, the two fields differ in terms of their training methods. APRNs train as nurses under a patient-focused model that takes a holistic and preventative approach to patient care. PAs complete a medical-based education that focuses on treating physical symptoms of diseases and injuries.

  • How do I become an APRN?

    APRNs earn an associate or bachelor’s degree in nursing and test for their state RN licenses, after which they obtain their MSN in their chosen specialty. Following program completion, they apply for APRN licenses and national certification in anesthesia, midwifery, or one of the NP specialties.

APRN Specialties

  • Clinical Nurse SpecialistCNSs improve healthcare delivery through direct patient care, training other nurses and advocating for the profession. They often specialize in one of eight patient populations, such as children, adults, or the elderly. Once learners complete a master’s program, they can sit for a certification exam from the American Nurses Credentialing Center (ANCC).
  • Certified Registered Nurse AnesthetistCRNAs perform many of the same tasks as anesthesiologists, including caring for patients before and after a procedure or surgery, maintaining and monitoring levels of anesthesia during the procedure, and pain management. CRNAs need a master’s degree or higher. They can take the National Board of Certification & Recertification for Nurse Anesthetists exam.
  • Certified Nurse Midwife:NMs focus on women’s reproductive health, prenatal care, labor and delivery, and perinatal care. Along with delivering babies, CNMs perform annual exams, counsel patients, and prescribe medications. CNMs hold master’s or doctoral degrees in nursing, along with credentials from the AMCB upon passing an examination.
  • Nurse PractitionerNPs can specialize in one of several areas, including emergency nursing, family care, gerontology, neonatology, and pediatrics. As primary and acute care providers, they perform many of the same job duties as physicians. NPs earn a master’s degree or higher and obtain certification from the applicable specialty nursing board.

Types of Nurse Practitioners

Types of NPs include primary, acute, and emergency care providers. The list below features NP specialties in which the ANCC offers certification, such as neonatal, psychiatric, and women’s health nursing. Additional credentialing boards certify critical-care nursespediatric nurses, and other NP fields. 

  • Acute Care Nurse Practitioner

    These NPs specialize in either pediatric or adult populations. Their work involves stabilizing and treating patients during medical emergencies.

  • Adult Gerontology Nurse Practitioner

    Working with two subgroups — adults and the elderly — these NPs address health conditions through assessment, diagnosis, treatment, and health maintenance and promotion. They may also provide referrals to other specialists as needed.

  • Emergency Nurse Practitioner

    NPs who staff emergency rooms provide primary care for patients with acute and critical illnesses, injuries, trauma, and other urgent care conditions. They generally work with all patient populations.

  • Family Nurse Practitioner

    FNPs work with patients of all ages as primary care providers, conducting examinations, ordering lab tests, designing treatment plans, and counseling patients on health promotion and disease prevention.

  • Neonatal Nurse Practitioner

    These professionals care for high-risk infants who were born prematurely or suffer from such problems as birth defects, cardiac malformations, chronic conditions, surgery complications, and infections.

  • Pediatric Nurse Practitioner

    This NP specialty consists of two practice subareas: acute care and primary care. Acute care specialists treat children with chronic or critical illness. Primary care pediatric NPs provide childrens’ physicals, immunizations, and health education for families.

  • Psychiatric Mental Health Nurse Practitioner

    PMHNPs help patients with mental illness and psychiatric disorders through assessment and evidence-based treatment therapies from various medical fields, including medication, psychotherapy, intervention, and education.

  • Women's Health Nurse Practitioner

    Focusing on women’s gynecological and reproductive health, these WHNPs advise patients on promoting and maintaining health, treat healthcare concerns, provide prenatal and postpartum care, and address menopausal issues.

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