APRN Advantages And Disadvantages

Mary has decided that she does not want to pursue a career in administration, as she would prefer more patient contact than an administrative role typically provides. Since Mary is prepared to continue her formal education and pursue a graduate degree, selecting which one of the four Advanced Practice Registered Nurse (APRN) roles would be the best fit, is Mary’s next step.
All of the APRN roles; Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), Certified Nurse Midwife (CNM), and Nurse Practitioner (NP) require a master’s, or doctoral degree as well as specialization in a specific population such as family, adult-gerontology, pediatrics, women’s health, or mental health, and or setting such as oncology, critical

care, or emergency department. Comparing the advantages, disadvantages, and functions of each role will assist Mary in making an informed decision regarding her graduate program (DeNisco & Barker, 2015; McClelland, 2014).
A CNS is an expert clinician who provides direct patient care within a specialty area such as cardiology, critical care, or oncology (McClelland, 2014).

Advantages: Possessing a broad scope of knowledge, CNSs are employed in a variety of health care settings, and sometimes act as educators, case managers, researchers, and quality improvement project managers (Foster & Flanders, 2014). There is no additional licensing requirement for CNSs (DeNisco & Barker, 2015).
Disadvantages: CNSs typically practice within a single specialty area such as cardiology or oncology, (McClelland, 2014). Because the CNS role lacks a clear definition, and due to their depth of knowledge, a CNS who would rather provide direct patient care may find themselves thrust into the role of an educator or quality improvement project manager (DeNisco & Barker, 2015; Foster & Flanders, 2014; McClelland, 2014).
CRNAs provide anesthesia to patients undergoing surgery in a variety of healthcare settings including hospitals and outpatient surgical centers (DeNisco & Barker, 2015; McClelland, 2014).
Advantages: CRNAs are independent autonomous practitioners and usually report high job satisfaction (DeNisco & Barker, 2015; McClelland,

2014).
Disadvantages: CRNAs are not primary care providers, and work in technical, high stress environments (McClelland, 2014). Additionally, critical care experience is required for acceptance into a CRNA program (Brassard & Summers, 2013).
CNMs specialize in women’s health, including well-woman visits, prenatal care, labor, and delivery, post-partum care, and newborn care up to 28 days (Brassard & Summers, 2013; McClelland, 2014).

Advantages: CNMs are independent, autonomous, primary care providers with prescriptive authority. CNMs practice is a variety of setting including hospitals, private practices, and home deliveries (Brassard & Summers, 2013; McClelland, 2014).
Disadvantages: Labor and delivery experience is a prerequisite for acceptance into some CNM programs (McClelland, 2014). CNMs are highly specialized, delivering care to a very specific patient population.
NPs provide both primary and acute care with a focus in a practice area such as family practice, pediatrics, or adult-gerontology, and are employed in a variety of settings including hospitals, clinics, and long-term care facilities (McClelland, 2014).
Advantages: NPs are independent, autonomous practitioners with prescriptive authority, and are not constrained to a single specialty area, or healthcare setting (Brassard & Summers, 2013; McClelland, 2014). The shortage of primary care providers is expected to continue, increasing the demand for NPs (Barnes, 2015; DeNisco & Barker,

2015).
Disadvantages: The transition from bedside nurse performing direct patient care to the NP prescribing patient care is difficult for some nurses, especially those with lengthier bedside experience (Poronsky, 2013).
The decision Mary has to make is similar to the decision that I had to make prior to entering graduate school. Like Mary, I too was not ready to give up regular patient contact; therefore, I eliminated the role of CNS, since there is a good possibility of being diverted into a quality improvement, research, or education position. CRNAs and CNMs are both independent and autonomous practitioners; however, both are highly specialized in terms of patient population and/or role. In my estimation, the role of NP offers the most versatility in practice setting and patient population, guarantees continued patient contact, and allows for the provision of a wide range of services in both primary and acute care.