Nurses at every level play a critical role in the American health care system. Registered nurses (RNs) provide direct patient care, assist with diagnoses, administer treatment, tend to wounds, and more. Nurses with more advanced degrees are often involved in program planning, public outreach, hospital leadership, and of course, training other nurses. Still another critical and growing role in the health care system is played by advanced practice registered nurses, or APRNs.
APRNs are distinguished by a higher level of education and certification, preparing them to play a more central and autonomous role in diagnosing patients and developing treatment plans. As the U.S. health care system grapples with an expected shortage of physicians, APRNs are poised to play an essential role in filling the primary care gap.
In fact, data from the U.S. Bureau of Labor Statistics (BLS) reveals that this is a fast-growing field, offering ample opportunity for nurses who desire to move their careers forward. Specifically, the BLS shows job openings in the field are expected to grow by 45% between 2020 and 2030.
For nurses who wish to enhance their training and experience greater independence in their practice, becoming an APRN may be an appealing career path. To decide if becoming an APRN is a good fit for you, it may be helpful to learn more about the specific APRN salary range, as well as specific career trajectories within this field. You’ll also want to consider the steps involved in becoming an APRN, such as completing a Master of Science in Nursing (MSN).
What Is an APRN?
What is an APRN? Simply put, it’s an RN who furthers their training via the completion of a Master of Science in Nursing or a more advanced degree, such as a Doctor of Nursing Practice (DNP). Due to their more extensive training, APRNs are qualified to assume responsibilities that RNs cannot, including playing a more independent role in assessing, diagnosing, and managing patient challenges. In addition, APRNs can order tests and prescribe medications.
APRN Job Description
There are a number of career paths available under the APRN umbrella, and the job description can vary by employer and setting. Generally speaking, some of the main duties that APRNs take on include:
- Gathering patient medical histories and recording their symptoms and complaints
- Performing physical examinations and patient observations
- Developing new plans for patient care, or building from existing plans
- Ordering or performing diagnostic tests, then interpreting the results
- Implementing treatments and clinical interventions, including prescribing pharmaceuticals
- Evaluating a patient’s response to treatment, adjusting treatment plans as needed
- Collaborating with other health care providers or specialists, as needed
- Counseling patients and their family members, educating them on disease prevention and wellness promotion
The skills of an APRN build on those of an RN, but the two roles are also different because of the APRN’s advanced duties and responsibilities.
APRN Work Environment
Due to the variety of available APRN roles, there are also a number of potential work environments. APRNs may work in any of the following settings.
- Physician offices
- Outpatient care facilities
- Birthing centers
- Addiction treatment centers
- Private industry
Some APRNs work on a travel basis, accepting short-term assignments at different facilities throughout a geographic area. Additionally, some APRNs provide care inside patient homes.
APRN Scope of Practice
One of the most critical concepts in the role of the APRN is scope of practice. Basically, this refers to the extent to which APRNs may practice autonomously, as opposed to working under the supervision of a physician.
APRN scope of practice can vary from state to state. Some states allow APRNs to practice independently, while others require APRNs to have collaborating physicians. State nurse licensing boards set the scope of practice for their area.
Currently, all 50 states allow nurse practitioners and other types of APRNs to prescribe medications, though some states limit an APRN’s ability to prescribe controlled substances.
How to Become an APRN
APRNs are distinguished from RNs by their advanced level of training and certification, qualifying them to perform a more comprehensive role in caring for patients. Learning about how to become an APRN provides a good overview of this advanced training and why APRNs have greater responsibilities.
Earn a Bachelor of Science in Nursing
The first step is ensuring a foundational education in core nursing practices. Earning a Bachelor of Science in Nursing degree (BSN) hones the skills to collaborate with physicians and other nurses, and to administer direct patient care. It’s also an important benchmark, offering qualification to become licensed as an RN.
Obtaining a BSN typically takes four years, though the timeline can vary from full-time to part-time nursing students. Nurses who already have an Associate Degree in Nursing (ADN) may be able to complete their BSN course requirements in just two years.
Pass the NC-LEX Exam
The second step is to sit for the NC-LEX exam. This examination is administered by the state nursing board, and covers core concepts associated with patient care and nursing ethics.
To sit for this examination, it’s first necessary to have a degree from an accredited nursing program. Successful completion of the exam means certification as an RN. After earning RN status, nurses may immediately begin caring for patients within their state of practice.
Gain Professional Experience
Upon earning their RN credentials, nurses who are interested in becoming APRNs are generally advised to practice for a couple of years. This is an opportunity to develop some hands-on clinical care experience and further develop the skills for diagnosing and treating patients.
Hands-on nursing experience can be invaluable for the pursuit of a more advanced degree, and ultimately for practicing as an APRN.
Earn an Advanced Degree
Post-graduate degree programs offer extended opportunities to develop clinical skills and nursing competence.
Most APRNs opt for an MSN, though others may choose to jump straight to a DNP. DNPs are not required for advanced practice nursing jobs, but they can pave the way to higher salaries, leadership positions, and more robust responsibilities.
Earning an MSN can take as little as two years for a full-time student. For those who are attending classes part-time, it may take a bit longer.
Choose a Specialization
APRNs must also choose a specialization, which will dictate the nature of their practice and the type of care they provide. Some of the most common options are certified nurse midwife (CNM), nurse practitioner (NP), clinical nurse specialist (CNS), and nurse anesthetist (CRNA).
Certified Nurse Midwife (CNM)
The nurse midwife’s role is to perform a full range of women’s health care services, spanning the patient’s entire lifespan. The CNM’s duties may encompass gynecological care, family planning, assistance during the childbirth process, postpartum care, and care for newborn babies. This is an outstanding option for nurses who are passionate about working with women and children. CNMs may provide home care, work in hospitals, or work in birthing centers.
Nurse Practitioner (NP)
The most common APRN role is that of the certified nurse practitioner, or NP. NPs can provide direct patient care with a variety of focuses, including primary care, acute care, women’s health, pediatric care, mental health, and more. NPs may provide comprehensive care to their patients, and may work in a wide variety of health care settings. The NP trajectory is popular because it offers much independence, plus opportunities for nurses to refine their field of practice.
Clinical Nurse Specialist (CNS)
The clinical nurse specialist role is often split between direct patient care and clinical research. The CNS may focus on disease prevention and management as well as patient wellness services and education. CNS roles can include private practice, hospital roles, community and population health positions, and more.
Certified Registered Nurse Anesthetist (CRNA)
The certified registered nurse anesthetist, or CRNA, involves a range of services related to anesthesia and anesthesia care, helping to prepare patients for surgery and also guide them through recovery. Most of the time, CRNAs work in hospital surgical suites, though they may sometimes be employed in private practices.
APRN Salary by State
While the typical APRN salary can be higher than that of many RNs, the salary range for an APRN may vary widely according to a number of factors, including specialization, work setting, and state of practice.
Examples of APRN Salary By State
According to the BLS, the median annual salary for an APRN as of May 2021 was $123,780.
BLS data also indicates state-by-state salary expectations for nurse practitioners, in particular. The five states with the highest NP salary levels include:
- California - $151,830
- New Jersey - $137,010
- New York - $133,940
- Washington - $130,840
- Massachusetts - $129,540
In terms of metropolitan areas, the locales that boast the highest nurse practitioner salary ranges include San Jose-Sunnyvale-Santa Clara, California; Napa, California; and Vallejo-Fairfield, California. In fact, the 10 metropolitan areas with the highest NP salaries are all in California. The non-metropolitan areas with the highest pay rates for nurse practitioners include California’s North Valley and North Coast regions, the southeastern part of Minnesota, and middle Georgia.
Other Factors Impacting APRN Salary
In addition to geographic location, there are several other factors that can affect APRN salary expectations. Some of the most significant factors include:
- Education. APRNs who hold higher post-graduate degrees, specifically DNPs, may earn a higher pay rate.
- Experience. Those with additional years of nursing experience can also anticipate higher salary ranges.
- Type of practice. APRNs in some specialties make higher salaries than others, with anesthesia usually being the biggest earner.
Travel APRN Salary
While there are a number of career trajectories available to APRNs, some may be especially noteworthy for nursing professionals who desire something off the beaten path. A great example is the travel APRN role.
Travel APRN Job Description
A travel APRN is simply a certified, advanced practice nurse who works in temporary or non-permanent assignments. Rather than being employed by a single practice, hospital, or facility, travel nurses are usually employed by a nursing agency, which dispatches them to assist at facilities that are short-staffed or overcrowded with patients. Typically, travel APRNs focus on acute care, though some may practice other subspecialties. Most travel APRN assignments last between four and 26 weeks, though the average is 13 weeks.
The basic job description of the travel APRN is to fill gaps in staffing for specific periods of time. According to TravelNursing.com, the most common specialties for travel RNs include:
- Intensive Care Units (ICU)
- Operating Rooms (OR)
- Medical Surgery
- Med-Surg Tele
- Emergency Rooms (ER)
- Progressive Care Units (PCU)
How to Become a Travel APRN
Becoming a travel APRN means fulfilling all of the standard requirements for advanced practice nursing. In other words, the travel APRN must first earn a foundational degree (such as a BSN), become an RN, gain some hands-on clinical experience, graduate with a more advanced degree (such as an MSN), then pass their state’s licensing exam to begin practicing as an APRN.
Beyond these basics, the only requirement for becoming a travel APRN is to gain some additional experience. Most travel nursing agencies desire their APRNs to have at least one full year of experience in the field, though this may vary by position.
Becoming a travel APRN requires flexibility with regard to scheduling, plus a strong desire to experience different positions, organizations, and cultures. An ability to quickly learn the policies, procedures, and technological requirements of a new health system is pivotal, as travel APRNs are usually expected to get up-to-speed pretty quickly.
Travel APRN Salary
APRNs who are interested in travel positions will naturally have some questions about pay. According to data obtained from the compensation website Payscale in August 2022, the annual median travel RN salary was approximately $81,000. According to ZipRecruiter, the average salary in the U.S. for all travel nurses as of August 2022 was $101,317, with travel nurse jobs in Chicago representing the average. Some areas of the country, such as parts of California, showed significantly higher salaries. ZipRecruiter listed the average salary in San Francisco as $116,871.
Nurse Practitioner Salary
The most common role within the APRN field is nurse practitioner. Nurse practitioners typically train and become credentialed in a subspecialty. Three examples include adult gerontology acute care nurse practitioner, family nurse practitioner, and psychiatric mental health nurse practitioner. Consider the responsibilities and salary ranges associated with each of these NP positions.
Adult Gerontology Acute Care Nurse Practitioner
These NPs provide clinical care to adults of all ages, including elderly patients who have geriatric health concerns. Acute care nurse practitioners generally work to treat, diagnose, and manage sudden or severe illness and injury. Adult gerontology acute care nurse practitioners can often be found working in hospital emergency rooms and intensive care units.
According to Payscale in August 2022, the annual median salary for an adult gerontology acute care nurse practitioner was around $96,100.
Family Nurse Practitioner Salary
Family nurse practitioners usually work in a primary care capacity, which can encompass wellness promotion, health education, and disease prevention. A family nurse practitioner may also diagnose and treat acute illness and injury, plus manage more chronic health conditions. Family nurse practitioners usually care for patients of all ages, including children and adults. This is a great role for APRNs who wish to develop ongoing relationships with their patients, and provide care over the course of a patient’s lifetime.
According to data reported by Payscale in August 2022, the annual median salary for a family nurse practitioner was around $98,400.
Psychiatric APRN Salary
Another trajectory for APRNs to consider is the role of psychiatric mental health nurse practitioner. Those who have training to work in this concentration may diagnose and treat patients who suffer from different types of mental health disorders, such as anxiety, depression, trauma, or substance use disorders.
A psychiatric mental health nurse practitioner (PMHNP) may prescribe pharmaceutical interventions and/or refer their patients for talk therapy, inpatient care, and more. In this position, APRNs may work for private practices, inpatient care facilities, or hospitals. Note that to gain this role, obtaining a post-master's certificate (PMC) in psychiatric mental health care is essential; this is one of many PMC careers to choose from.
According to data reported by Payscale in August 2022, the annual median psychiatric APRN salary was approximately $113,600.
Become an APRN and Pursue Your Passion for Helping Others
As the American health system faces an ongoing shortage of qualified physicians, demand for advanced practice nurses is expected to stay strong. If you have a passion for helping others and feel drawn to nursing, or if you’re an RN looking to advance your career, consider a Master of Science in Nursing.
Hawai'i Pacific University’s online Master of Science in Nursing (MSN) program provides an opportunity to acquire the core skills to successfully master patient care and experience a fulfilling career in nursing. At HPU, you can enrich your knowledge of nursing essentials with core courses exploring advanced clinical practice, health care policy and program development, nursing research, and pharmacology, plus choose from three in-demand specializations, including Family Nurse Practitioner.