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There are vast differences between practicing as a staff nurse, whether specialized or not, vs. practicing as an APN.  The question of how to communicate differences in nursing roles and educational preparation reminds me of similar questions within nursing in the 1980’s.  At that time there was controversy between 2 and 4 year programs about what level of educational preparation was necessary for professional nursing.  There were many who argued that the practical, skills based education was adequate, yet others insisted the BSN program be the basic preparation for professional nursing.   

     The conversation about practical, skills based knowledge of the 2 year RN program vs. the broader vision and theoretical training of the 4 year BSN program is somewhat analogous to the knowledge base of specialty nursing vs. APN.  The specialty trained nurse gains knowledge through experience and with specific individual patients in a clinical setting. This nurse works in an acute care setting with implementing and evaluating specific interventions within a medical model of care.  There is no requirement for further formal education and, like APN; the credentialing is done by a national organization, such as the Medical Surgical Nursing Certification Board (MSNCB).  There is no additional regulation apart from the usual Registered Nurse Licensure and renewal. 

     In contrast, the APN has greater educational requirements, a vastly broader scope of practice, and greater ongoing regulation by the state and certifying bodies.  While this scope of practice varies from state to state, in MN, “State practice and licensure law provides for all nurse practitioners to evaluate patients, diagnose, order and interpret diagnostic tests, initiate and manage treatments—including prescribe medications—under the exclusive licensure authority of the state board of nursing.  This is the model recommended by the Institute of Medicine and National Council of State Boards of Nursing” (American Association of Nurse Practitioners).  In MN, to become an APN, the applicant must first be a Registered Nurse, have completed an accredited graduate level APRN program, be credentialed by a national certifying body in one of four APRN roles: Clinical Nurse Specialist, Nurse Practitioner, Nurse Midwife, or Registered Nurse Anesthetist with one of 6 population foci: Family and Individual Across the Lifespan, Adult Gerontology, Neonatal, Pediatrics, Women’s and Gender-Related Health, Psychiatric and Mental Health (MN Board of Nursing).  The applicant must also prove a year’s full time equivalent post graduate practice as an APRN.  When renewing, the APRN must also renew as an RN.

Medical Surgical Nursing Certification Board (MSNCB),

American Association of Nurse Practitioners (AANP),

Minnesota Board of Nursing,