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Lauren Danner

Dr. Cassel

ENG 1201

6 July 2020

I am trying to decide how I want to pursue my master’s degree in Nursing. I have wanted

to be a Nurse Practitioner for quite some time now. I am also interested in being a Certified

Registered Nurse Anesthetist or a Nurse Midwife. I wanted to learn more about each of the areas

to try and help me decide which path to take. I have three years from now if I stay on track

before I will complete my bachelors. I am trying to figure out which route I am going to take to

help me better prepare.

In 2016 the Department of Veteran Affairs established APRN’s were able to practice

without the supervision of a Physician. The first NP education was at the University of Colorado

in 1965. In 1967 at Boston College the first masters level program was established. By 1973

there were more than 65 NP programs in the U.S. In 1994 Mary O’Neil Mudinger founded the

first clinical nurse doctorate in the country. Yale Nursing Nurse-Midwifery program was started

in 1956 and is the second oldest of its land in the U.S. They got their first year of funding from

the federal division of nursing in 1976. There is evidence of the role of midwives in ancient

Hindu and biblical writings. It became popular in the U.S in the early 1900’s. The Certified

Nurse Midwife can practice under an NP in 45 states. CRNA’s can be seen in history back to the

late 1800’s. They can work under a NP in 44 states.

The NP role came about in the 1960’s they are “protected “title” in all 50 states and in

DC. Regulatory authority is vested in boards of nursing in 45 of the states and shared with the
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board of medicine in 5 others.: (Phillips 2007) Discussed to require doctorate level degree for all

NP to be able to practice in 2015 but it is still a discussion. Surveys are completed to get info

through various methods, all 50 states. Started in 1977 and are done every 3-4 years. Most jobs

are at hospitals and doctors’ offices. In 2006 the salary for NP and CNM is around 70,000.

CRNA salary is around 140,000 the same year.

The need for healthcare workers keeps increasing. NP/APRN is defined as a “Registered

Nurse who has acquired the expert knowledge base, complex decision-making skills, and clinical

competencies for expanded practice, the characteristics of which are shaped by the context and

or country in which s/he is credentialed to practice.” The DNP is being pushed for all APRN’s to

be required to have and practice. If this is pursued after a master’s degree has been obtained it

will take 2-3 years with 500 clinical hours. You could also get this after your BSN, and it will

take 4-5 years with 1,000 clinical hours. You just must decide if you are willing to risk having to

go to school longer after getting your master’s degree, or if you think you should take the time.

They have been pushing for the DNP since 2015 with nothing being set yet.

Nurse Practitioners do patient medication history, symptoms, do exams and observe,

perform, and order diagnostic tests. They can also diagnose health problems as well as treat

patients for them. They can evaluate responses to medication and treatments, consult with other

physicians and APP’s. They also educate patients. NP can work alone or under the supervision of

a physician. They focus solely on patient care. A CRNA administers anesthesia and cares for a

patient before, during and after whatever the reason they are administering the anesthesia for.

They can do pain management, monitor vitals, go over medications and history. The Certified

Nurse Midwife care for patients in the women’s health specialty. They can deliver babies but

also able to help basic women’s health needs such as yearly paps, or any other issues women
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may have with their hormones or reproductive organs. They are more holistic than a regular

OBGYN.

Certified Nurse Specialist (CNS) require a masters or doctoral degree. They are focused

on a specialty, setting or population. It takes 36 graduation credits, 500 clinical hours and can

take anywhere from 2-4 years. The salary for an Adult Clinical Nurse Specialist, Board Certified

ACNS-BC is 78,000-110,000. More information about this is available at www.nacns.org. A

CRNA takes 2-3 years full time and 56-110 credit hours to complete, plus the board certification

is required as well. You also must have at least one-year ICU experience as an RN at most

schools. Some require OR experience and that is where you mostly would work as a CRNA in

the field. They have the highest job satisfaction among all nursing careers across the board.

Certified Nurse Midwife graduate program is accredited by American College of Nursing

Midwifes on women’s health. You must pass a national certification exam. The median pay is

around 69,000 and 90,000. If this is a specialty is something you are considering it is wise to

work on the labor and delivery department. You can work at the hospital or at people’s homes as

a Nurse Mid-wife.

NP’s work a lot of places such as primary care, specialty offices, schools, hospitals, LTC

facilities just to name a few. They can prescribe meds and treat patients with out physicians

working over them in most states. It is 36-60 credit hours and will take 18 months full time to

complete the program or 36-48 months part time. There is a minimum of 500 clinical hours that

must be completed, and you must pass a National Certification exam. They make anywhere from

85,000 to 120,000 a year for their median salary.

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Works Cited

Ament, Lynette PhD. “The evolution of midwifery faculty practice: Impact and outcomes of

care”. Science Direct Nursing Outlook, Volume 52 Issue 4, August 2004. Pages 203-208,

https://www-sciencedirect-

com.sinclair.ohionet.org/science/article/pii/S0029655404000624?via%3Dihub. Accessed

5 July 2020.

Fullerton, Judith T. PhD, Sipe, Theresa Anne PhD, Schulling, Kerri Durnell PhD. “Demographic

Profiles of Certified Nurse-Midwives, Certified Registered Nurse Anesthetist, and Nurse

Practitioners: Reflections on Implications for Uniform Education and Regulation.”

Science Direct Journal of Professional Nursing, Volume 25 Issue 3, May-June 2009.

Pages 178-185, https://www-sciencedirect-

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5 July 2020.

“Home : Occupational Outlook Handbook.” U.S. Bureau of Labor Statistics, U.S. Bureau of

Labor Statistics, 10 Apr. 2020, www.bls.gov/ooh/.

https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-

practitioners.htm. Accessed 5 July 2020.

Mack, Rachel PhD, FNP. “Increasing Access to Health Care by Implementing a Consensus

Model for Advance Practice Nurse Practice Practice.” Science Direct The Journal for

Nurse Practitioners, Volume 14 Issue 5, May 2018, Pages 419-424 https://www-

sciencedirect-com.sinclair.ohionet.org/science/article/pii/S1555415518302277?via

%3Dihub. Accessed 5 July 2020.

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McClleand, Molly PhD. “A guide to Advanced Practice Registered Nurse Roles.” Academy of

Medical Surgical Nurses, Volume 23 Number 4, July 2, 2014, https://web-a-ebscohost-

com.sinclair.ohionet.org/ehost/pdfviewer/pdfviewer?vid=6&sid=aa981085-d297-4141-

893d-ce610631b25b%40sessionmgr4008. Accessed 5 July 2020.