When talking about the current status of Advanced Practice Registered Nurses (APRNs), it’s important to understand the education required to reach that level of health care practice. There’s often a knee-jerk response to the idea that APRNs should be able to practice autonomously (without direct instruction from a doctor), citing they don’t have the education level of a doctor. In reality, they have many years of education – and share similarities to doctors training – more than you might expect.
The specifics for the educational requirements vary slightly from state to state, but generally boil down to being equivalent. Which is good: that means becoming an APRN in one state means other states will most likely allow them to maintain being an APRN if they move to another state. But, for the sake of this article, we’re focusing on the State of Kansas for APRN education.
If you haven’t already, go check out part 1 of our series, which dives into the history of APRNs, explaining both the roles and demand for APRNs.
A special thanks to our Guest Editor Professor Betty Smith-Campbell, Ph. D., APRN-CNS at Wichita State University.
The First Degree: BSN
The first requirement is that all APRNs must first be Registered Nurses. Today a Bachelor of Science in Nursing degree (BSN) is required before applying to an APRN program. It’s a four year degree (though, accelerated degree programs do exist) and covers a wide range of topics including:
- Health Assessment
- Basic Pharmacology
- An understanding of care through all stages of life
In addition, students will have to do clinical rotations under supervision across a range of specialities.
A License is required of all nurses: NCLEX exam
The degree sets up for the first test, the National Council Licensure Examination for Registered Nurses (NCLEX-RN). In Kansas, the test has an 80% pass rate, and it usually takes a couple of months for the certification to go through. At this point, they can practice as a Registered Nurse (RN) in Kansas (and many other states, since the license transfers, though some states have additional requirements.)
At this point, it’s back to school again. Kansas has four specific areas of specialization:
- Clinical Nurse Specialist (CNS)
- Registered Nurse Anesthetist (RNA)
- Nurse Midwife (NMW)
- Nurse Practitioner (NP)
In Kansas, it specifies that the program must include:
- Role alignment between the RN and APRN roles
- Theoretical instruction in your chosen APRN category
- Health care delivery system
- Ethical and legal implications of advanced nursing practice
- 3 hours in advanced pharmacology
- 3 hours in advanced pathophysiology
- 3 hours in advanced health assessment
- Clinical instruction that includes:
- Performing or ordering diagnostic procedures
- Evaluating diagnostic and assessment findings
- Prescribing medication and other treatments for patients
- 500 hours of learning in each clinical track
In Kansas, all graduate APRN programs offer the Doctor of Nursing Practice (DNP) degree. Typically, this represents another 3-4 years full time study or 5-6 years of part-time study after having already completed a BSN degree, or two years of full-time study for post-Master’s Degree in Nursing (MSN) students. During this time, they’ll also have to work with a preceptor at some point – an experienced APRN or physician that makes sure the educational programs they’ve taken are put to real-world use within their area of expertise. The preceptor is not employed by the nursing education program but provides clinical supervision for nursing courses taken during the nursing education program. The preceptor is responsible for assessing performance in the clinical setting with the support of nursing faculty.
The APRN License
At this point, they can apply for a license to become registered as an APRN in Kansas, which is required to do work as an ARPN. This includes a background check on everything from meeting the educational requirements to criminal records.
How Long Does it Take?
From beginning to end, the whole process from first day of entering the program to finally having an APRN license runs about 8 – 10 years, though accelerated programs can cut the time considerably, depending on a lot of factors.
Simply put: it’s no small thing to become licensed in any of the APRN areas (CNS, RNA, NMW, or NP) in Kansas. And all this sets up for our next – and final – article on APRNs, which explores the legal issues that APRNs have been dealing with, such as APRN autonomous practice. It’s important to understand that, for instance, a Nurse Practitioner isn’t “just another nurse” – they’ve had to go through a great deal more training to become an expert in their area.