The intrinsic value of the roles is less easy to quantify, but U.S.


News and World Reports states that good jobs are those that pay well, challenge us, are a good match for our talents, aren’t too stressful, offer room to advance, and provide a satisfying work-life balance. CRNA is ranked fourth and NP is ranked sixth on the 100 best jobs list of 2016.6


Nurse-midwife is also listed as is RN; however, no listing is found for CNS. Besides job fulfillment, other benefits of the APRN role include au-


tonomy of practice, independence, flexibility, and active engagement with patients.


Skills Assessment:


Clinical and Professional Experience Mix APRN roles are clinically focused. A strong clinical foundation is an advantage, both for selection into the educational program and success in the program. Admission to specialty programs can be very competitive. Many schools have limited openings for enrollment. As of 2016, there were only 115 accredited nurse anesthesia programs in the U.S.7


also a possibility to take some of the requirements concurrently with other classes after admission.


Scholarly records, such as transcripts from your previous school of nursing documenting successful completion, will be required. Generally, the acceptable grade average is a 3.0 on a 4.0 scale. Some may require higher or accept lower. A strong GRE score may provide evidence of your current readiness if your previous grade point is low. Never hesitate to ask the school if an exception can be made, particu- larly if extenuating circumstances affected the grades.


Applicants from countries where English is not the primary language will be required to complete additional testing for English language competency.


CRNA programs require a minimum of one-year full-time or


part-time equivalent RN work experience in a critical care setting. The university may require additional clinical experiences. In exploring admission requirements, one university lists pre-admission require- ments of two years of experience as an RN, one year of full-time ICU experience, and certification in advanced cardiac life support/basic life support/pediatric advanced life support. Midwifery schools noted preferences for RNs with a minimum of one-year experience, ideally in labor and delivery. The Consensus Model notes six population foci for APRNs: family/individual across lifespan, adult-gerontology, neonatal, pediatrics, women’s health/gender related, and psychiatric mental health. When considering a CNS or NP in a specialty area, work with the population (preferably as a nurse but volunteer if need- ed to gain clinical experience).


Although clinical experience is required, demonstrating pro- fessionalism within the clinical setting is of equal importance. Reference letters are required as part of applications to programs. The leaders and colleagues within the work environment are the ones who can attest to your clinical competence and professional accountability. Demonstrate a willingness to work as part of a team, respect others, show patient advocacy, and participate in profes- sional activities. Volunteer for leadership roles in committees and build professional relationships.


Academic Prerequisites Prerequisites vary among programs. A valid RN license is required. Programs require a BSN, but it may be possible to find a bridge pro- gram to attain the BSN while transitioning to the higher degree. Some schools require test scores from the GRE General Test, which is a measure of applicant’s readiness for graduate-level work.


University programs often require prerequisite courses in statistics,


research, physical assessment, or human pathophysiology. Review the requirements and check your transcripts to see if they include the required classes. Classes have course numbers indicating the level of the course; the level must meet the requirement. When in doubt, contact the admission office to verify which are acceptable. There is


8


Types of Programs There are a number of ways to become an APRN. Most programs prefer to accept RNs with a bachelor’s degree; however, some schools offer bridge programs for those with an associate’s degree or a nursing di- ploma. A master’s degree is the minimum level for becoming an APRN, but RNs should also give strong consideration to earning a doctor of nursing practice due to the value and recognition given for doctoral education. A 2011 salary survey found the DNP-prepared NP earned $8,576 more than a master’s prepared.8


Modern technology has made for more options in types of programs. Besides the traditional face-to-face classes, universities may offer on- line and hybrid (a combination of online and face-to-face) programs. Full or partially online programs can be intimidating for those with lim- ited computer skills; however, most schools provide technical support.


Selecting a Program After determining the type of program that fits your APRN goals, you need to research universities that offer the requirements to meet licensing and certification standards.


According to The Campaign for Nursing’s Future, there are 2,043 nursing schools, and programs of nursing may be found in both private and public institutions. You may want to consider the pros and cons described in “Should You Choose a Public or Private College?”9


The


Johnson & Johnson website includes a search function to identify school offering degree programs for CRNAs, NPs, and CNMs. It also designates online schools and traditional campus, public and private schools, as well as those that do not have a wait list. Also, a CNS Pro- gram Directory can be downloaded from the NACNS website.


It is critically important that the program is accredited. A certify- ing body will not release APRN certification — even if the exam was passed — without transcripts from an accredited program. I can attest through personal experience of a relative who attended and graduated after complete requirements for geriatric nurse practitioner. The uni- versity assured the class that the university would have accreditation by the time the cohort completed the program. The students graduated; my niece passed the certification exam and was offered a well-paying position. Unfortunately, the university failed accreditation, and the certification was denied. She found another university that was accred- ited and, unfortunately, had to repeat most classes since they were not transferable from a university without accreditation.


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