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Discussion

Need advice about Advanced Practice

Hello everyone,

I'm a 29 year old male who is contemplating entering nursing. I have a BA in History and for a while was considering Medical School, but have decided that nursing (with an eye specifically on Advanced Practice Nursing at some point) may be better. I ahve some questions for anyone that could help me out with info on Advanced Practice Nursing.

I've worked in two different hospitals as a CNA over the past four years and I've worked with a lot of RNs and a lot of MDs, but relatively few APRNs. The first hospital was a private hospital Telly unit and one of the practices that regularly took care of pts there was made up of one MD and 4 NPs. We also had a CNS that did mainly education.

The second was an emergency dept in a Level I Trauma center (University teaching hospital). I didn't encounter any APRNs here. I also did some elective rotations in the OR at both hospitals and worked a bit with CRNAs.

So, having said all that, here are my questions:

What is the scope of practice for each of these three (NP, CNS, CRNA)? That is, is what they do more similar to an MD or to an RN? Diagnosis, treatment, prescriptions etc.

What are they allowed to do as compared to RNs and MDs (prescribing drugs, narcotics, procedures - intubation, central vascular access, artial line insertion etc.)

I'm very interested in critical care/trauma/emergency medicine and would like to work as an RN in one of these areas before proceeding to advanced practice. I'm also very interested in flight nursing.

When I was considering Medicine, I was interested in anesthesiology and Emergency Med for the procedurces and the management of critically ill patients. Is this something that is available to an APRN?

My ideal advance practice situation would be working in an ICU alongside MDs/PAs, rounding on patients, making decisions (in collaboration with others) on treatment and getting to do lots of "hands on" care (procedures). On of the things that I really like about nursing is the hands on care (starting IVs, NG tube insertions etc.) that most MDs I've observed (especially in Private practice) tend to not do much of.

Any help that you could offer would be GREATLY appreciated!

Thanks,

Bryan

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