Learn about Advanced Practice Registered Nurses (APRN)

Information about APRN practice and clinical categories.

What is an Advanced Practice Registered Nurse?

Advanced Practice Registered Nurses (APRN) are registered nurses with post graduate education. They are prepared with expert knowledge, complex decision-making skills, and clinical competencies to engage in advanced practice nursing activities.

APRN practice activities include, but are not limited to:

  • Advanced assessment
  • Diagnosis
  • Treatment
  • Referrals
  • Consultations 

APRN practice also involves other modalities for individuals, groups, or communities across the life span for health promotion or health maintenance. This includes those who are experiencing acute or chronic disease, illness, trauma, or other life-altering event in which rehabilitative and/or palliative interventions are necessary.

An APRN must pass a rigorous national certification examination and demonstrate continued competency in order to maintain certification.

Massachusetts authorizes 5 APRN clinical categories

  • Nurse Practitioners (CNP) – provides health care services to individuals throughout the lifespan, including health promotion, disease prevention, health education, counseling and making referrals to other members of the health care team, as well as the diagnosis and management of acute and chronic illness and disease. A CNP provides care in diverse settings, including, but not limited to, home, hospital, nursing facilities, and a variety of ambulatory care settings including private offices, community and public health clinics.
     
  • Certified Nurse-midwives (CNM) – provides primary health care services to women throughout the lifespan including gynecologic care, family planning services, preconception care, prenatal and postpartum care, childbirth, care of the newborn and treatment of the partner of their clients for sexually transmitted disease and reproductive health. A CNM practices within a healthcare system and develops clinical relationships with obstetrician-gynecologists to provide care in diverse settings, including, but not limited to, home, hospital, birth center, and a variety of ambulatory care settings including private offices, community and public health clinics.
     
  • Certified Nurse Anesthetists (CRNA) – provides anesthesia care and anesthesia-related care for individuals across the lifespan, whose health status may range from healthy through all recognized levels of acuity, including persons with immediate, severe, or life-threatening illness or injury. A CRNA provides care in diverse settings, including, but not limited to, hospital surgical suites and obstetrical delivery rooms; critical access hospitals; acute care; ambulatory centers; and the offices of dentists, podiatrists, and physicians.
     
  • Psychiatric Clinical Nurse Specialists (PCNS) – provides psychiatric health care services to individuals throughout the lifespan, including health promotion, disease prevention, health education, counseling and making referrals to other members of the health care team, as well as the diagnosis and management of acute and chronic psychiatric illness and psychiatric disease. A PCNS provides care in diverse settings, including, but not limited to, home, hospital, nursing facilities, and a variety of ambulatory care settings including private offices, community and public health clinics.
     
  • Clinical Nurse Specialists (CNS) – integrates an advanced level of direct and indirect nursing care beyond the scope of RN practice. In addition to the provision of assistance to other nurses and health professionals in establishing and meeting health goals of individuals and groups, a CNS may provide health care services to individuals throughout the lifespan, including health promotion, disease prevention, health education, counseling and making referrals to other members of the health care team, as well as the diagnosis and management of illness and disease. A CNS provides care in diverse settings, including, but not limited to home, hospital, nursing facilities, and a variety of ambulatory care settings including private offices and community, and public health clinics.
     

With the exception of the CNS, an APRN is authorized to order medications, treatments, and therapeutics for their patients.

APRN Independent Practice 244 CMR 4.00

At its meeting June 9, 2021, the Board of Registration in Nursing voted to approve emergency amendments to 244 CMR 4.00. The approved regulation can be found in the attached:

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