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Advanced Practice Nursing

Advanced Nursing Pathways

This page is designed for students wishing to pursue graduate education in nursing. A Master of Science in Nursing (MSN) is a highly underrated degree, mainly due to students unaware of the differences between an MSN and a BSN.  

This page will act as a comprehensive guide on Advanced Practice Nursing, where we review higher education options for nursing professionals. Whether you are a current registered nurse seeking to enhance your career prospects, a nursing student aspiring to pursue advanced studies, or an experienced healthcare practitioner looking to specialize, this page will help you understand MSNs and what the possibilities are with this degree.

In the rapidly evolving field of healthcare, advanced nursing degrees play a crucial role in preparing nurses for leadership positions, specialized roles, and advanced clinical practice. From Master of Science in Nursing (MSN) programs to Doctor of Nursing Practice (DNP) and PhD in Nursing programs, the spectrum of advanced degrees offers a wealth of opportunities for professional growth, skill development, and contribution to the evolving landscape of healthcare delivery.

So, What's the Difference Between an MSN, DPN, a BSN, and an ASN?

MSN

The higher the education, the higher the opportunities tend to be. With an MSN, there is room for specialization and the opportunity to become a nurse practitioner/nurse educator. There are also possibilities to perform research, run an executive position, and teach prospective nurses. Along with these, it is also good to keep in mind that the average salary of a nurse with an MSN degree in California is $180k a year (ZipRecruiter). The journey of obtaining an MSN would typically take around 6-7 years to complete (4 years in undergrad and 2-3 years in masters). Below are the different pathways for students seeking an MSN

  • Master of Science in Nursing (MSN): There are two MSN pathways that a person can take, either a Master of Science in Nursing (MSN) or an Entry-Level Master of Science in Nursing (EL-MSN). The MSN is tailored for students who already have a Bachelor of Science in Nursing, while the EL-MSN is made for students who have an undergraduate degree in anything else besides nursing. EL-MSN degrees take a bit longer than MSN degrees due to the student having to take courses similar to undergraduate nursing degrees.​​​​​
    • Master of Science in Nursing (MSN): MSN programs offer several tracks designed to prepare current nurses for careers as Advanced Practice Nurses, nurse administrators, and nurse educators. Nurses who graduate with an MSN are called advanced practice nurses (APNs). These nurses deliver health care services that were previously delivered by physicians, and they typically focus on an advanced practice area.
    • Entry-level Master of Science in Nursing (EL-MSN): EL-MSN degrees are designed for students who already possess a bachelor's degree or higher in a discipline other than nursing.  They also have completed the necessary prerequisites are interested in advanced practice and know which nursing specialty they want to practice in. Alternate names for Entry-level Masters include Direct-Entry MSN, Accelerated MSN, and Masters Entry to Nursing Practice (MENP). Students complete their baccalaureate-level content and initial RN licensure within the first year of the program before moving onto a specialized track for their Masters-level content. These fast-paced programs provide a challenging environment for students who have already proven their ability to succeed in post-secondary studies.
MSN Specialties
Nurse Practitioner (NP)

A Nurse practitioner is a nurse who has advanced knowledge in medicine. These nurses can perform duties that were once limited to physicians such as ordering/analyzing tests and lab work, prescribing medication, taking medical histories, and referring patients to specialists. Because of this, some states allow NPs to serve as primary care providers. Nurse practitioners can specialize in their scope of practice, which includes (but is not limited to):

  • Acute Care
  • Adult Health
  • Family Health
  • Gerontology Health
  • Neonatal Health
  • Oncology
  • Pediatric Health
  • Psychiatric Health
  • Women's Health

For further reading on what a Nurse Practitioner is, does, and the possibilities with this position, please visit AANP.org: What's a Nurse Practitioner (NP)?

Clinical Nurse Specialist (CNS)

A clinical nurse specialist is an Advanced Practice Registered Nurse (APRN) who diagnoses, prescribes, and treats patients in specific populations. For these APRNs, the focus of care is specialized. Specialization can vary, but they usually fall under:

  • Population (e.g. pediatrics, geriatrics, women’s health)
  • Setting (e.g. critical care, emergency room)
  • Disease or medical subspecialty (e.g. diabetes, oncology)
  • Type of care (e.g. psychiatric, rehabilitation)
  • Type of health problem (e.g. pain, wounds, stress)

For more information about CNS's, please visit Nursing License Map: Clinical Nurse Specialist and NACNS: What is a CNS?

Nurse Anesthetist (CRNA)

A certified registered nurse anesthetist (CRNA) is an Advanced Practice Registered Nurse (APRN) who, alongside anesthesiologist (the medical school kind), administer medication and perform techniques in order to keep patients asleep, sedated, and/or pain-free during a medical procedure. They also monitor patients to ensure proper bodily function and prevent pain or awakening of the patient. CRNA's ensure proper pre-surgery consultations along with post-operative pain management.

For more information about CRNA's, please visit NurseJournal: How to Become a Nurse Anesthetist

Nurse Midwife (CNM)

*NOTE: A Midwife (CM) and a Nurse Midwife (CNM) are not the same; the former (CM) is an undergraduate certification while the latter (CNM) is a post-graduate certification. CNM's are Advanced Practice Registered Nurses (APRNs) while CM's are not.*

A Certified Nursing Midwife (CNM) is a graduate-level midwife/primary healthcare provider that focuses on the health of women from adolescence to menopause. The focus of this Advanced Practice Registered Nurse (APRN) is on gynecologic care and family planning. When it comes to planning a baby, CNMs monitor and assist with preconception, pregnancy, childbirth, postpartum and newborn care. The scope of practice for CNM's include:

  • Confirming and dating pregnancy
  • Providing prenatal and postpartum care
  • Caring for women during childbirth (including monitoring the mother and fetus during labor, assessing labor progress, managing complications, assisting with pain management, performing episiotomies if needed, and delivering the newborn and placenta)
  • Providing education for new parents on infant care
  • Supporting new mothers who are breastfeeding with education and training
  • Preparing pregnant women for what to expect during the birthing process
  • Performing preventive health screenings and tests
  • Diagnosing and treating gynecological disorders such as sexually transmitted diseases and infertility

For more information about CNMs, please visit Nursing License Map: How to Become a CNM

Nurse Educator

A nurse educator is a teacher and instructor that trains the future generation of nurses. These master-level nurses prove to be invaluable to aspiring nurses, serving as instructors, collaborators, role models, and leaders. Nurse educators are commonly found working in nursing schools, community colleges. and technical schools. Examples of specific positions include becoming a professor, a clinical educator, a nursing educator consultant, or a clinical lab instructor. Nurse educators have a wide range of responsibilities, but they can be summed up as:

  • Teaching clinical skills and patient care
  • Instructing hospital research
  • Guiding students through clinical rotations
  • Designing and evaluating program curriculum
  • Researching related topics
  • Maintaining clinical skills and certifications
  • Demonstrating communication and collaboration
  • Following legal and ethical teaching practices

For more information about Nurse Educators, please visit Registered Nursing: Nurse Educator and Indeed: How to Become a Nurse Educator

Nurse Administrator

A nurse administrator is a master-level nurse who has moved into a position of supervision. Rather than caring for a patient, this type of nurse cares for the business aspect of nursing. This is a defining feature of nurse administrators, as most people see nurses as being involved with the patient directly all of the time. Nurse administrators have an indirect influence on patient outcomes, depending on how they function in their position. Specific duties can vary, but they usually fall under:

  • Hiring/training nurses
  • Maintaining budgets
  • Placing/enforcing policies
  • Building work schedules
  • conducting performance reviews
  • Developing hospital-wide visions/goals

For more information regarding Nurse Administrators, please visit Nursing World: How to Become a Nurse Administrator

 DNP

A DNP is a terminal degree for practicing nurses, meaning it is the highest degree type attainable for clinical nurses. Some nursing specializations, such as Advanced Practice Registered Nurses (APRNs), are transitioning to having one of the requirements be a DNP instead of an MSN. These specializations include nurse practitioners (NP), certified nurse-midwives (CNM), certified registered nurse anesthetists (CRNA), and clinical nurse specialists (CNS). Generally, preference for leadership roles is given to those who possess a DNP over an MSN. This isn't to say you cannot get a leadership role with a MSN or even a BSN, but it would definitely prove more difficult without a DNP. The average salary of a nurse with a DNP degree in California is $122k (ZipRecruiter) but can vary greatly (depending on what you specialize in, where you practice, etc). Obtaining a DNP can take anywhere from 6-10 years to obtain. RN to DNP routes take the shortest time while BSN to MSN to DNP takes the longest. No matter how far someone is in their journey to a DNP, there are plenty of routes that can take them there.

  • Doctor of Nursing Practice (DNP): There are three routes you can take when pursuing a DNP degree. All three end up with having the same type of degree, the Doctor of Nursing Practice. Specializations can occur depending on what the program offers. This all depends on the institution, so be sure to check in to see what specializations they offer.
    • RN to DNP: The least common of the three, Registered Nurse to Doctor of Nurse Practice allows entry-level nurses to pursue the degree directly. The baseline requirement for most of these is to be a registered nurse, whether that be an ADN, a certificate, or other kinds of proof. Some programs also require a minimum college unit credit and/or the completion of general education requirements (can vary between institutions).
    • BSN to DNP: This accelerated program allows BSN students to obtain a DNP without having to go through an MSN. The baseline requirements for these programs usually are having a BSN along with a certain amount of time practicing in a clinical setting of the preferred concentration, which is usually around 1 year. These programs can get specific in terms of requirements, so be sure to check in with your program(s) of choice.
    • MSN to DNP: The most common of the three, Master of Science in Nursing to Doctor of Nurse Practice gives graduate-level nurses a chance to further their education. An MSN is a requirement, and the prerequisite requirements are very similar to BSN to DNP programs. Those who are APRNs can transition into a DNP program under special circumstances, so be sure to contact the institution to ask about keeping / changing your APRN specialty.

BSN

Bachelor of Science in Nursing (BSN): A BSN is the most common nursing degree, making up a little over 50% of the current nurse workforce. This provides a baseline for the most common way to become a nurse, indicating that this degree is relatively safe in terms of job security and availability. The average salary of a nurse with a BSN degree in California is $128k a year. A BSN would typically take 4 years to complete. For more information about BSN degrees, please visit our Nursing Professions and Pathways page.

ADN

Associate of Science in Nursing (ADN): An ADN is an undergraduate degree program that prepares individuals to become registered nurses (RN). These programs are designed to provide students with the knowledge and skills needed for entry-level nursing practice. ADNs take around 2 years. The average salary of a nurse with an ADN degree is $85k a year. For more information about ADN degrees, please visit our Nursing Professions and Pathways page.