Nurse Anesthetist, Nurse Midwife, or Nurse Practitioner
What they do:
Administer anesthesia, monitor patient's vital signs, and oversee patient recovery from anesthesia. May assist anesthesiologists, surgeons, other physicians, or dentists. Must be registered nurses who have specialized graduate education.
On the job, you would:
- Manage patients' airway or pulmonary status, using techniques such as endotracheal intubation, mechanical ventilation, pharmacological support, respiratory therapy, and extubation.
- Respond to emergency situations by providing airway management, administering emergency fluids or drugs, or using basic or advanced cardiac life support techniques.
- Monitor patients' responses, including skin color, pupil dilation, pulse, heart rate, blood pressure, respiration, ventilation, or urine output, using invasive and noninvasive techniques.
Work Schedules
Most APRNs work full time. In physicians’ offices, APRNs typically work during normal business hours. In hospitals and other healthcare facilities, they may work in shifts—including nights, weekends, and holidays—to provide round-the-clock patient care. Some APRNs, especially those who work in critical care or those who deliver babies, also may need to be on call.
Job Outlook
Overall employment of nurse anesthetists, nurse midwives, and nurse practitioners is projected to grow 40 percent from 2021 to 2031, much faster than the average for all occupations.
About 30,200 openings for nurse anesthetists, nurse midwives, and nurse practitioners are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.
Important Qualities:
Communication skills. Advanced practice registered nurses have to be able to communicate with patients and other healthcare professionals to ensure the appropriate course of action.
Critical-thinking skills. APRNs must be able to assess changes in a patient’s health, quickly determine the most appropriate course of action, and decide if a consultation with another healthcare professional is needed.
Compassion. APRNs should be caring and sympathetic when treating patients.
Detail oriented. APRNs need to be thorough in providing treatments and medications that affect their patients’ health. During an evaluation, they must notice even small changes in a patient’s condition.
Interpersonal skills. APRNs must work with patients and families as well as with other healthcare providers and staff. They work as part of a team to determine and execute healthcare options for the patients they treat.
Leadership skills. APRNs often work in positions of seniority. They must effectively direct and sometimes manage other nurses on staff when providing patient care.
Resourcefulness. APRNs should know where to find the answers that they need.
Personality
| A3 | Your Strengths | Importance |
Characteristics of this Career |
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96% | Attention to Detail - Job requires being careful about detail and thorough in completing work tasks. | |
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96% | Dependability - Job requires being reliable, responsible, and dependable, and fulfilling obligations. | |
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96% | Stress Tolerance - Job requires accepting criticism and dealing calmly and effectively with high-stress situations. | |
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94% | Integrity - Job requires being honest and ethical. | |
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93% | Concern for Others - Job requires being sensitive to others' needs and feelings and being understanding and helpful on the job. | |
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92% | Analytical Thinking - Job requires analyzing information and using logic to address work-related issues and problems. | |
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92% | Self-Control - Job requires maintaining composure, keeping emotions in check, controlling anger, and avoiding aggressive behavior, even in very difficult situations. | |
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92% | Adaptability/Flexibility - Job requires being open to change (positive or negative) and to considerable variety in the workplace. | |
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90% | Cooperation - Job requires being pleasant with others on the job and displaying a good-natured, cooperative attitude. | |
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89% | Achievement/Effort - Job requires establishing and maintaining personally challenging achievement goals and exerting effort toward mastering tasks. | |
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88% | Independence - Job requires developing one's own ways of doing things, guiding oneself with little or no supervision, and depending on oneself to get things done. | |
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87% | Initiative - Job requires a willingness to take on responsibilities and challenges. | |
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85% | Persistence - Job requires persistence in the face of obstacles. | |
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76% | Leadership - Job requires a willingness to lead, take charge, and offer opinions and direction. | |
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75% | Social Orientation - Job requires preferring to work with others rather than alone, and being personally connected with others on the job. |
| A3 | Your Strengths | Importance |
Strengths |
|---|---|---|---|
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95% | Investigative - Work involves studying and researching non-living objects, living organisms, disease or other forms of impairment, or human behavior. Investigative occupations are often associated with physical, life, medical, or social sciences, and can be found in the fields of humanities, mathematics/statistics, information technology, or health care service. | |
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67% | Realistic - Work involves designing, building, or repairing of equipment, materials, or structures, engaging in physical activity, or working outdoors. Realistic occupations are often associated with engineering, mechanics and electronics, construction, woodworking, transportation, machine operation, agriculture, animal services, physical or manual labor, athletics, or protective services. |
| A3 | Your Strengths | Importance |
Values of the Work Environment |
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72% | Support - Occupations that satisfy this work value offer supportive management that stands behind employees. Corresponding needs are Company Policies, Supervision: Human Relations and Supervision: Technical. | |
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67% | Relationships - Occupations that satisfy this work value allow employees to provide service to others and work with co-workers in a friendly non-competitive environment. Corresponding needs are Co-workers, Moral Values and Social Service. | |
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61% | Achievement - Occupations that satisfy this work value are results oriented and allow employees to use their strongest abilities, giving them a feeling of accomplishment. Corresponding needs are Ability Utilization and Achievement. |
Job Details
What Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners Do
Nurse anesthetists, nurse midwives, and nurse practitioners, also referred to as advanced practice registered nurses (APRNs), coordinate patient care and may provide primary and specialty healthcare. The scope of practice varies from state to state.
Duties
Advanced practice registered nurses typically do the following:
- Take and record patients' medical histories and symptoms
- Perform physical exams and observe patients
- Create patient care plans or contribute to existing plans
- Perform and order diagnostic tests
- Operate and monitor medical equipment
- Diagnose various health problems
- Analyze test results or changes in a patient’s condition and alter treatment plans, as needed
- Give patients medicines and treatments
- Evaluate a patient’s response to medicines and treatments
- Consult with doctors and other healthcare professionals, as needed
- Counsel and teach patients and their families how to stay healthy or manage their illnesses or injuries
- Conduct research
APRNs work independently or in collaboration with physicians. In most states, they can prescribe medications, order medical tests, and diagnose health problems. APRNs may provide primary and preventive care and may specialize in care for certain groups of people, such as children, pregnant women, or patients with mental health disorders.
APRNs have some of the same duties as registered nurses, including gathering information about a patient’s condition and taking action to treat or manage the patient’s health. However, APRNs are trained to do other tasks, including ordering and evaluating test results, referring patients to specialists, and diagnosing and treating ailments. APRNs focus on patient-centered care, which means understanding a patient’s concerns and lifestyle before choosing a course of action.
Some APRNs also conduct research or teach staff about new policies or procedures. Others may provide consultation services based on a specific field of knowledge, such as oncology, which is the study of cancer.
The following are types of APRNs:
Nurse anesthetists (CRNAs) administer anesthesia and provide care before, during, and after surgical, therapeutic, diagnostic, and obstetrical procedures. They also provide pain management and some emergency services. Before a procedure begins, nurse anesthetists discuss with a patient any medications the patient is taking as well as any allergies or illnesses the patient may have, so that anesthesia can be safely administered. Nurse anesthetists then give a patient general anesthesia to put the patient to sleep so they feel no pain during surgery or administer a regional or local anesthesia to numb an area of the body. During the procedure, they monitor the patient’s vital signs and adjust the anesthesia as necessary.
Nurse midwives (CNMs) provide care to women, including gynecological exams, family planning services, and prenatal care. They deliver babies, manage emergency situations during labor, repair lacerations, and may provide surgical assistance to physicians during cesarean births. Nurse midwives may act as primary maternity care providers for women. They also provide wellness care, educating their patients on how to lead healthy lives by discussing topics such as nutrition and disease prevention. Nurse midwives also provide care to their patients’ partners for sexual or reproductive health issues.
Nurse practitioners (NPs) serve as primary and specialty care providers, delivering advanced nursing services to patients and their families. They assess patients, determine how to improve or manage a patient’s health, and discuss ways to integrate health promotion strategies into a patient’s life. Nurse practitioners typically care for a certain population of people. For instance, NPs may work in adult and geriatric health, pediatric health, or psychiatric and mental health.
Although the scope of their duties varies by state, many nurse practitioners work independently, prescribe medications, and order laboratory tests. Nurse practitioners consult with physicians and other health professionals when needed.
See the profile on registered nurses for more information about clinical nurse specialists (CNSs), also considered to be a type of APRN.
| A3 | Your Strengths | Importance |
Attributes & Percentage of Time Spent |
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100% | Indoors, Environmentally Controlled - How often does this job require working indoors in environmentally controlled conditions? | |
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100% | Face-to-Face Discussions - How often do you have to have face-to-face discussions with individuals or teams in this job? | |
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96% | Work With Work Group or Team - How important is it to work with others in a group or team in this job? | |
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96% | Exposed to Disease or Infections - How often does this job require exposure to disease/infections? | |
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96% | Wear Common Protective or Safety Equipment such as Safety Shoes, Glasses, Gloves, Hearing Protection, Hard Hats, or Life Jackets - How much does this job require wearing common protective or safety equipment such as safety shoes, glasses, gloves, hard hats or life jackets? | |
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95% | Importance of Being Exact or Accurate - How important is being very exact or highly accurate in performing this job? | |
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94% | Consequence of Error - How serious would the result usually be if the worker made a mistake that was not readily correctable? | |
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93% | Freedom to Make Decisions - How much decision making freedom, without supervision, does the job offer? | |
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92% | Exposed to Contaminants - How often does this job require working exposed to contaminants (such as pollutants, gases, dust or odors)? | |
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92% | Contact With Others - How much does this job require the worker to be in contact with others (face-to-face, by telephone, or otherwise) in order to perform it? | |
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89% | Physical Proximity - To what extent does this job require the worker to perform job tasks in close physical proximity to other people? | |
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88% | Level of Competition - To what extent does this job require the worker to compete or to be aware of competitive pressures? | |
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87% | Responsible for Others' Health and Safety - How much responsibility is there for the health and safety of others in this job? | |
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86% | Structured versus Unstructured Work - To what extent is this job structured for the worker, rather than allowing the worker to determine tasks, priorities, and goals? | |
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86% | Impact of Decisions on Co-workers or Company Results - What results do your decisions usually have on other people or the image or reputation or financial resources of your employer? | |
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84% | Coordinate or Lead Others - How important is it to coordinate or lead others in accomplishing work activities in this job? | |
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83% | Sounds, Noise Levels Are Distracting or Uncomfortable - How often does this job require working exposed to sounds and noise levels that are distracting or uncomfortable? | |
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83% | Telephone - How often do you have telephone conversations in this job? | |
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80% | Frequency of Decision Making - How frequently is the worker required to make decisions that affect other people, the financial resources, and/or the image and reputation of the organization? | |
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79% | Importance of Repeating Same Tasks - How important is repeating the same physical activities (e.g., key entry) or mental activities (e.g., checking entries in a ledger) over and over, without stopping, to performing this job? | |
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78% | Time Pressure - How often does this job require the worker to meet strict deadlines? | |
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78% | Spend Time Using Your Hands to Handle, Control, or Feel Objects, Tools, or Controls - How much does this job require using your hands to handle, control, or feel objects, tools or controls? | |
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76% | Wear Specialized Protective or Safety Equipment such as Breathing Apparatus, Safety Harness, Full Protection Suits, or Radiation Protection - How much does this job require wearing specialized protective or safety equipment such as breathing apparatus, safety harness, full protection suits, or radiation protection? | |
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76% | Deal With External Customers - How important is it to work with external customers or the public in this job? | |
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76% | Electronic Mail - How often do you use electronic mail in this job? | |
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72% | Exposed to Radiation - How often does this job require exposure to radiation? | |
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71% | Deal With Unpleasant or Angry People - How frequently does the worker have to deal with unpleasant, angry, or discourteous individuals as part of the job requirements? | |
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70% | Frequency of Conflict Situations - How often are there conflict situations the employee has to face in this job? | |
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82% | Duration of Typical Work Week - Number of hours typically worked in one week. |
| A3 | Your Strengths | Importance |
Tasks & Values |
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96% | Assisting and Caring for Others - Providing personal assistance, medical attention, emotional support, or other personal care to others such as coworkers, customers, or patients. | |
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94% | Getting Information - Observing, receiving, and otherwise obtaining information from all relevant sources. | |
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92% | Documenting/Recording Information - Entering, transcribing, recording, storing, or maintaining information in written or electronic/magnetic form. | |
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91% | Updating and Using Relevant Knowledge - Keeping up-to-date technically and applying new knowledge to your job. | |
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91% | Making Decisions and Solving Problems - Analyzing information and evaluating results to choose the best solution and solve problems. | |
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91% | Identifying Objects, Actions, and Events - Identifying information by categorizing, estimating, recognizing differences or similarities, and detecting changes in circumstances or events. | |
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89% | Analyzing Data or Information - Identifying the underlying principles, reasons, or facts of information by breaking down information or data into separate parts. | |
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88% | Inspecting Equipment, Structures, or Materials - Inspecting equipment, structures, or materials to identify the cause of errors or other problems or defects. | |
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88% | Communicating with Supervisors, Peers, or Subordinates - Providing information to supervisors, co-workers, and subordinates by telephone, in written form, e-mail, or in person. | |
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87% | Monitoring Processes, Materials, or Surroundings - Monitoring and reviewing information from materials, events, or the environment, to detect or assess problems. | |
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84% | Evaluating Information to Determine Compliance with Standards - Using relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards. | |
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83% | Processing Information - Compiling, coding, categorizing, calculating, tabulating, auditing, or verifying information or data. | |
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80% | Training and Teaching Others - Identifying the educational needs of others, developing formal educational or training programs or classes, and teaching or instructing others. | |
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80% | Establishing and Maintaining Interpersonal Relationships - Developing constructive and cooperative working relationships with others, and maintaining them over time. | |
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79% | Working with Computers - Using computers and computer systems (including hardware and software) to program, write software, set up functions, enter data, or process information. | |
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74% | Organizing, Planning, and Prioritizing Work - Developing specific goals and plans to prioritize, organize, and accomplish your work. | |
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72% | Performing General Physical Activities - Performing physical activities that require considerable use of your arms and legs and moving your whole body, such as climbing, lifting, balancing, walking, stooping, and handling materials. | |
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72% | Guiding, Directing, and Motivating Subordinates - Providing guidance and direction to subordinates, including setting performance standards and monitoring performance. | |
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72% | Performing for or Working Directly with the Public - Performing for people or dealing directly with the public. This includes serving customers in restaurants and stores, and receiving clients or guests. | |
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72% | Interpreting the Meaning of Information for Others - Translating or explaining what information means and how it can be used. | |
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71% | Controlling Machines and Processes - Using either control mechanisms or direct physical activity to operate machines or processes (not including computers or vehicles). | |
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70% | Estimating the Quantifiable Characteristics of Products, Events, or Information - Estimating sizes, distances, and quantities; or determining time, costs, resources, or materials needed to perform a work activity. | |
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69% | Developing and Building Teams - Encouraging and building mutual trust, respect, and cooperation among team members. | |
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69% | Handling and Moving Objects - Using hands and arms in handling, installing, positioning, and moving materials, and manipulating things. | |
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68% | Judging the Qualities of Objects, Services, or People - Assessing the value, importance, or quality of things or people. | |
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68% | Providing Consultation and Advice to Others - Providing guidance and expert advice to management or other groups on technical, systems-, or process-related topics. | |
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67% | Resolving Conflicts and Negotiating with Others - Handling complaints, settling disputes, and resolving grievances and conflicts, or otherwise negotiating with others. | |
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67% | Coordinating the Work and Activities of Others - Getting members of a group to work together to accomplish tasks. |
Getting Started
How to Become a Nurse Anesthetist, Nurse Midwife, or Nurse Practitioner
Nurse anesthetists, nurse midwives, and nurse practitioners, also referred to as advanced practice registered nurses (APRNs), must have at least a master’s degree in their specialty role. APRNs also must be licensed registered nurses in their state, pass a national certification exam, and have a state APRN license.
Education
Nurse anesthetists, nurse midwives, and nurse practitioners typically need at least a master's degree in an advanced practice nursing field. Accredited healthcare and related programs in these specialties typically include classroom education and clinical experience. Courses in subjects such as advanced health assessment, pathophysiology, and pharmacology are common as well as coursework specific to the chosen APRN role.
An APRN must have a registered nursing (RN) license before pursuing education in one of the advanced practice roles, and a strong background in science is helpful.
Most APRN programs prefer candidates who have a bachelor’s degree in nursing. However, some schools offer bridge programs for registered nurses with an associate’s degree or diploma in nursing. Graduate-level programs are also available for individuals who did not obtain a bachelor’s degree in nursing but in a related health science field. These programs prepare the student for the RN licensure exam in addition to offering the APRN curriculum.
Although a master’s degree is the most common form of entry-level education, APRNs may choose to earn a Doctor of Nursing Practice (DNP) or a Ph.D. The specific educational requirements and qualifications for each of the roles are available on professional organizations’ websites.
Prospective nurse anesthetists must have 1 year of experience working as registered nurse in a critical care setting as a prerequisite for admission to an accredited nurse anesthetist program.
Licenses, Certifications, and Registrations
States’ requirements for APRNs vary. In general, APRNs must have a registered nursing license, complete an accredited graduate-level program, pass a national certification exam, and have an APRN license. Details are available from each state’s board of nursing.
To become licensed and use an APRN title, most states require national certification.
The National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) offers the National Certification Examination (NCE). Certified registered nurse anesthetists (CRNAs) must maintain their certification through the Continued Professional Certification (CPC) Program.
The American Midwifery Certification Board offers the Certified Nurse-Midwife (CNM). Individuals with this designation must recertify via the Certificate Maintenance Program.
There are several different certifications for nurse practitioners, including those available from the American Academy of Nurse Practitioners Certification Board (AANPCB), the American Nurses Credentialing Center (ANCC), and the Pediatric Nursing Certification Board (PNCB). Each of these certifications requires periodic renewal.
In addition, APRN positions may require cardiopulmonary resuscitation (CPR), basic life support (BLS), or advanced cardiac life support (ACLS) certification.
Advancement
Some APRNs take on managerial or administrative roles; others go into academia. APRNs who earn a doctoral degree may conduct independent research or work on an interprofessional research team.