Facts about Advanced Practice Registered Nurses (APRNs) in Virginia

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Who are APRNs?

APRNs are registered nurses, who receive additional education at the graduate-level, or a post graduate certificate from an accredited program, and are board certified nationally in their areas of specialty. At the national level, APRNs include nurse practitioners (NP), certified nurse- midwives (CNM), certified registered nurse anesthetists (CRNA), and clinical nurse specialists (CNS).  In Virginia, the law currently licenses APRNs including nurse practitioners, nurse anesthetists and nurse- midwives as nurse practitioners who are jointly regulated by the Boards of Nursing and Medicine.  Clinical nurse specialists are regulated by the Board of Nursing and are not currently defined as APRNs under Virginia law.

APRNs Play an Integral Role in Improving Access to High-Quality, Cost- Effective Care.

  • Nurse practitioners provide comprehensive primary or specialty care including diagnosing, treating and managing acute and chronic illnesses and diseases. This includes ordering, performing and interpreting laboratory and imaging studies; prescribing medication and durable medical equipment; and making appropriate referrals.
  • Nurse- midwives provide a full range of primary health care services to women throughout the lifespan Including gynecologic care, family planning services, preconception care, prenatal and postpartum care, childbirth and care of the newborn.
  • Nurse anesthetists provide the full spectrum of anesthesia care and anesthesia related care for individuals across the lifespan, whose health status may range from healthy through all levels of acuity, including immediate, severe, or life threatening illness or injury.
  • Clinical nurse specialists provide patient care and expert advice in nursing specialty practices related to setting, population, type of care, or disease, with primary goal for continuous improvement of patient outcomes and nursing care.
  • APRNs practice in hospitals, outpatient settings including birthing centers, free clinics, community health centers, schools, universities, private offices, public health departments, long-term care settings and patient’s homes. In other words, wherever Virginians seek care, you find a practicing APRN.

APRN Numbers (September 2014):

  • 6,064 nurse practitioners (NP) licensed in Virginia
  • 259 nurse- midwives (CNM) licensed in Virginia
  • 1,952 nurse anesthetists (CRNA) licensed in Virginia
  • 428 clinical nurse specialists (CNS) registered in Virginia

Current Status for APRNs in Virginia

  • In 2012, HB346 (O’Bannon) classified nurse practitioners as APRN. In Virginia, the term nurse practitioner is defined by regulation to include CNMs and CRNAs. 
  • CNSs are not currently defined as APRNs.
  • Labeling CNMs and CRNAs as NPs creates confusion among the public, as well as health providers, given the significant practice and legal differences between NPs, CNMs and CRNAs. 
  • One recognized title will eliminate confusion on the part of the public and foster uniform recognition for APRNs. 

Reference:  Institute of Medicine (IOM) report.  The Future of Nursing:  Leading Change, Advancing Health through the Center to Champion Nursing America, Initiative of AARP, the AAPR Foundation, and the Robert Wood Johnson Foundation