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Nursing profession

A nurse practitioner (NP) is a nurse with a graduate degree in advanced practice nursing. This allows him or her to provide a broad range of health care services, including:

Taking the patient's history, performing a physical exam, and ordering appropriate laboratory tests and procedures
Diagnosing, treating, and managing acute and chronic diseases
Providing prescriptions and coordinating referrals
Promoting healthy activities in collaboration with the patient
Nurse practitioner specialties include family practice, women's health, pediatrics, geriatric, neonatology, school health, emergency, oncology and primary care.

Some nurse practitioners work in clinics without physician supervision, and others work together with physicians as a joint health care team. Their scope of practice and authority depends on state laws. For example, some states allow nurse practitioners to write prescriptions, while other states do not.

Like many other professions, nurse practitioners are regulated at two different levels. Licensure is a process that takes place at the state level in accordance with specific state laws. In contrast, certification is established through national organizations with requirements for minimal professional practice standards being consistent across all states.

Licensure

Laws specific to NP licensure vary greatly from state to state. The current trend is in the direction of more states requiring master's degree educational preparation and national certification. In some states, NP practice is completely independent, while some states require proof of a collaborative MD only for prescriptive practice privileges, and other states require proof of a collaborative MD for licensure at all. A few states still do not have specific nurse practitioner licensure or recognize practice by NPs.

Certification

National certification is offered through various nursing organizations (such as the American Nurses' Association, National Association of Pediatric Nurse Practitioners and Assistants, and others), most of which require completion of an approved master's-level NP program prior to taking the certification exam. The exams tend to be offered in specialty areas such as family nurse practitioner, pediatric nurse practitioner, school nurse practitioner, adult nurse practitioner, women's health care nurse practitioner, and geriatric nurse practitioner.

Re-certification involves proof of continuing education. Only certified nurse practitioners may use a "C" either in front of or behind their other credentials (e.g., Certified Pediatric Nurse Practitioner, FNP-C, Certified Family Nurse Practitioner). Some nurse practitioners may use the credential APN rather than NP, denoting advanced practice nurse, a broader category that also includes clinical nurse specialists, certified nurse midwives, and nurse anesthetists.

What you need to know about a Nurse-Midwife

Certified nurse-midwives (CNMs) are licensed health care practitioners educated in the two disciplines of nursing and midwifery. They provide primary health care to women of childbearing age including: prenatal care, labor and delivery care, care after birth, gynecological exams, newborn care, assistance with family planning decisions, preconception care, menopausal management and counseling in health maintenance and disease prevention. 

In order to evaluate the credential and standards of practice of your midwife, ask these questions:

Do you have a college degree?
Did you graduate from a nationally accredited midwifery education program?
Did your midwifery education require preparation in core sciences such as biology, chemistry, anatomy and physiology, microbiology, psychology, sociology, epidemiology/statistics, pathophysiology, and nutrition?
Have you passed a national certification examination?
Are you licensed to practice?
How will you determine if I am an appropriate candidate for midwifery care and what will happen if I need the care of a physician?
Are you prepared to provide well-woman and gynecological care, including screening for common health problems and writing prescriptions?
Are you certified by the ACNM Certification Council?

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