Advanced Practice Registered Nurses (APRNs) are licensed nurses with post-graduate education and training in nursing. They provide primary and/or specialty nursing and medical care in ambulatory, acute and long-term care settings. APRNs may practice autonomously and/or in coordination with health care professionals and other individuals. Masters, post-masters or doctoral preparation and national board certification is required for entry-level practice. There are four types of APRNs. These include: nurse practitioners, certified nurse midwives, certified registered nurse anesthetists and clinical nurse specialists. This site currently features policy information for nurse practitioners and certified nurse midwives.
- Nurse practitioners (NPs) are registered nurses with specialized, advanced education and clinical practice competency to provide health care for diverse populations in a variety of primary care, acute and long-term care settings.
- Certified nurse midwives (CNMs), also referred to as nurse midwives, specialize in the provision of care during pregnancy, childbirth and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care.
The links to the right lead to maps showing a comparison of all states and territories for the following policy areas:
- Nurse practitioner practice authority
- Certified nurse midwife practice authority (shown below)
- Nurse practitioners identified as primary care providers
- Nurse practitioners authority to sign provider orders for life-sustaining treatment (POLST) forms
Choose a tab to explore different options. For more detailed information, please click on a state or territory.
Practice authority can be defined as certified nurse midwives’ ability to practice with or without physician oversight. Prescriptive authority refers to a certified nurse midwife’s authority to prescribe medications. Some states require a certified nurse midwife to have a relationship with a physician that outlines procedures the nurse midwife may perform and procedures for consulting with the physician, including their ability to prescribe medications. In some states, policy specifies whether a nurse midwife must complete a transition to practice period before practicing or prescribing independently. In other states, certified nurse midwives have full independent practice and prescriptive authority, meaning they practice independently with no physician oversight.