Advanced Nursing Practice

Subject: Nursing
Pages: 6
Words: 1398
Reading time:
5 min
Study level: College

Executive Summary

This paper compares and contrasts the roles and educational requirements of nurse practitioners and nurse anaesthetists. Compared to nurse practitioners, this paper shows that nurse anaesthetists draw from an older and richer history of the practice. The nursing practice is therefore a more recent discipline. This paper also demonstrates that the roles and duties of a nurse practitioner are broader and more dynamic than the roles and duties of a nurse anaesthetist. The educational qualifications for both areas of practice are however similarly rigorous. Nonetheless, both areas of practice are pivotal to the success of the broader nursing practice.


Many potential nurses often debate on the decision regarding whether to be a nurse practitioner or a nurse anaesthetist. Both professions share some inherent similarities, but they appeal to people in different measures. Their differences in appeal stem from the differences in job responsibilities, educational requirements, and professional histories. Based on these key areas of apparent differences, this paper compares and contrasts the structural aspects of a nurse practitioner and a nurse anaesthetist. The evolution of roles between both professions, the educational requirements for the advanced practice roles, and the practical responsibilities for each category of nursing practice outlines the main parts of this report.

Role Evolution

Nurse Anaesthetists

The discovery of the anaesthetic properties of drugs in the 19th century provided the grounds for the development of anaesthesia administration as a profession. During this time, the use of general anaesthesia for surgical properties gained credence in the medical field, but the lack of qualified anaesthetist agents undermined the effectiveness of anaesthesia administration during surgery (Metcalfe, 2005). Conversely, unqualified personnel (including house officers, unqualified medical students, hospital administrators, or anybody who was available to offer their time) became an anaesthetist (Metcalfe, 2005). The inclusion of these unqualified groups of personnel in surgery led to the rise of anaesthesia as the leading cause of surgical deaths. From the above misfortunes, the role of nurse anaesthetists started to grow and become more specific. Since the 1900s, nurse anaesthetists have provided anaesthetic care for hundreds of years (their roles make them among the oldest nurse Specialty groups in America). This group of professionals also provides anaesthetic care to American service men and women, both locally and around the world. Among the first main events (of national scale) where the roles of nurse anaesthetists were vivid was the American civil war (1861-1865) (Metcalfe, 2005).

Nurse Practitioners

Compared to nurse anaesthetists, the roles of nurse practitioners are relatively new. Advanced nursing practice roles started in the mid 20th century (Lagerwey, 2010). However, the development of the advanced nursing roles, as a primary care practice, developed in the mid-1960s (Lagerwey, 2010). This development started when a shortage of medical doctors (at the time) undermined the efficiency of the medical practice. The official training of nurses started in 1965 to strike a balance between the distribution of natural resources and the rise of medical costs. Since then, advanced nursing practice roles have steadily developed to improve the practice. However, the greatest issue that has undermined this development is the conflicting titles and uncertain abilities of different nursing groups (Blais & Hayes, 2011). This issue has persisted even in modern times as advanced nursing practice roles continue to develop.

Educational Requirements

Nurse Anaesthetists

The educational requirements of nurse anaesthetists in America are relatively strict. First, certified nurse anaesthetists have to complete a bachelor’s degree in Nursing and serve two years in the practice before they become registered nurses (Webster, 2000). The experience is especially valuable if a nurse works in an acute care setting. Intensive care units or surgical care units are valuable medical settings.

If the nurses meet the above educational and professional criteria, they are required to apply for additional certification from the Council on Accreditation of Nurse Anaesthesia. Through this accreditation, the nurse anaesthetists may graduate with a masters or doctoral degree after undergoing an educational course that may last for up to 36 months. Most of such educational programs only require entry-level qualifications that would allow the admission of students in a medical school. The Council on Accreditation standards outline the educational standards of these courses (Webster, 2000). When the students complete the courses, they are supposed to have the scientific, clinical, and professional backgrounds to build on their professional careers as certified nurse anaesthetists (Metcalfe, 2005).

Nurse Practitioners

The educational requirements to be a nurse practitioner differ slightly from the educational requirements that nurse anaesthetists require. Nonetheless, both practices are alike because their educational requirements are rigorous and strict. Unlike a registered nurse, a certified nurse practitioner requires advanced coursework and clinical rotations. The curriculum for nurse practitioners also tends to have more curriculum components (Lagerwey, 2010, p. 591).

The path to obtain full accreditation for becoming a nurse practitioner however starts from the completion of a Bachelor of Science in nursing degree, which takes about four years. Later, the nurse practitioners need to complete a master’s degree in the same field (usually takes about three years). Before students gain admission to a master’s degree course in nursing, they are required to complete a Graduate Record and NCLEX-RN exams (besides the completion of the undergraduate course in nursing). If a nursing practitioner intends to pursue a Doctorate in nursing practice, he/she is required to pursue a doctorate course, which may take two more years, beyond the level required for a master’s degree (Lagerwey, 2010).

Practice Responsibilities

Nurse Anaesthetists

The practice responsibilities for nurse anaesthetists are diverse. A core responsibility for this group of nurses is to evaluate a patient’s response to anaesthesia (Smith, 1977). From the evaluation of a patient’s response to the anaesthesia care plan, the nurse anaesthetist would learn how to improve the care of future patients. In addition, because nurse anaesthetists have a vast knowledge about lung and heart pathophysiology, their duties may include being a member of the cardiopulmonary resuscitation team (Smith, 1977). This group of nurses also acts as consultants in respiratory care and contribute to the peer-review process on the same. Comprehensively, unlike popular belief, the roles of nurse anaesthetists do not include prescribing drugs or diagnosing patients, unless under the supervision of a doctor. The above issues outline the roles of nurse anaesthetists.

Nurse Practitioners

The roles of nurse practitioners are often very diverse because they are required to provide holistic and preventive care. In this nursing model, the nurse practitioners are also required to be the primary point of contact between patients and their care plans (Blais & Hayes, 2011). Nurse practitioners are also required to promote patient advocacy by collaborating with different stakeholder groups for the realisation of maximum health benefits for the patients. Nurse practitioners are also required to observe a patient’s health within a community or family setting. This may happen through cultural relativism (Blais & Hayes, 2011).

Significance of the AACN 2015 Recommendations for Advanced Practice

The American Association of Critical Care Nurses (AACN) introduced a raft of recommendations to solve some of the most pressing issues in nursing, including the lack of a common definition of APRN roles, the lack of standardisation of APRN programs, and the excessive increase of Specialty nursing divisions that complicate the practice. However, the attempts to solve some of these challenges pose new implications for the nursing practice. For example, nursing practitioners now need to undergo an accredited graduate level education program to meet AACN’s requirements. This provision may force existing nursing practitioners to seek new certifications, which may be costly and time-consuming. In practice, AACN’s regulations may also redefine how we understand critical care and acute care. The new recommendations narrow the differences between these two types of care. This redefinition may significantly change the education, evaluation, and regulation of critical care, under the guidelines of acute care competencies.


After weighing the findings of this paper, it is easy to point out a rich history for nurse anaesthetists, compared to the advanced nursing practice. The latter is more recent and differs from the administration of anaesthesia, based on its broad and patient-centred nature. The educational qualifications for both areas of practice are however similarly rigorous, but this similarity does not effectively mirror the duties and responsibilities of both areas of practice (the duties and responsibilities of advanced nursing practice are broader and more dynamic). Nonetheless, both areas of practice are pivotal to the success of the broader nursing practice.


Blais, K., & Hayes, J. (2011). Professional Nursing Practice: Concepts and Perspectives. Upper Saddle River, NJ: Prentice Hall.

Lagerwey, M. (2010). Ethical vulnerabilities in nursing history: Conflicting loyalties and the patient as ‘other’. Nursing Ethics, 17(5), 590-602.

Metcalfe, N. H. (2005). Military influence upon the development of anaesthesia from the American Civil War (1861–1865) to the outbreak of the First World War. Anaesthesia, 60(12), 1213-1217.

Smith, B. (1977). Should You Become A Nurse Anesthetist? Nursing, 7(11), 108-111.

Webster, N. R. (2000). The anaesthetist as peri-operative physician. Anaesthesia, 55(9), 839-840.