How to become an advanced nursing practitioner in 7 steps

Updated 21 July 2023

Nurses make up more than half of clinical employees, a number that highlights their significance in ensuring sustainable healthcare for the long term. An advanced nursing practitioner is the highest role in clinical nursing and is among the highest-paid medical professionals. In-depth knowledge of the components and requirements of this profession can help you make informed decisions on your career trajectory in advanced nursing. In this article, we describe what an advanced nursing practitioner is, explain how to become one and highlight this role's responsibilities.

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What is an advanced nursing practitioner?

An advanced nursing practitioner (ANP), or advanced practice registered nurse, is a primary care professional specialising in offering public medical care. Professionals in this field include nurse midwives and clinical nursing experts making critical decisions about a patient's health. This is one of the most advanced positions in nursing. Sometimes, an APN may order tests, make clinical diagnoses and give medical advice without consulting a doctor. Modern ANPs have specialised qualifications and experience and carry indemnity insurance.

How to become an ANP

Here are seven important steps to becoming an ANP:

1. Become a registered nurse

The first step to becoming an ANP is to become a registered nurse. ANPs are usually senior registered nurses with autonomy and a higher level of skill and competence. This position prepares nurses for the higher demands of an ANP role. Regardless of your grades or academic qualifications, experience in the nursing field is mandatory to become an ANP. Usually, employers or educational programmes only consider candidates with at least two or three years of experience in relevant clinical duties.

2. Earn an MSc nursing degree

Although the academic requirements for an ANP vary in various areas, this role typically requires a masters-level educational qualification. You can choose the Master of Science in Nursing or the Doctor of Nursing Practice programme. Ensure that the modules you study are in your preferred discipline. After completing this programme, you can apply to register for any of the ANP roles.

Related: Primary nursery nurse duties (with definitions and examples)

3. Make a portfolio

Before admission into most ANP training programmes, educational institutions usually request proof of your competencies. Create a portfolio showing your academic, leadership and learning competencies. It's a good idea to include details of your higher education modules, recent projects, learning logs and assessment records.

4. Demonstrate competence in advanced practice

Besides having a master's degree, an ANP nurse proves their competence in advanced practice. Advanced practice, a high level of medical practice, consists of the following four core concepts:

  • learning facilitation

  • leadership

  • clinical practice

  • evidence, research and development

Health Education England oversees healthcare workers' education and development schemes, including advanced medical practice. The organisation monitors and guides the advanced practice training of medical practitioners, professionals who make complex decisions about a patient's health. Advanced practice competence enables an ANP to exhibit the high-level skill, composure and knowledge that allow them to make autonomous medical decisions at a high level.

Related: How to become a perioperative nurse (plus duties and skills)

5. Get indemnity insurance

Indemnity coverage is essential for an ANP. Since this role sometimes involves making critical judgement calls under pressure, some decisions may not produce the expected outcome. Indemnity insurance protects an ANP from liability for damages that an error or misjudgement might cause. Research top insurance companies offering indemnity cover, send your job description to them and discuss the terms.

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6. Develop relevant skills

Besides a master's degree, specific soft and hard skills can give you an advantage over other candidates. Some of the most relevant skills for an ANP include digital intelligence, decision-making, attention to detail and empathy. These skills enable you to use modern technology for healthcare purposes, perform health checks and make accurate diagnoses.

7. Look for job opportunities

Although there's high demand for professionals in these roles, most employers hire only those with experience, high recommendations and relevant qualifications. Start looking for open positions in any ANP role. You may speak to close friends, family, mentors and former educators about your job search. Search job websites such as Indeed to find organisations looking for qualified candidates.

Related: How to become a vet nurse (including duties and skills)

Advanced roles of a nursing career

During the early years of a nursing career, nurses in training learn virtually every aspect of the profession. In advanced roles, a nurse focuses on an area of the field to provide specialised care for the public. The following are the four essential speciality roles for an ANP:

Clinical nurse specialist (CNS)

A CNS typically works in a specialised unit. This role combines medical research, management and communication expertise. While CNSs work with other medical experts to care for patients with specific health complications, they also participate in developing sustainable treatment solutions to enhance patient recovery. A CNS is usually an integral research team member and trains other nurses to boost their proficiency.


Besides doctors, patients with health challenges in their area of specialisation meet ANPs for consultation. They test and treat patients with their high-level healthcare competency. An ANP typically works as part of the diagnostic team in hospitals and health centres. They collaborate with doctors to examine patients and make diagnoses and other critical healthcare and treatment decisions. They can work in various areas, from mental health care to acute care.

Related: How much does a paediatric nurse make? (With duties)

Certified nurse midwife (CNM)

A CNM primarily works with other medical experts specialising in mother and infant care, including surgeons and nurses. CNMs are instrumental in ensuring pregnant women receive the critical healthcare they need before, during and after delivery. CNMs have directly contributed to a nationwide decline in childbirth-related mortality rates. This role involves making critical decisions such as performing an emergency caesarean section or medically inducing labour.

Related: Nurse role and responsibilities plus the skills needed

Certified registered nurse anaesthetist

A nurse anaesthetist helps patients ease their pain and is usually part of the surgical team. Their primary responsibility during surgery is administering anaesthetics to patients and ensuring they safely regain consciousness after surgery. While a patient undergoes a surgical procedure, the anaesthetist monitors their vital signs and plays an important role in the patient's post-operative recovery. Besides playing a vital role in surgery, a nurse anaesthetist gives patients sedatives to help them feel little or no pain during non-surgical procedures.

Related: 17 types of nurses (with job descriptions and salary info)

Responsibilities of an ANP

This profession involves responsibilities critical to the well-being of patients. The autonomy this position provides enables ANPs to make some of the major decisions a doctor usually makes. Here are the duties you may perform on a typical day at work:

  • Diagnosing patients: Like a doctor, an ANP can diagnose patients after a series of tests. They help the patient feel at ease regardless of the diagnosis.

  • Running or ordering tests: Medical professionals in this role may run tests to ensure that they accurately diagnose a patient. If they don't run tests, these professionals usually supervise and ensure the accuracy of the test results.

  • Providing medical treatment advice: After making specific analyses based on the test results they acquire, an APN may offer medical advice in the absence of a doctor. From medicine prescriptions to food choices, they can advise patients on managing their health conditions.

  • Assisting surgeons in the theatre: Some nurses have the privilege of joining a surgical team under the supervision of surgeons. A surgical nurse, or 'scrub nurse', assists the medical team with duties such as sterilising and managing surgical equipment, cleaning surgical tables and preparing patients for surgery.

  • Helping patients prepare for surgery: Nurses typically help patients with vital information and healthcare tips before surgery. They also ensure that patients adhere to surgeons' pre-surgical directives, such as avoiding eating in the hours before their scheduled procedure.

  • Caring for patients after surgery: Since each patient's needs after an operation are unique, an ANP supervises and provides medical care after surgery. Post-surgical care may include feeding patients, administering medicine, dressing stitched areas and reporting any complications to the surgeon in charge.

  • Evaluating patients' recovery and response to treatment: Besides the immediate post-operative patient care, ANPs help with recovery and rehabilitation exercises. They also monitor the patient's vital signs and their response to treatment.

  • Assisting pregnant women during delivery: ANPs in the pregnant women and infant care unit have the skill and knowledge to help deliver babies with or without the help of a doctor. They also help pregnant women prepare for delivery and are instrumental in providing post-natal care to mothers and newborns.

  • Performing regular medical check-ups on patients: Usually, nurses attend to patients with benign medical conditions and those who need regular check-ups. An ANP may provide care for patients with malignant conditions or refer them to a doctor in severe cases.

  • Mentoring junior nurses: ANPs with years of experience in specialised roles train other nurses with less experience and qualifications. They teach them the basics of the field, help them develop the essential skills and character they need for the role and may mentor them after their apprenticeship or training.

Please note that none of the companies, institutions or organisations mentioned in this article are affiliated with Indeed.

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