Nurse anesthetists, nurse midwives, and nurse practitioners held about 300,000 jobs in 2021. Employment in the detailed occupations that make up nurse anesthetists, nurse midwives, and nurse practitioners was distributed as follows:
| Nurse practitioners | 246,700 |
| Nurse anesthetists | 45,200 |
| Nurse midwives | 8,100 |
The largest employers of nurse anesthetists, nurse midwives, and nurse practitioners were as follows:
| Offices of physicians | 47% |
| Hospitals; state, local, and private | 25 |
| Outpatient care centers | 9 |
| Offices of other health practitioners | 5 |
| Educational services; state, local, and private | 3 |
Some advanced practice registered nurses (APRNs) provide care in patients’ homes. Some nurse midwives work in birthing centers, which are a type of outpatient care center.
APRNs may travel long distances to help care for patients in places where there are not enough healthcare workers.
Injuries and Illnesses
APRN work can be both physically and emotionally demanding. Some APRNs spend much of their day on their feet. They are vulnerable to back injuries because they must lift and move patients. APRN work can also be stressful because they make critical decisions that affect a patient’s health.
Because of the environments in which they work, APRNs may come in close contact with infectious diseases. Therefore, they must follow strict guidelines to guard against diseases and other dangers, such as accidental needle sticks or patient outbursts.
Work Schedules
Most APRNs work full time. In physicians’ offices, APRNs typically work during normal business hours. In hospitals and other healthcare facilities, they may work in shifts—including nights, weekends, and holidays—to provide round-the-clock patient care. Some APRNs, especially those who work in critical care or those who deliver babies, also may need to be on call.
Nurse anesthetists, nurse midwives, and nurse practitioners, also referred to as advanced practice registered nurses (APRNs), must have at least a master’s degree in their specialty role. APRNs also must be licensed registered nurses in their state, pass a national certification exam, and have a state APRN license.
Education
Nurse anesthetists, nurse midwives, and nurse practitioners typically need at least a master's degree in an advanced practice nursing field. Accredited healthcare and related programs in these specialties typically include classroom education and clinical experience. Courses in subjects such as advanced health assessment, pathophysiology, and pharmacology are common as well as coursework specific to the chosen APRN role.
An APRN must have a registered nursing (RN) license before pursuing education in one of the advanced practice roles, and a strong background in science is helpful.
Most APRN programs prefer candidates who have a bachelor’s degree in nursing. However, some schools offer bridge programs for registered nurses with an associate’s degree or diploma in nursing. Graduate-level programs are also available for individuals who did not obtain a bachelor’s degree in nursing but in a related health science field. These programs prepare the student for the RN licensure exam in addition to offering the APRN curriculum.
Although a master’s degree is the most common form of entry-level education, APRNs may choose to earn a Doctor of Nursing Practice (DNP) or a Ph.D. The specific educational requirements and qualifications for each of the roles are available on professional organizations’ websites.
Prospective nurse anesthetists must have 1 year of experience working as registered nurse in a critical care setting as a prerequisite for admission to an accredited nurse anesthetist program.
Licenses, Certifications, and Registrations
States’ requirements for APRNs vary. In general, APRNs must have a registered nursing license, complete an accredited graduate-level program, pass a national certification exam, and have an APRN license. Details are available from each state’s board of nursing.
To become licensed and use an APRN title, most states require national certification.
The National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) offers the National Certification Examination (NCE). Certified registered nurse anesthetists (CRNAs) must maintain their certification through the Continued Professional Certification (CPC) Program.
The American Midwifery Certification Board offers the Certified Nurse-Midwife (CNM). Individuals with this designation must recertify via the Certificate Maintenance Program.
There are several different certifications for nurse practitioners, including those available from the American Academy of Nurse Practitioners Certification Board(AANPCB), the American Nurses Credentialing Center (ANCC), and the Pediatric Nursing Certification Board (PNCB). Each of these certifications requires periodic renewal.
In addition, APRN positions may require cardiopulmonary resuscitation (CPR), basic life support (BLS), or advanced cardiac life support (ACLS) certification.
Advancement
Some APRNs take on managerial or administrative roles; others go into academia. APRNs who earn a doctoral degree may conduct independent research or work on an interprofessional research team.
Nurse anesthetists, nurse midwives, and nurse practitioners typically have an interest in the Thinking and Helping interest areas, according to the Holland Code framework. The Thinking interest area indicates a focus on researching, investigating, and increasing the understanding of natural laws. The Helping interest area indicates a focus on assisting, serving, counseling, or teaching other people.
If you are not sure whether you have a Thinking or Helping interest which might fit with a career as a nurse anesthetist, nurse midwife, and nurse practitioner, you can take a career test to measure your interests.
Nurse anesthetists, nurse midwives, and nurse practitioners should also possess the following specific qualities:
Communication skills. Advanced practice registered nurses must be able to communicate with patients and other health care professionals to ensure that the appropriate course of action is understood.
Critical-thinking skills. ARPNs must be able to assess changes in a patient’s health, quickly determining the most appropriate course of action and if a consultation with another health care professional is needed.
Compassion. Nurses should be caring and sympathetic when treating patients who are in pain or who are experiencing emotional distress.
Detail oriented. APRNs must be responsible and detail oriented because they provide various treatments and medications that affect the health of their patients. During an evaluation, they must pick up on even the smallest changes in a patient’s condition.
Interpersonal skills. Advanced practice registered nurses must work with patients and families as well as with other health care providers and staff within the organizations where they provide care. They should work as part of a team to determine and execute the best possible healthcare options for the patients they treat.
Leadership skills. Advanced practice registered nurses often work in positions of seniority. They must effectively lead and sometimes manage other nurses on staff when providing patient care.
Resourcefulness. APRNs must know where to find the answers that they need in a timely fashion.
The median annual wage for nurse anesthetists, nurse midwives, and nurse practitioners was $123,780 in May 2021. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $79,870, and the highest 10 percent earned more than $200,540.
Median annual wages for nurse anesthetists, nurse midwives, and nurse practitioners in May 2021 were as follows:
| Nurse anesthetists | $195,610 |
| Nurse practitioners | 120,680 |
| Nurse midwives | 112,830 |
In May 2021, the median annual wages for nurse anesthetists, nurse midwives, and nurse practitioners in the top industries in which they worked were as follows:
| Outpatient care centers | $128,190 |
| Hospitals; state, local, and private | 128,190 |
| Offices of physicians | 121,280 |
| Offices of other health practitioners | 104,790 |
| Educational services; state, local, and private | 102,680 |
Most advanced practice registered nurses (APRNs) work full time. In physicians’ offices, APRNs typically work during normal business hours. In hospitals and other healthcare facilities, they may work in shifts—including nights, weekends, and holidays—to provide round-the-clock patient care. Some APRNs, especially those who work in critical care or those who deliver babies, also may need to be on call.
Overall employment of nurse anesthetists, nurse midwives, and nurse practitioners is projected to grow 40 percent from 2021 to 2031, much faster than the average for all occupations.
About 30,200 openings for nurse anesthetists, nurse midwives, and nurse practitioners are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.
Employment
Projected employment of nurse anesthetists, nurse midwives, and nurse practitioners varies by occupation (see table). Growth will occur because of an increase in the demand for healthcare services. Several factors will contribute to this demand, including an increased emphasis on preventive care and demand for healthcare services from the aging population.
Advanced practice registered nurses (APRNs) perform many of the same services as physicians. APRNs will be increasingly used in team-based models of care, particularly in hospitals, offices of physicians, clinics, and other ambulatory care settings, where they will be needed to provide preventive and primary care.
APRNs will also be needed to care for the large baby-boom population. As baby boomers age, they will experience ailments and complex conditions that require medical care. APRNs will be needed to keep these patients healthy and to treat the growing number of patients with chronic and acute conditions.
As states change their laws governing APRN practice authority, APRNs are being allowed to perform more services. APRNs also are being recognized more widely by the public as a source for primary healthcare.
For more information about nurse anesthetists, including a list of accredited programs, visit
American Association of Nurse Anesthetists
For more information about nurse midwives, including a list of accredited programs, visit
American College of Nurse-Midwives
For more information about nurse practitioners, including a list of accredited programs, visit
American Association of Nurse Practitioners
For more information about registered nurses, including credentialing, visit
For more information about nursing education and being a registered nurse, visit
For more information about undergraduate and graduate nursing education, nursing career options, and financial aid, visit
American Association of Colleges of Nursing
For more information about states’ Boards of Nursing, visit
National Council of State Boards of Nursing
For more information about certification, visit
American Academy of Nurse Practitioners Certification Board
American Association of Critical-Care Nurses
American Midwifery Certification Board
American Nurses Credentialing Center
National Certification Corporation
National Board of Certification and Recertification for Nurse Anesthetists
Pediatric Nursing Certification Board