Kathleen Dracup, D.N.Sc, RN, Professor and Dean, School of Nursing, University of California, San Francisco

The transformation of the health-care system is taking place as you read this, and it can be seen even today in the most common areas:

• A mother brings her child into a clinic for treatment of an earache. Instead of a physician, a nurse practitioner provides the care.
• A patient is readied for surgery. A variety of specialists move around the surgery room, but it’s not a specially trained physician administering the anesthetic—it’s a certified nurse anesthetist.
• During a patient’s recovery from an acute illness, it’s decided that the patient no longer needs to stay in the hospital but isn’t well enough to return home. The best place to continue the recovery is an intermediate-care facility. Who makes that decision? A clinical nurse specialist. Who oversees the physical and emotional rehabilitation programs at this facility? Another clinical nurse specialist.

Advanced practice nurses
These health-care professionals are all advanced practice nurses (APNs). All have graduate-level degrees, and they serve as proof that the demand for nurses with master’s and doctoral degrees for advanced practice, clinical specialties, teaching, and research will double the supply.

Another study estimated that the U.S. could save as much as $8.75 billion annually if APNs were used appropriately in place of physicians. As more and more of the restrictions on APNs succumb to legislative or economic forces, the demand for graduate-level nurses is expected to remain high.

Educational core for APN
A master’s degree in nursing is the educational core that allows advanced practice nurses to work as nurse practitioners, certified nurse-midwives, clinical nurse specialists, and certified nurse anesthetists.

• Nurse practitioners conduct physical exams, diagnose and treat common acute illnesses and injuries, administer immunizations, manage chronic problems such as high blood pressure and diabetes, and order lab services and X-rays.
• Nurse-midwives provide prenatal and gynecological care, deliver babies in hospitals and private settings such as homes, and follow up with postpartum care.
• Clinical nurse specialists provide a range of care in specialty areas, such as oncology, pediatrics, and cardiac, neonatal, obstetric/gynecological, neurological, and psychiatric nursing.
• Nurse anesthetists administer anesthesia for all types of surgery in operating rooms, dental offices, and outpatient surgical centers.
• Master’s degrees in nursing administration or nursing education are also available.

Variety of programs
There are more than 330 master’s degree programs accredited by the Commission on Collegiate Nursing Education (CCNE) or by the National League for Nursing Accrediting Commission (NLNAC). The wide spectrum of programs includes the Master of Science in Nursing (M.S.N.) degree, Master of Nursing (M.N.) degree, Master of Science (M.S.) degree with a nursing major, or Master of Arts (M.A.) degree with a nursing major. The specific degrees depend on the requirements set by the college or university or by the faculty of the nursing program. There are accelerated programs for RNs, which allow the nurse with a hospital diploma or associate degree to earn both a baccalaureate and a master’s degree in a condensed program. Some schools offer accelerated master’s degree programs for nurses with non-nursing degrees and for non-nursing college graduates. There are joint-degree programs, such as a master’s in nursing combined with a Master of Business Administration, Master of Public Health, or Master of Hospital Administration.