Advanced Practice

Advanced practice nurses are a vital part of the expert care given to patients at Cedars-Sinai Medical Center.

With advanced training in highly specialized areas, advanced practice nurses are able to care for patients with complex conditions who have under gone sensitive and highly technical procedures.

More than 200 men and women have participated in internship training programs supported by the Nursing Institute in many specialty areas, including:

  • Acute care
  • Care for specific populations such as seniors, children and adults
  • Critical care
  • Emergency care
  • Neonatal care
  • Nurse midwifery
  • Oncology
  • Operating room subspecialties


What Is Advanced Practice Nursing?

The term advanced practice nurse refers to registered nurses who have gained advanced preparation for expanded clinical practice by earning a master's degree in nursing. Their specific training and skills make them different than other registered nurses.

Advanced practice nurses include nurse practitioners (NPs), clinical nurse specialists (CNSs), nurse anesthetists (CNAs) and certified nurse-midwives (CNMs).

Nurse Practitioners

A nurse practitioner provides direct care to a specific population of patients. These groups of people may be adults, seniors, children or neonates.

Nurse practitioners diagnose and manage common acute and stable chronic health problems. In addition to their traditional registered nursing skills, nurse practitioners can perform comprehensive physical examinations, order and interpret diagnostic tests, request specialty consultations, perform and prescribe therapeutic measures and furnish medications.

A nurse practitioner may be involved with health promotion and disease prevention as well as patient and family education.

Nurse practitioners are individually accountable for their practice. They collaborate closely with physicians.

A nurse preparing to become a nurse practitioner must complete courses related to the direct care of individuals, including differential diagnosis, clinical decision-making, medical therapeutics and pharmacology.

Nurse practitioner students also must complete more than 500 hours of clinical practice under the close supervision of experienced nurse practitioners and physicians.

After they graduate, a nurse practictioner must take national certification exams. In most cases, they must also be specially licensed by the state in which they practice.

Clinical Nurse Specialist

A Clinical Nurse Specialist (CNS) is an expert in clinical nursing who is familiar with the theory and research related to a nursing specialty area. Clinical Nurse Specialists are registered nurses, who have graduate level nursing preparation at the master's or doctoral level as a CNS. They are clinical experts in evidence based nursing practice within a specialty area, treating and managing the health concerns of patients and populations. As an advanced practice registered nurse, the CNS continues to perform many of the same actions used in basic nursing practice. The difference in this practice relates to a greater depth and breadth of knowledge, a greater analysis of data, and complexity of skills and actions.

Traditionally, the CNS provides direct clinical care to patients as well as education, research, consultation and leadership/management. The CNS influences care outcomes by providing expert consultation and implementing improvements in the healthcare delivery system. He/she often functions as a program coordinator, a leader in implementing change strategies to improve patient outcomes, an educator, and/or manager of complex patient populations. The CNS provides direct patient care, including assessing, diagnosing, planning, and treatment of health problems, health promotion, and preventive care within this specialized area of practice.

The CNS specialty may be focused on individuals, populations, settings, type of care, type of problem, or diagnostic systems subspecialty.

The California Board of Registered Nursing must certify any registered nurse who calls themselves a Clinical Nurse Specialist. CNS's may also be certified in their specialty by examination from a national nursing association's credentialing branch such as the American Nurses Credentialing Center.