Nursing Reflection Paper: Why I Rejected CRNA & CNS Roles

Introduction: Advanced Nursing Roles Are Evolving. Are You Ready?

Nursing today is more than bedside care. As healthcare continues to grow more complex, nurses are stepping into expanded roles that require leadership, critical thinking, and clinical decision-making. This nursing reflection paper explores the four core roles of Advanced Practice Nurses; Certified Nurse Practitioner (CNP), Clinical Nurse Specialist (CNS), Certified Nurse Midwife (CNM), and Certified Registered Nurse Anesthetist (CRNA) and reflects on why the CNP role is the best fit for me.

If you’re a registered nurse considering your next step, or a student trying to ace your course, this article offers valuable insights into each APN role and what it truly means to transition into advanced practice.

Understanding the Four Core APN Roles

Certified Nurse Practitioner (CNP): The Autonomous Leader in Patient Care

Certified Nurse Practitioners provide primary and specialty care to patients across all age groups. Their responsibilities include diagnosing illnesses, prescribing medication, ordering diagnostic tests, and developing treatment plans. One of the most appealing aspects of the CNP role is the ability to practice independently in many states, giving them authority similar to that of physicians.

To become a CNP, one must earn a Master of Science in Nursing (MSN), obtain state licensure, and become certified in a specific population focus such as family, pediatric, psychiatric mental health, or adult-gerontology.

Because CNPs work so closely with patients and have the freedom to make clinical decisions, they are often seen as the most versatile of the APN roles. This clinical independence raises important questions about responsibility, patient safety, and professional integrity – topics closely explored in our detailed analysis of nursing ethics, virtue, and community-based decision-making. Understanding these ethical foundations is crucial for CNPs navigating real-world challenges in their evolving roles.

Clinical Nurse Specialist (CNS): The Expert Behind the Systems

CNSs are highly trained nurses who focus on improving healthcare delivery systems, mentoring nurses, and driving evidence-based practice. They may still provide direct patient care, but their main role is often indirect, working on healthcare quality improvement, staff education, and research initiatives.

While CNSs are vital to hospital and organizational success, they generally do not have the authority to diagnose conditions or prescribe medication independently Cooper et al. (2019). Their strength lies in supporting nurses and improving care through leadership and innovation.

Certified Nurse Midwife (CNM): Advocates for Women’s Health

CNMs provide specialized care in reproductive health, from prenatal appointments to childbirth and postpartum care. They work in various settings, including hospitals, birthing centers, and clinics, and often collaborate with obstetricians when needed.

They offer a holistic approach to women’s health, focusing not just on childbirth but also on education, family planning, and menopause care. While incredibly rewarding, the CNM role requires dedication to a narrow scope of care compared to other APN roles.

Certified Registered Nurse Anesthetist (CRNA): Specialists in Surgical Care

CRNAs play a critical role in the operating room. They administer anesthesia, monitor vital signs, and provide pain management before, during, and after surgical procedures. CRNAs are essential in both surgical and trauma care, often working closely with anesthesiologists, surgeons, and dentists.

The path to becoming a CRNA requires an MSN and often a Doctor of Nursing Practice (DNP), along with prior experience in critical care nursing.

Why I Chose to Become a Certified Nurse Practitioner

After careful reflection, the CNP role stood out to me because of its balance between autonomy, patient interaction, and clinical complexity. As a registered nurse, I’ve always wanted more responsibility in patient care. I wanted to be the one making critical decisions, managing chronic illnesses, and supporting patients through every stage of treatment.

CNPs have more control over their practice compared to CNSs and don’t face the same limitations in diagnosis or prescribing medication. They also work in a broader variety of settings, from clinics and hospitals to schools and home health care. This flexibility is important to me as I envision my future career.

Beyond the technical aspects, I chose the CNP role because it aligns with my passion for patient-centered care. It allows me to grow as both a nurse and a healthcare leader.

My Plans for Clinical Practice as a CNP

Learning about the four advanced practice nursing roles helped me clarify where I want to go. My long-term goal is to practice in family and psychiatric mental health, areas where I believe I can make a meaningful impact.

I plan to apply for residency programs that offer robust mentorship and practical exposure. I also want to specialize in underserved communities and use telehealth as a tool to reach patients who may not otherwise have access to qualified care.

Eventually, I hope to contribute to policy discussions and advocate for full-practice authority for nurse practitioners across all states. But for now, my focus is on becoming a competent, compassionate, and confident CNP.

Transitioning from RN to CNP: The Challenges and the Growth

Moving from an RN to an advanced practice role is a big shift. It’s not just about adding more responsibilities; it’s about reshaping your entire approach to care. As Barnes (2015) observed, many nurses struggle with the transition due to factors like lack of support, inadequate orientation, and feelings of unpreparedness.

I expect this journey will challenge me emotionally and mentally, but I also know it’s worth it. To ease the transition, I plan to pursue hands-on experience early, seek mentors who’ve walked this path, and take advantage of peer networks.

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Conclusion: More Than Just a Nursing Reflection Paper

This nursing reflection paper is more than an academic task. It’s a window into my personal and professional journey. After examining all four APN roles – CNP, CNS, CNM, and CRNA – I know that the Certified Nurse Practitioner role aligns most closely with my strengths, goals, and passion.

It gives me the autonomy I need to care deeply and act decisively. It allows me to connect with patients, shape outcomes, and lead with compassion.

If you’re planning to ace your course, writing a compelling nursing reflection paper with proper sources can set your work apart. Using evidence from experts like Wheeler et al., Cooper et al., and Barnes strengthens your argument and boosts your credibility both academically and in SEO rankings.

Barnes, H. (2015). Exploring the factors that influence nurse practitioner role transition. The Journal for Nurse Practitioners, 11(2), 178–183. https://doi.org/10.1016/j.nurpra.2014.11.004

Cooper, M. A., McDowell, J., & Raeside, L. (2019). The similarities and differences between advanced nurse practitioners and clinical nurse specialists. British Journal of Nursing, 28(20), 1308–1314. https://doi.org/10.12968/bjon.2019.28.20.1308

Wheeler, K. J., Miller, M., Pulcini, J., Gray, D., Ladd, E., & Rayens, M. K. (2022). Advanced practice nursing roles, regulation, education, and practice: A global study. Annals of Global Health, 88(1). https://doi.org/10.5334/aogh.3698