Description of Registered Nurse Titles

Professional Nursing--the performance for compensation of any act which requires substantial specialized education, judgment, and skill based knowledge and application of principles derived from the biological, physical, social and nursing sciences, including, but not limited to:

• Responsibility for the teaching of health care and the prevention of illness to the patient and his family;
• Assessment, nursing diagnosis, nursing care, and counsel of persons who are ill, injured or experiencing alterations in normal health processes;
• The administration of medications and treatments as prescribed by a person licensed by a state regulatory board to prescribe medications and treatments;
• The coordination and assistance in the delivery of a plan of health care with all members of a health care team;
• The teaching and supervision of other persons in the performance of any of the foregoing.

Registered Professional Nurse or Registered Nurse--A person licensed under the provisions of sections 335.011 to 335.096, RSMo, to engage in the practice of professional nursing.

Registered Professional Nurse Certification--A nurse who has met requirements for clinical or functional practice in a specialized field; pursued education beyond basic nursing preparation; and passed a written examination based on nationally recognized standards of nursing practice.

Advanced Practice Registered Nurse--A registered professional nurse who has had education beyond the basic nursing education and is certified by a nationally recognized professional organization as having a nursing specialty, or who meets criteria for an advanced practice registered nurse established by the board of nursing. The board of nursing promulgates rules specifying which professional nursing organization certifications are recognized as advanced practice registered nurses, and sets standards for education, training and experience required for those without such specialty certification to become advanced practice registered nurses.

The term advanced practice registered nurse applies to a registered professional nurse as defined in Section 335.016(2), RSMo, who is a nurse anesthetist, nurse midwife, nurse practitioner, or clinical nurse specialist. An individual who meets the requirements to be an advanced practice registered nurse is recognized by the Missouri State Board of Nursing within a specific advanced practice nursing clinical specialty area and role. The specific advanced practice nursing clinical specialty area and role is identified on a “Document of Recognition” sent to the licensed registered professional nurse. The “Document of Recognition” is not a license.

Nurse Practitioner--An advanced practice registered nurse who is prepared through a formal nursing educational program to provide a full range of primary health care services. Most nurse practitioner programs currently confer a master’s degree. The nurse practitioner, utilizing a broad knowledge base, focuses on health promotion, prevention of disease/health problems, early diagnosis and treatment of common acute minor illnesses and injuries, and management of stabilized chronic illnesses. Current nurse practitioner specialties for which certification is available are pediatric, school, family, adult, Ob/Gyn, neonatal, and gerontological.

Clinical Nurse Specialist--An advanced practice registered nurse with a graduate degree, master’s or doctoral, in nursing who has become expert in a defined area of nursing knowledge and practice. The primary emphasis of the clinical nurse specialist is on client-centered practice that is defined by a select client population and practice setting such as cardiac, cancer, community health or mental health. Currently, clinical nurse specialist certification is available in the areas of psychiatric and mental health (adult), psychiatric and mental health (child), medical-surgical, gerontological, and community health.

Certified Nurse Midwife--An advanced practice registered nurse who has completed specialized education in nurse midwifery and who has received certification through the American College of Nurse Midwives. Nurse midwives provide primary care in the area of women’s health including gynecologic, prenatal, delivery, and postpartum care.

Certified Registered Nurse Anesthetist--An advanced practice nurse who has 2 to 3 years of formal education beyond a Bachelor of Science degree in nursing and who has received certification from the Council of Certification of Nurse Anesthetists. Nurse anesthetists administer anesthesia to patients in a variety of settings, including hospital operating rooms, ambulatory surgical settings, and dentist’s offices.

References
ANA Congress of Nursing Practice. (1992). “Working Definition -- Nurses in Advanced Practice.”

American Nurses Association. (1993). “Nursing Facts -- Advanced Practice Nursing: A New Age in Health Care.”

Code of State Regulations. (1996). 4 CSR 200-4.200, Collaborative Practice Rule.

Marion, Lucy and Williamson, Geraldine C. (1985). The Scope of Practice of the Primary Health Care Nurse Practitioner. American Nurses’ Association.

Missouri State Board of Nursing. (1990). The Missouri Nurse 59.5. “Advanced Registered Professional Nursing Position Statement.”

RSMo Chapter 335. (1995). State of Missouri Nursing Practice Act.

Sanders, Melinda Dolan. (1993). The Missouri Nurse 62. “Your Nursing Practice.”

Sparacino, Patricia and Durand, Barbara A. (1986). Council of Primary Health Care Nurse Practitioner Newsletter. “Specialization in Advanced Nursing Practice.” American Nurses’ Association.

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