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A Master of Science in Nursing (MSN) provides RNs with the advanced skills they need to enter advanced clinical practice or to begin careers in vital nonclinical roles as educators, administrators, patient advocates, informaticists and more.
In April 2015, the Illinois Center for Nursing (ICN) identified the growing demand for advanced practice nurses (APNs) as one of the central challenges that needed to be addressed in strategic planning designed to meet the healthcare needs of the citizens of Illinois. The necessity for more advanced clinicians in the state is due in part to an increasing citizen demand for health care services. With advanced practice skills in pathophysiology, health assessment and pharmacology, APNs working in independent practice, physician’s offices and the state’s 140 hospitals are seen as the solution to the shortage of primary healthcare providers in Illinois, particularly in the state’s rural, medically underserved areas.
The value of Illinois’s APNs is reflected in the salaries they earn. In May 2014, the U.S. Bureau for Labor Statistics (BLS) published nurse salaries, showing the dramatic increase in earning power that comes with earning a Master of Science (MSN) in nursing and entering advanced practice. Shown here is a comparison of salaries between ADN/BSN-prepared RNs and MSN-prepared APNs in Illinois (salary ranges are shown as mean and top 10% average):
- Registered Nurses – $66,080; $95,610
- Nurse Practitioners – $90,480, $117,910
- Nurse Anesthetists – $146,470; equal to or greater than $187,199
- Nurse Midwives – $89,740, $119,960
Licensing Requirements for the Four APN Roles Recognized by the Illinois Center for Nursing
A growing number of RNs in Illinois are pursuing Master of Science in Nursing (MSN) programs in advanced practice nursing roles. With an MSN degree and national certification, RNs with unencumbered licenses in good standing would qualify for APN licensure through the Illinois Center for Nursing (ICN) in one of four advanced practice nursing roles:
- Nurse practitioner (NP)
- Certified registered nurse anesthetist (CRNA)
- Certified nurse-midwife (CNM)
- Clinical nurse specialist (CNS)
Upon receiving their degree, nurses must earn and maintain certification from a national body recognized by the ICN. Master’s programs and national certification for nurse practitioners and clinical nurse specialists are further specialized according to population focus (Adult-Gerontology, Family/Individual Across the Lifespan, Neonatal, Pediatrics, Psychiatric/Mental Health, Women’s Health).
The ICN recognizes the following national certification agencies as granting the certification necessary for APN licensure in the respective advanced practice roles and patient population foci:
Nurse Practitioners
American Academy of Nurse Practitioners
- Adult Nurse Practitioner (ANP)
- Family Nurse Practitioner (FNP)
- Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP)
American Nurses Credentialing Center
- Acute Care Nurse Practitioner-Board Certified (ACNP-BC)
- Adult Nurse Practitioner-Board Certified (ANP-BC)
- Family Nurse Practitioner-Board Certified (FNP-BC)
- Gerontological Nurse Practitioner-Board Certified (GNP-BC)
- Pediatric Primary Care Nurse Practitioner-Board Certified (PPCNP-BC)
- Adult-Gerontology Acute Care Nurse Practitioner-Board Certified (AGACNP-BC)
- Adult-Gerontology Primary Care Nurse Practitioner-Board Certified (AGPCNP-BC)
- Psychiatric-Mental Health Nurse Practitioner-Board Certified (PMHNP-BC)
- Adult Psychiatric-Mental Health Nurse Practitioner-Board Certified (PMHNP-BC)
- School Nurse Practitioner-Board Certified (SNP-BC)
AACN Certification Corporation
- Acute Care Nurse Practitioner Adult-Gerontology (ACNPC-AG)
- Acute Care Nurse Practitioner Adult (ACNPC) – not aligned with APRN Consensus Model
Pediatric Nursing Certification Board
- Pediatric Nurse Practitioner Primary Care (CPNP-PC)
- Pediatric Nurse Practitioner Acute Care (CPNPAC)
- Pediatric Primary Care Mental Health Specialist (PMHS)
National Certification Corporation
- Women’s Health Care Nurse Practitioner-Board Certified (WHNP-BC)
- Neonatal Nurse Practitioner-Board Certified (NNP-BC)
Certified Nurse-Midwives
American Midwifery Certification Board
- Certified in Nurse-Midwifery (CNM)
Clinical Nurse Specialists
AACN Certification Corporation
- Clinical Nurse Specialist; Wellness through Acute Care (Adult-Gerontology) (ACCNS-AG)
- Clinical Nurse Specialist; Wellness through Acute Care (Pediatric) (ACCNS-P)
- Clinical Nurse Specialist; Wellness through Acute Care (Neonatal) (ACCNS-N)
- Acute/Critical Care Clinical Nurse Specialist (Adult, Pediatric & Neonatal) (CCNS) – not aligned with APRN Consensus Model
American Nurses Credentialing Center
- Adult Health Clinical Nurse Specialist-Board Certified (ACNS-BC)
- Adult-Gerontology Clinical Nurse Specialist-Board Certified (AGCNS-BC)
- Adult Psychiatric-Mental Health Clinical Nurse Specialist-Board Certified (PMHCNS-BC)
- Child/Adolescent Psychiatric-Mental Health Clinical Nurse Specialist-Board Certified (PMHCNS-BC)
- Gerontological Clinical Nurse Specialist-Board Certified (GCNS-BC)
- Home Health Clinical Nurse Specialist-Board Certified (HHCNS-BC)
- Pediatric Clinical Nurse Specialist-Board Certified (PCNS-BC)
- Public/Community Health Clinical Nurse Specialist-Board Certified (PHCNS-BC)
Certified Registered Nurse Anesthetist (CRNA)
National Board of Certification and Recertification for Nurse Anesthetists
- Certified Registered Nurse Anesthetist (CRNA)
Earning a Master of Science (MSN) in Illinois
Illinois is home to a number of campus-based MSN programs. However, RNs in the state may also pursue their MSN through accredited online programs. Online programs offer working nurses an increased level of flexibility that allows them to continue their professional practice while completing graduate studies. Program advisors help online students find placement in medical facilities in Illinois to complete the clinical portion of their master’s program.
All Illinois programs that prepare APNs must offer a curriculum that aligns with national certification in one of the advanced practice nursing roles by meeting accreditation standards.
- Nurse Practitioner and Clinical Nurse Specialist MSN programs must be accredited by the Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing (ACEN)
- Nurse Anesthetist MSN programs must be accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA)
- Nurse-Midwifery MSN programs must be accredited by the Accreditation Commission for Midwifery Education (ACME)
Illinois Requirements for MSN Programs that Prepare Advanced Practice Nurses
Accredited programs in the four roles include an established set of coursework designed to support the core competencies in the respective roles:
Certified Nurse Midwife (CNM) Program Requirements
The American College of Nurse Midwives (ACNM) requires all CNM programs to prepare graduate students for the core competencies for basic midwifery practice:
- Hallmarks of Midwifery
- Components of Midwifery Care: Professional Responsibilities of CNMs
- Components of Midwifery Care of Women
- Components of Midwifery Care of the Newborn
- Components of Midwifery Care: Midwifery Management Process
- Components of Midwifery Care: Fundamentals
Programs must offer courses in the following areas to prepare CNMs for the fundamental components of midwifery care:
- Nutrition
- Anatomy and physiology, including pathophysiology
- Psychosocial, sexual, and behavioral development
- Principles of individual and group health education
- Clinical genetics and genomics
- Normal growth and development
- Pharmacokinetics and pharmacotherapeutics
- Basic epidemiology
- Bioethics related to the care of women, newborns, and families
The ACNM also defines the clinical experience requirements for all CNM programs as follows:
- Management of sexually transmitted infections in male partners
- Management of primary care for women throughout the lifespan, including reproductive health care, pregnancy and birth
- Care of the normal newborn
- An AMCB-certified CNM or APRN who has clinical expertise and didactic knowledge commensurate with the content taught must supervise the clinical practice
- Attainment of clinical skills must meet Core Competencies for Basic Midwifery Education
Clinical Nurse Specialists (CNS) Program Requirements
The National Association of Clinical Nurse Specialists, the preeminent advocacy association for CNSs, requires all master’s-level CNS programs to meet criteria in these five areas:
- CNS Program Evaluation
- Student Admission, Progression and Graduation
- CNS Program Resources: Faculty, Clinical, and Institutional
- Program Organization and Administration
- CNS Curriculum
CNS programs must also prepare RNs in the following core competencies:
- Direct Care Competency
- Consultation Competency
- Systems Leadership Competency
- Collaboration Competency
- Coaching Competency
- Research Competency
- Ethical Decision-Making, Moral Agency and Advocacy Competency
Each competency has its own set of behavioral statements, found in detail on the Association website.
Certified Registered Nurse Anesthetist (CRNA) Program Requirements
The standards for master’s programs in nurse anesthesia are governed by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA)
Nurse anesthetist programs must include coursework in the following areas:
- Clinical correlation conferences
- Preanesthetic preparation and evaluation
- Anesthesia practice
- Postanesthesia care
- Professional aspects of nurse anesthesia practice
- Research
- Pharmacology of anesthetic agents and adjuvant drugs including concepts in chemistry and biochemistry
- Perianesthetic and clinical support functions
- Basic and advanced principles of anesthesia practice including physics, equipment, technology and pain management
- Anesthesia induction, maintenance and emergence
- Anatomy, physiology, and pathophysiology
Programs must additionally provide students with clinical experience opportunities that allow for the following:
- Application of knowledge to clinical problems
- Testing of theory
- Learning of anesthesia techniques
Nurse Practitioner Program Requirements
The National Task Force on Quality Nurse Practitioner Education sets the standards for NP programs. Programs must offer courses that prepare students for the nine core competencies of professional practice:
- Scientific Foundation Competencies
- Quality Competencies
- Leadership Competencies
- Health Delivery System Competencies
- Technology and Information Literacy Competencies
- Ethics Competencies
- Independent Practice Competencies
- Policy Competencies
- Practice Inquiry Competencies
Programs must also prepare students for the NP Core Competencies based on population focus.
NP programs are also required to offer clinical experience opportunities that include a minimum of 500 supervised direct patient care clinical hours overall.
Selecting the Right Type of MSN Program Based on Current Education
RNs would select from a number of different types of MSN programs designed to accommodate and build off of their current level of education.
RNs with a Bachelor of Science in Nursing may apply to Illinois’s many campus-based conventional terminal MSN programs, or programs online. These BSN-MSN programs typically offer a curriculum consisting of between 40-60 course credits, and take between 18 and 30 months to complete
As of January 2016, Illinois was home to 19 BSN-MSN programs, located in the following cities throughout the state:
- Addison
- Aurora
- Bourbonnais
- Chicago
- Decatur
- Elmhurst
- Joliet
- Lebanon
- Lisle
- Peoria
- Quincy
- Rockford
- Romeoville/Fox Valley Region
A complete list of MSN programs in Illinois that includes details on each program’s course offerings may be found on the ICN website.
BSN-DNP programs may allow RNs to take both their master’s and doctorate curriculum through the same program. Most of these programs take four to five years to complete. Many programs offer students the opportunity to opt out once they have earned their master’s degree.
RNs with an Associate’s Degree in Nursing may be eligible for campus-based or online RN-to-MSN bridge programs, which consist of both a BSN and MSN curriculum in one accelerated program. Most nurses are able to finish these programs within two-to-three years, completing the seven-to-nine semesters of work in a part-time or full-time format. As of January 2016 there were five RN-MSN bridge programs in Illinois, located in the following cities:
- Chicago
- Decatur
- Quincy
Professionals with a Bachelor’s in an Area Other than Nursing may be eligible to apply to online direct-entry MSN programs. Consisting of 15-24 months of accelerated study, these programs prepare bachelor’s-educated professionals from a non-nursing background with an RN license and MSN in preparation for national certification and state licensure in advanced practice.
Scope of Practice and Illinois State Laws Governing Advanced Practice Registered Nursing
As defined in the State of Illinois Nurse Practice Act, all APNs in Illinois must enter into a written collaborative practice agreement with a physician before practicing in the state. The agreement must detail the procedures performed by the APN as well as the APN’s areas of care. Once the agreement has been established, an APN may practice without the direct supervision of a physician, although a physician must be available by phone at all times for consultation.
According to the ICN, certified nurse practitioners, certified nurse anesthetists, certified nurse midwives, and clinical nurse specialists may perform acts including, but not limited to:
- Providing patient assessment, diagnosis, and treatment
- Ordering, performing, and analyzing diagnostic and therapeutic tests and procedures
- Ordering treatments and medical devices
- Providing end-of-life and palliative care
- Counseling, educating, and advocating for patients
- Delegating approved nursing tasks to licensed practical nurses, registered professional nurses, or other personnel.
The ICN sets forth the additional provisions for certified registered nurse anesthetists in the state including, but not limited to:
- In order for a CRNA to provide anesthesia services outside of a hospital or ambulatory surgical treatment center, the CRNA must enter into a written collaborative agreement with one of the following professionals:
- An anesthesiologist
- The physician licensed to practice medicine in all its branches
- The podiatrist performing the procedure.
- The services the CRNA provides outside of a hospital may consist only of the services the collaborating podiatrist is authorized to provide pursuant to the Podiatric Medical Practice Act of 1987 and rules adopted under that Act.
- A CRNA may only provide anesthesia services in a physician’s office if the physician has training and experience in the delivery of anesthesia services to patients. Additionally, the services must take place with the active participation, approval, presence and availability of the physician.
- A CRNA and physician who enter into a collaborative agreement to work within a physician’s office must earn and maintain current Advanced Cardiac Life Support (ACLS) certification.
- In order for a CRNA to provide anesthesia services in a dental office, the CRNA must enter into a collaborative agreement with one of the following professionals:
- An anesthesiologist
- A physician licensed to practice medicine in all the office’s branches
- The operating dentist performing the procedure
- The services provided by the CRNA in the dentist office may consist only of the services the collaborating dentist is authorized to provide pursuant to the Illinois Dental Practice Act and rules adopted under that Act. Additionally, the services must take place with the active participation, approval, presence and availability of the physician or dentist.
Implementation of the APRN Consensus Model and Prescriptive Privileges
In 2008, over 40 nursing organizations collaborated to establish a national set of rules designed to provide uniformity in the regulation of APRN roles in each state. This framework, entitled the National APRN Consensus Model, has been adopted in varying degrees by states across the U.S. APNs in Illinois are still fighting to achieve full independence without the need to maintain a collaborative agreement with a physician in accordance with the Model, however, as of January 2016 Illinois had adopted four major components of the model:
- Roles
- Education
- Licensing
- Certification
APNs in Illinois may be granted prescriptive authority through their written collaborative agreement with a physician. Through this authority, APNs may order, store, administer, and accept samples of the following substances:
- Medical gases
- Legend drugs
- Schedule III through V controlled substances, as defined in Article II of the Illinois Controlled Substances Act
An APN may also be delegated the authority to prescribe Schedule II controlled substances through oral dosage or topical or transdermal application, provided their prescriptions meet the conditions set forth by the ICN.
All APNs who are granted prescriptive authority must obtain a mid-level practitioner and controlled substances license. Additionally, APNs must include the name of the collaborating physician in all written prescriptions, although a physician signature is not required on the prescriptions.
Continuing Education Requirements for APNs in Illinois
Newly licensed APNs in Illinois are not required to complete Continuing Education (CE) hours during their first license renewal period. Following the first renewal, however, the ICN requires APNs to complete 50 hours of approved CE during every two-year license cycle. The CE must meet the following requirements, set forth by the ICN:
- CE may consist of approved forms of independent study
- CE may consist of approved academic courses
- CE may consist of approved presentations related to the nurse’s certification area to other health professionals; presentations that are non-repetitive and last for 60 minutes may be used for five CE hours each
- CE hours may consist of authoring approved work related to the area of practice; authoring papers or published articles may constitute for 10 CE hours while authoring a dissertation, book chapter, or research project may constitute for 20 CE hours
- Up to five hours of skills certification courses can constitute as CE
- Cardiopulmonary resuscitation certification from the American Red Cross, American Heart Association, or other qualified organization may constitute up to two hours of CE
- Certification or recertification in Basic Life Support for Healthcare Providers (BLS), Advanced Cardiac Life Support (ACLS), or Pediatric Advanced Life Support (PALS) or their equivalent may constitute up to three hours of CE
- APNs may earn their CE hours through preceptorship of an APN student within the regulations set forth by the ICN
- Successfully completing a recertification examination in the APN’s area of specialty may constitute up to 50 hours of CE
- CE hours must be earned by either verified attendance or participation in a program offered by a sponsor approved by the ICN. CE sponsors and programs may include:
- American Nurses Credentialing Center (ANCC) accredited or approved providers
- Illinois Society for Advanced Practice Nursing (ISAPN)
- American Academy of Nurse Practitioners
- Nurse Practitioner Association for Continuing Education (NPACE)
- American Association of Nurse Anesthetists
- National Association of Clinical Nurse Specialists (NACNS)
- American College of Nurse Midwives
- Illinois Nurses Association or its affiliates
- Providers approved by another state’s board of nursing.
- Approved nursing education programs and state agencies
- Employers who have received their license under the Hospital Licensing Act or the Ambulatory Surgical Treatment Center Act