Sponsored School(s)
The Master of Science in Nursing (MSN) is the educational standard for ambitious RNs interested in entering advanced clinical practice as nurse practitioners, clinical nurse specialists, nurse midwives, or nurse anesthetists. RNs interested in establishing careers in nonclinical settings also have the option of pursuing specialized tracks in MSN programs that would prepare them to work as nurse educators, health care administrators, nurse informaticists, and more.
In February of 2014, the Nevada State Board of Nursing adopted a series of changes related to how they regulate the state’s advanced practice registered nurses (APRNs). These changes moved to align Nevada’s nursing laws for advanced clinicians with the national APRN Consensus Model, which seeks uniformity in APRN education, credentialing and practice authority. These amendments significantly expanded the scope of practice for APRNs in the state, allowing them to practice to the full extent of their education without having to maintain a collaborative agreement with a physician.
As of February 2016, Nevada is one of only 11 states to have adopted all major components of the APRN Consensus Model, placing it among the states that lead the nation in terms of granting full autonomy, including prescriptive privileges, to advanced practice registered nurses. This increased level of autonomy will allow APRNs to better serve the needs of patients in the state’s medically underserved areas.
Licensing Requirements for the APRN Roles Recognized by the Nevada State Board of Nursing
Qualifying for advanced practice registered nurse licensure through the Nevada State Board of Nursing requires:
- An unencumbered/unrestricted RN license in good standing
- A master’s or higher degree specific to an APRN role and patient population focus
- National certification specific to an APRN role and patient population focus
The Nevada State Board of Nursing issues APRN licenses to qualified candidates who have earned a master’s or higher degree and national certification in one of these four roles:
- Nurse Practitioner (NP)
- Clinical Nurse Specialist (CNS)
- Certified Registered Nurse Anesthetist (CRNA)
- Certified Nurse-Midwife (CNM)
Nurse practitioners and clinical nurse specialists further focus their education and become certified in a particular patient population focus (adult-gerontology; family/individual across the lifespan; neonatology; pediatrics; psychiatric/mental health; or women’s health).
The Nevada State Board of Nursing recognizes the following national certifying bodies as issuing the national certification necessary for APRN candidates to qualify for state licensure:
Nurse Practitioner (NP)
- AACN Certification Corporation
- Acute Care Nurse Practitioner Adult-Gerontology (ACNPC-AG)
- American Academy of Nurse Practitioners
- Adult nurse practitioner
- Family nurse practitioner
- Gerontologic nurse practitioner
- American Nurses Credentialing Center
- Acute care nurse practitioner (adult/gerontology)
- Adult nurse practitioner
- Family nurse practitioner
- Gerontological nurse practitioner
- Pediatric nurse practitioner
- Adult psychiatric and mental health nurse practitioner
- Family psychiatric and mental health nurse practitioner
- Pediatric Nursing Certification Board
- Pediatric nurse practitioner primary care
- Pediatric nurse practitioner acute care
- National Certification Corporation
- Women’s health nurse practitioner
- Neonatal nurse practitioner
Clinical Nurse Specialist (CNS)
- AACN Certification Corporation
- Adult acute and critical care CNS
- American Nurses Credentialing Center
- Adult psychiatric-mental health CNS
- Family psychiatric-mental health CNS
- Gerontology CNS
- Adult health CNS
- Public/Community Health CNS
Certified Registered Nurse Anesthetist (CRNA)
Certified Nurse-Midwife (CNM)
Earning a Master of Science in Nursing (MSN) in Nevada
Aspiring APRNs in Nevada must graduate from a nationally certified graduate-level program that is at least one year in academic length and includes the following:
- Advanced courses in pathophysiology, the assessment of the health of patients, and preparation for practice as an APRN
- Courses related to student’s chosen APRN role
- Clinical experience opportunities related to student’s chosen APRN role
- Training in making clinical decisions
Since there are so few campus-based MSN programs in Nevada, many of the state’s aspiring APRNs pursue their graduate education through accredited online programs. This option is particularly popular among working RNs since it allows them to complete their curricular coursework without sacrificing current work obligations. For the clinical portion of these programs, nurses work with a program advisor to find placement at an approved medical facility nearby. In most cases, students can complete the clinical component of their program at the facility in which they work.
Clinical Nurse Specialist/Nurse Practitioner Programs – The Accreditation Commission for Education in Nursing (ACEN) and the Commission on Collegiate Nursing Education (CCNE) are the two recognized national certifying bodies for CNS and NP graduate-level nursing programs.
There are no ACEN-accredited graduate programs located in Nevada. The CCNE accredits two MSN programs and three doctoral programs in Nevada, located in Las Vegas and Reno.
Certified Registered Nurse Anesthetist Programs – The Council on Accreditation of Nurse Anesthesia Educational Programs (COA) is the nationally recognized certifying body for CRNAs. There are no COA-accredited schools with campus locations in Nevada.
Certified Nurse-Midwife Programs – The Accreditation Commission for Midwifery Education (ACME) is the national accrediting body for nurse-midwifes programs. The are no ACME-accredited programs with campus locations in Nevada.
Selecting the Right Type of Program Based on Current Education
Aspiring APRNs in Nevada must apply to an MSN program designed to accommodate their current level of education:
- RNs with an Associate’s Degree in Nursing: RN-MSN bridge programs allow associate’s-prepared RNs to earn their BSN and MSN in one accelerated program. Some schools offer fast-track completion options, which allows RNs to earn their BSN and MSN in as little as three years.
- RNs with a Bachelor of Science in Nursing (BSN): Bachelor’s-prepared RNs would apply to standard terminal MSN programs, which typically take two years to complete.
- Professionals with a Bachelor’s Degree in a Subject Other Than Nursing: Through direct-entry (also referred to as entry-level) MSN programs, professionals who hold a bachelor’s degree in an area other than nursing may pursue both RN licensure and an MSN degree. These programs typically take three years to complete.
Scope of Practice and Nevada State Laws Governing Advanced Practice Registered Nursing
The Nevada Nurse Practice Act outlines the scope of practice for APRNs in the state.
All APRNs in Nevada may perform acts including, but not limited to:
- Assessing and managing care of patients with common, acute, recurrent, or long-term health problems
- Taking, recording, and interpreting medical histories of patients
- Beginning a program of treatment for patients
- Modifying treatment programs
- Referring patients to appropriate providers of health care
- Commencing care to stabilize a patient’s condition during an emergency
- Performing physical examinations
Additional Details on Clinical Nurse Specialist and Certified Registered Nurse Anesthetist Scope of Practice
The Nevada Board of Nursing specifies additional acts within the scope of practice for CNSs and CRNAs.
Clinical Nurse Specialists
In addition to performing acts within the general APRN scope of practice, CNSs may perform acts including, but not limited to:
- Acting as an expert clinician in the direct care of patients
- Acting in the indirect care of patients through one of the following roles:
- Consultant
- Leader of other nurses
- Educator
- Researcher and agent
Certified Registered Nurse Anesthetists
CRNAs may perform acts in addition to the general APRN scope of practice when a patient’s physician, dentist or podiatric physician determines that an anesthetic is necessary for a test, procedure, or other treatment. These acts include, but are not limited to:
- Obtaining a patient’s health history
- Assessing a client’s condition
- Recommending, requesting, and ordering diagnostic studies; analyzing the results of these studies
- Writing a preanesthetic evaluation of the patient
- Obtaining a patient’s informed consent for anesthesia
- Ordering and administering anesthetic and postanesthetic medication
- Performing and managing general, local, and regional anesthesia and techniques of hypnosis
- Selecting and ordering anesthesia equipment
- Performing tracheal intubation and extubation
- Providing mechanical ventilation
- Providing perianesthetic invasive and noninvasive monitoring; responding to any abnormal findings
- Managing patient’s blood, fluid, and balance of electrolytes and acid base
- Identifying and managing medical emergencies requiring technique such as:
- Cardiopulmonary resuscitation
- Airway maintenance
- Ventilation
- Tracheal intubation
- Pharmacological cardiovascular support
- Fluid resuscitation
- Evaluating patient response to anesthesia and responding with proper treatment to ensure recovery
- Initiating, ordering, and administering respiratory support to ensure adequate ventilation and oxygenation immediately following anesthesia
- Releasing patients from postanesthetic care unit or discharging patients from ambulatory surgical settings
Implementation of the APRN Consensus Model and Prescriptive Authority in Nevada
APRNs in Nevada may earn a certificate of registration to independently prescribe approved controlled substances, drugs and devices through passing an examination administered by the State Board of Nursing on Nevada laws related to pharmacy.
To prescribe Schedule II controlled substances, the APRN must have a minimum of 2,000 hours or two years of clinical practice experience. Before this period, APRNs may only prescribe Schedule II controlled substances through a collaborative agreement with a physician. This provisionary period for prescriptive authority is the only time a collaborative agreement is required for APRNs to prescribe. In line with the national APRN Consensus Model, APRNs in Nevada may perform all other functions independently without entering into a collaborative agreement with a physician.
Nevada has adopted all major components of the national APRN consensus model, including:
- Titles
- Roles
- Education
- License
- Certification
- Independent practice
- Prescriptive authority
Continuing Education Requirements for APRNs in Nevada
All APRNs in Nevada must complete a minimum of 45 hours of Continuing Education (CE) every two-year license renewal cycle. The hours must be related to the APRN’s role or population focus. APRNs must maintain documentation demonstrating proof of CE for at least four years, as the Nevada Board of Nursing performs random audits to ensure CE compliance.
The Nevada Board of Nursing offers a list of approved CE providers on its website.