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The Master of Science in Nursing (MSN) is the educational standard for registered nurses looking to work as advanced clinicians, as clinical nurse leaders, and in vital nursing roles outside of the clinical environment.
MSN programs offer specialized tracks specifically designed for those interested in advanced practice registered nurse (APRN) careers, whether as a nurse-midwife, clinical nurse specialist, nurse anesthetist or nurse practitioner. Other specialty tracks prepare former clinicians to transition to nonclinical roles in healthcare management and administration, nursing education or informatics.
There are an alarmingly high number of areas in South Carolina designated as Medically Underserved Areas/Populations (MUA/Ps) and Health Professional Shortage Areas (HPSAs). In these areas, residents deal with a lack of access to primary healthcare services, mental health services, and healthcare specialty services. As advanced clinicians skilled in health assessment, pathophysiology and pharmacology, APRNs have the opportunity to play a very important role in alleviating these shortages.
According to statistics released by the American Association of Colleges of Nursing (AACN), there were more than 5,100 APRNs licensed to practice in South Carolina as of 2014. The following list shows the total number of APRNs licensed in each role along with average annual salaries as published by the U.S. Bureau of Labor Statistics in 2014:
- Nurse Practitioners – 3,274 earning an average salary of $88,460
- Certified Nurse Midwives – 108 earning an average salary of $80,440
- Certified Registered Nurse Anesthetists – 1,652 earning an average salary of $152,450
- Clinical Nurse Specialists – 111 earning an average salary of $78,980
Licensing Requirements in South Carolina for Advanced Practice Registered Nurses
The South Carolina Board of Nursing grants advanced practice registered nurse licensure to qualified candidates that have been educated and nationally certified in one of these four roles:
- Nurse Practitioner (NP)
- Certified Nurse Midwife (CNM)
- Certified Registered Nurse Anesthetist (CRNA)
- Clinical Nurse Specialist (CNS)
The South Carolina Board of Nursing requires APRN licensure applicants to hold a valid South Carolina RN license, a graduate degree from an accredited program specific to one of these four roles, and national certification through a Board-recognized certification agency.
South Carolina is part of the Nurse Licensure Compact (NLC), an initiative that was introduced in early 2000 as a way to help APRNs become more mobile in the U.S. This allows nurses the freedom to practice in any state involved in the NLC without having to reapply for a license when they cross state lines. South Carolina implemented the NLC in February of 2006, joining 24 other U.S. states in the compact.
The South Carolina Board of Nursing recognizes national certification from any of the following organizations for the purpose of qualifying candidates for APRN licensure in the four respective roles:
- Registered Nurse Practitioner (RNP)
- American Nurses Credentialing Center (ANCC)
- Adult Nurse Practitioner – Board Certified (ANP-BC)
- Family Nurse Practitioner – Board Certified (FNP-BC)
- Pediatric Primary Care Nurse Practitioner – Board Certified (PPCNP-BC)
- Acute Care Nurse Practitioner – Board Certified (ACNP-BC)
- Adult-Gerontology Acute Care – Board Certified (AGACNP-BC)
- Gerontological Nurse Practitioner – Board Certified (GNP-BC)
- Adult-Gerontology Primary Care Nurse Practitioner – Board Certified (AGPCNP-BC)
- Adult Psychiatric and Mental Health Nurse Practitioner – Board Certified (PMHNP-BC)
- Family Psychiatric-Mental Health Nurse Practitioner – Board Certified (PMHNP-BC)
- American Association of Nurse Practitioners (AANP)
- Adult Nurse Practitioner (ANP)
- Family Nurse Practitioner (FNP)
- Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP)
- Pediatric Nursing Certification Board (PCNB)
- Certified Pediatric Nurse Practitioner (CPNP)
- National Certification Corporation (NCC)
- Women’s Health Nurse Practitioner – Board Certified (WHNP-BC)
- Neonatal Nurse Practitioner – Board Certified (NNP-BC)
- American Association of Critical-Care Nurses (AACN)
- Adult Acute Care Nurse Practitioner (ACNPC)
- Adult-Gerontology Acute Care Nurse Practitioner (ACNPC-AG)
- American Nurses Credentialing Center (ANCC)
- Clinical Nurse Specialist (CNS)
- American Nurses Credentialing Center (ANCC)
- Adult Psychiatric-Mental Health Clinical Nurse Specialist – Board Certified (PMHCNS-BC)
- Child/Adolescent Psychiatric Mental Health Clinical Nurse Specialist– Board Certified (PMHCNS-BC)
- Adult Health Clinical Nurse Specialist – Board Certified (ACNS-BC)
- Gerontological Clinical Nurse Specialist – Board Certified (GCNS-BC)
- Adult-Gerontology Clinical Nurse Specialist – Board Certified (AGCNS-BC)
- Pediatric Clinical Nurse Specialist – Board Certified (PCNS-BC)
- American Association of Critical-Care Nurses (AACN)
- Adult, Neonatal and Pediatric Acute Care Clinical Nurse Specialist (CCNS)
- Adult, Neonatal and Pediatric Wellness through Acute Care Clinical Nurse Specialist (ACCNS-AG)
- American Nurses Credentialing Center (ANCC)
- Certified Nurse Midwife (CNM)
- American Midwifery Certification Board (AMCB)
- Certified Nurse Midwife (CNM)
- American Midwifery Certification Board (AMCB)
- Certified Registered Nurse Anesthetist (CRNA)
- National Board of Certification & Recertification for Nurse Anesthetists (NBCRNA)
- Certified Registered Nurse Anesthetists (CNRA)
- National Board of Certification & Recertification for Nurse Anesthetists (NBCRNA)
Earning a Master of Science in Nursing (MSN) in South Carolina
As states move to align with the APRN Consensus Model and allow APRNs the ability to practice and prescribe independently, more RNs are choosing to go back to school to earn an MSN degree. Though South Carolina’s APRNs do not yet have the ability to practice independently and are not yet granted full prescriptive authority, they can perform health assessments, develop treatment plans and prescribe medications under the auspices of a collaborative agreement with a physician.
All accredited master’s programs designed for advanced nurse clinicians prepare students to perform these functions through a core curriculum that covers:
- Advanced Health Assessment
- Advanced Physiology/Pathophysiology
- Advanced Pharmacology
For the purpose of national certification and state licensure, APRN candidates must graduate from master’s programs accredited by an agency recognized by the US Department of Education and/or the Council for Higher Education Accreditation. These agencies accredit MSN degree programs in both on-campus and online formats:
The Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing (ACEN) handles the accreditation process for graduate programs for nurse practitioners and clinical nurse specialists. Graduate programs for certified nurse midwives are accredited through the Accreditation Commission for Midwifery Education (ACME), whereas graduate programs that prepare certified registered nurse anesthetists are accredited through the Council on Accreditation of Nurse Anesthesia Programs (COA).
South Carolina Requirements for MSN Programs that Prepare Advanced Practice Registered Nurses
The South Carolina Board of Nursing requires MSN programs to meet the following standards in preparing candidates for APRN licensure in each of the four roles:
Nurse Practitioner and Clinical Nurse Specialist – According to the National Task Force of Quality Nurse Practitioner Education, an acceptable nurse practitioner graduate program must meet the following standards:
- The curriculum must prepare students for a national certification exam
- The program must include at least 500 hours of supervised clinical practice hours
- The program must train a nurse practitioner or clinical nurse specialist in one of the six population foci
- Both APRN core and nurse practitioner-specific courses must be included in the curriculum
Certified Nurse Midwife – The Accreditation Commission for Midwifery Education requires that graduate programs in nurse midwifery include the following coursework and clinical practice hours:
- Midwifery fundamentals
- Newborn healthcare
- Assessment and treatment of common health issues
- Gynecology
- Women’s primary care
- Midwifery management
- 500 supervised clinical practice hours
Certified Registered Nurse Anesthetist – According to the Council on Accreditation of Nurse Anesthesia Educational Programs (COA), a CNRA graduate program must include the following:
- The program must be at least 24 months in total length
- A minimum of 600 supervised clinical cases
- A minimum of 2000 supervised clinical hours
- 105 hours of study in pharmacology, including concepts in chemistry and biochemistry
- 135 hours of study in anatomy, physiology, and pathophysiology
- 45 hours of study in professional aspects of nurse anesthesia
- 105 hours of study in principles of anesthesia practice including physics, equipment, technology, and pain management
- 30 hours of research
- 45 hours of clinical correlation conferences
- Coursework in radiology and ultrasound
- At least three graduate level courses in advanced physiology/pathophysiology, advanced health assessment, and advanced pharmacology
Selecting the Right APRN Program Based on Current Education
Nursing schools have a number of options when it comes to graduate nursing program that serve students with different educational backgrounds:
For Students Who Have Completed a Bachelor of Science in Nursing – Nurses who have already earned a bachelor’s degree in nursing typically enroll in traditional MSN degree programs. These graduate programs are comprised of between 36-60 credits (this varies from program to program), and students usually are able to earn an MSN degree within two years. There are currently on-campus MSN degree programs available in the following locations in South Carolina:
- Lancaster
- Columbia
- George
For Students with an Associate’s Degree in Nursing – There are also programs available for those who have not yet completed a bachelor’s degree but do have a valid RN license and an ADN degree. These accelerated RN-BSN bridge programs quickly and conveniently catch students up on undergraduate nursing courses and include graduate-level material, resulting in both a BSN and MSN degree upon graduation. Programs like these are a bit more extensive than a regular MSN degree and take between 2 and 3 years to complete.
For Students with a Bachelor’s Degree in a Non-Nursing Discipline – Students who have completed a bachelor’s degree in a non-nursing discipline may also enroll in special direct-entry graduate programs. These programs make it possible for students to catch up on the nursing prerequisites as well as the graduate level training required to become an APRN. These direct-entry programs are commonly completed in between 18-24 months.
Scope of Practice and State Laws Governing Advanced Practice Registered Nursing in South Carolina
The scope of practice for APRNs in these four roles includes, but is not limited to the following:
Scope of Practice for a Nurse Practitioner (NP)
- Examine patients
- Make advanced assessments
- Suggests treatment for acute and long-term care
- Oversee the ordering of diagnostic or lab tests
- Admit, manage, and discharge patients
- Prescribe therapeutic or pharmacologic treatments (if under a collaborative agreement with a licensed physician)
Scope of Practice for a Clinical Nurse Specialist (CNS)
- Perform advanced nursing skills in the designated population foci and specialization
- Practice in a wide variety of specialty areas
- Diagnose chronic and acute conditions
Scope of Practice for a Certified Nurse Midwife (CNM)
- Provide primary health care to women across the lifespan
- Order and interpret lab and diagnostic tests
- Provide postpartum healthcare – both physical and mental
- Assists in sexual healthcare, testing and treatment of sexually transmitted illnesses
- Handles newborn care
Scope of Practice for a Certified Registered Nurse Anesthetist (CRNA)
- Performs preanesthetic assessments and evaluations on patients
- Assists in forming and implementing an anesthetic plan
- Performs various anesthetic procedures
- Monitors patients under anesthesia
- Provides post-op care and monitoring
Implementation of the APRN Consensus Model in South Carolina
The APRN Consensus Model is an initiative that was set into motion by The National Council of State Boards of Nursing (NCSBN) in 2008. The Consensus Model’s main goal is to standardize APRN licensing requirements and practice standards across the nation, allowing APRNs to travel freely and practice in any state without the need to attain permissions in each jurisdiction.
The Consensus Model seeks to standardize the following elements for APRN licensure and practice:
- Recognition of all four APRN roles (CNS, CNP, CNRA, CNM)
- Master’s degree in nursing as the minimum education requirement
- National certification in one of the four roles as a requirement for licensure
- Recognition of APRN licensure as distinct from RN licensure
- The ability to practice independently without physician oversight to the full extent of nurses’ education and training
- Prescriptive authority
As of February 2016 there are 12 states in which the model is fully implemented, with other states having partially integrated some elements of the Consensus Model. South Carolina has integrated the Consensus Model approximately halfway, which means that APRNs are still fairly restricted when it comes to being able to practice independently and must maintain a collaborative agreement with a physician.
APRNs in South Carolina are eligible to receive limited prescriptive authority only through this written collaborative agreement with a licensed physician. Licensed APRNS must send in an application for prescriptive authority, which lists a licensed supervising physician and an alternate supervising physician who has agreed to oversee the APRN’s prescriptive activities. APRNs applying for prescriptive authority must have already completed at least 45 hours of education in pharmacotherapheutics in order to be eligible, and complete 24 hours of continuing education biannually on an ongoing basis.
Continuing Education Requirements for APRNs in South Carolina
All nurses in South Carolina must renew their licenses biannually by April 30th in order to continue practicing. Within the two-year period before license renewal, one of the following three things must be documented for license renewal:
- Proof of 30 hours of continuing education approved by a national certifying body that is recognized by the South Carolina Board of Nursing
- Completion of an advanced academic program in nursing or related field
- Written verification of competency from an employer as well as the total number of hours a nurse has practiced throughout the two-year period
It is not necessary to submit documented evidence of completed continuing education with an application for license renewal. However, the Board of Nursing recommends that nurses retain continuing education documentation for their own records in the case of an audit, which happens to 5 percent of APRNs during each renewal cycle.