The many acronyms used to describe nurses can cause confusion about who they are and what they do. Several of the many acronyms are CNL, DNP, NP and CNS. Many people would like to believe a nurse is a nurse, but the truth is that nurses have different educational backgrounds which prepare them for a variety of roles and responsibilities in healthcare.

This article discusses the following nurses: Advanced Practice Nurse (APN), which includes the Clinical Nurse Specialist (CNS), Nurse Practitioner (NP) and the Doctor of Nurse Practice (DNP). The Clinical Nurse Leader (CNL) is a new role, but is not classified as an APN. The focus of this article is to briefly describe the qualifications and responsibilities of the APN, NP, CNS, DNP and CNL.

The term Advanced Practice Nurse (APN) designates a registered nurse (RN) with either a Master of Science degree in Nursing (MSN) or a doctorate degree in Nursing (DNP) with specialization in caring for adults, families or children with medical, surgical and acute and critical care conditions. With advanced education and clinical experience the APN performs complete physical assessments; treats patients using advanced knowledge of diseases; orders, performs, interprets and supervises diagnostic procedures; and prescribes drug therapy. The APN can be nationally certified with a state license to practice independently or in consultation with a physician.

The NP and CNS function as APNs providing safe, quality care by assessing, diagnosing and treating patient illnesses in many healthcare settings. In some settings the NP and CNS are similar. One difference between the NP and the CNS is that the NP focuses on individualized patient care. The NP may be a patient’s regular care provider, since some NPs perform tasks similar to the physician. The CNS focuses on individualized patients with specialized healthcare and work at the organizational or management level to assist groups of patients.

The DNP may be a CNS or NP with a doctorate degree. The doctorate in nursing prepares the nurse for administrative or executive level positions to provide oversight for safe quality patient care at the organizational and patient care levels. Working at the management level, expertise is needed in areas of leadership, global healthcare, finance, policy development and research to assist the DNP in developing, implementing and evaluating new healthcare delivery models and programs that will enhance healthcare outcomes.

The CNL is a generalist who works closely with other healthcare staff members to provide and coordinate direct patient care in hospital, doctor office or ambulatory care centers. The CNL holds an MSN degree. The CNL works to achieve optimal client outcomes, serve as an advocate for patients and the nursing profession and manage healthcare teams. Nursing staff relies on the CNL to provide in-depth rationale for patient care and to assist them with the increasingly complex and diverse healthcare issues.

All of these RNs will be patient advocates, focus on safe, quality healthcare and emphasize health promotion and disease prevention, but each will provide their specialized patient care at a different level of knowledge, skills and competence. Although there are many acronyms describing the RN, nursing education has set definite educational backgrounds and levels of responsibilities. As the RN’s educational and professional experience levels increase, the expectations for positive patient outcomes increase respectively. IBI