An advanced practice nurse (APN) is a nurse with post-graduate education and training in nursing. Nurses practicing at this level may work in either a specialist or generalist capacity. APNs are prepared with advanced didactic and clinical education, knowledge, skills, and scope of practice in nursing. The National Council of State Boards of Nursing along with other nursing authorities and organizations recommend the use of the term and acronym advanced practice registered nurse (APRN) as described in the Consensus Model for APRN Regulation, Licensure, Accreditation, Certification and Education. Education, accreditation, and certification APNs or APRNs are intended to demonstrate effective integration of theory, practice and experiences along with increasing degrees of autonomy in judgments and interventions, while remaining under physician supervision. Post-graduate education is designed to teach an APRN to use multiple approaches to decision-making, manage the care of individuals and groups, engage in collaborative practices with the patient or client to achieve best outcomes; provide a supportive environment for colleagues; manage the utilization of staff and physical resources; engage in ethically justifiable nursing practice; protect the rights of individuals and groups; engage in activities to improve nursing practice; develop therapeutic and caring relationships; fulfill the conduct requirements of the profession; act to enhance the professional development of self; and function in accordance with legislation and common law affecting nursing practice. APRN education forms the basis of four recognized general areas of specialization: Clinical Nurse Specialist (CNS) Certified Registered Nurse Anesthetist (CRNA) Certified Nurse-Midwife (CNM) Certified Nurse Practitioner (CNP) Each nurse specialty can have concentrations in a specific field or patient population. In 2004, The American Association of Colleges of Nursing (AACN) in conjunction with the National Council of State Boards of Nursing (NCSBN) recommended that advanced practice registered nurses move the entry level degree to the doctorate level by 2015. Accordingly, all APN training programs are recommended (but not required as of yet) to convert their master's degree to a Doctor of Nursing Practice (DNP) degree by the year 2015. Although the American Association of Nurse Anesthetists approved this recommendation, it is not requiring program compliance until the year 2025. The majority of programs will grant a DNP degree. Because 45% of the nurse anesthesia programs are located in schools of allied health, these programs will award a Doctor of Nurse Anesthesia Practice (DNAP). The DNP will be the direct-entry, minimum academic requirement for advanced practice registered nurses; it