The certified nurse-midwife provides a full range of primary healthcare services to women throughout the lifespan, including gynecologic care, family planning services, preconception care, prenatal and postpartum care, childbirth and care of the newborn. This care is provided in diverse settings, which may include home, hospital, birth center and a variety of ambulatory care settings including private offices and community and public health clinics.

For the certified nurse practitioner, care along the wellness-illness continuum is a dynamic process in which direct primary and acute care is provided across settings. CNPs are members of the health delivery system, practicing autonomously in areas as diverse as family practice, pediatrics, internal medicine, geriatrics and women’s healthcare. CNPs are prepared to diagnose and treat patients with undifferentiated symptoms, as well as those with established diagnoses.

Both primary and acute care CNPs provide initial, ongoing and comprehensive care, which includes taking comprehensive histories, providing physical examinations and other health assessment and screening activities, and diagnosing, treating and managing patients with acute and chronic illnesses and diseases. This includes ordering, performing, supervising and interpreting laboratory and imaging studies; prescribing medication and durable medical equipment; and making appropriate referrals for patients and families. Clinical CNP care includes health promotion, disease prevention, health education and counseling, as well as the diagnosis and management of acute and chronic diseases. Certified nurse practitioners are prepared to practice as primary care CNPs and acute care CNPs, which have separate national consensus-based competencies and separate certification processes.

The certified registered nurse anesthetist is prepared to provide the full spectrum of patients’ anesthesia care and anesthesia-related care for individuals across the lifespan, whose health status may range from healthy through all recognized levels of acuity, including persons with immediate, severe, or life-threatening illnesses or injury. This care is provided in diverse settings, including hospital surgical suites and obstetrical delivery rooms; critical access hospitals; acute care; pain management centers; ambulatory surgical centers; and the offices of dentists, podiatrists, ophthalmologists and plastic surgeons.

The clinical nurse specialist has a unique APP role to integrate care across the continuum and through three spheres of influence: patient, nurse, and system. The primary goal of the CNS is continuous improvement of patient outcomes and nursing care. Key elements of CNS practice are to create environments through mentoring and system changes that empower nurses to develop caring, evidence-based practices to alleviate patient distress and facilitate ethical decision-making. The CNS is responsible and accountable for diagnosis and treatment of health/illness states, disease management, health promotion and prevention of illness and risk behaviors among individuals, families, groups and communities.

A physician assistant is a specially qualified healthcare professional who provides medical care under the supervision of a licensed physician in a variety of healthcare settings. Physicians may delegate to PAs those medical duties that are within the PA’s training and experience and state law. Such duties include performing physical examinations, diagnosing and treating illnesses, ordering and interpreting lab tests, assisting in surgery and making rounds in nursing homes and hospitals. Physicians may also delegate prescriptive privileges to the PAs they supervise.