Karen Smith is an Advanced practice registered nurse, as defined is: A level of nursing practice that  utilizes extended and expanded skills, experience and knowledge in assessment,  planning, implementation, diagnosis and evaluation of the care required.

Nurses  practicing at this level are educationally prepared at the post-graduate level and may work in either a specialist or generalist capacity. However, the basis of  advanced practice is the high degree of knowledge, skill and experience that is  applied within the nurse-patient/client relationship to achieve optimal outcomes  through critical analysis, problem solving and evidence-based decision making.