Anybody feels they still wanna go the CNS route? - page 2

I have been thinking of going this route but am still unsure of the job market.... Read More

  1. 0
    Hey Psychcns,
    Thanks for asking.
    I just feel like prescribing is too much of a responsibility. Is it not required for all NP roles? I dont know much about the CNS role but from the little i know about it i like it much even though its less dollars than the NP. Do you prescribe and how do you like it? You can PM me more. Thanks once again.

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  2. 1
    I think prescriptive authority for advanced practice nurses is here to stay. I don't think it is mandatory and it would not make sense in many roles. ie educator, manager, even case manager. Prescriptive authority fits well with the provider role or for psych CNS who does psychotherapy with medications.

    The CNS role seems the least uniform of the advanced practice roles across the country. Right now it seems state dependent and at least 16 states do not allow CNS to have prescriptive authority at all. But without prescriptive authority, your job prospects are less. It almost seems discriminatory that I can prescribe in one state and not the one right next to it.

    I like prescribing but when I became a CNS prescribing was new. I think there is increased responsibility (compared to RN) in all the advanced practice roles. I think diagnosing and psychotherapy take more skill but right now there are a lot of jobs for prescribers. Prescribing includes diagnosing.

    I think CNS will make a comeback. Or maybe the NP will dominate. I have known at least one NP who was a nurse manager. (not prescribing). In some facilities they have eliminated CNS educator roles and instead hire managers with CNS. As health care changes it will be interesting to see how the CNS fares. New advanced practice roles will likely develop. In the meantime, I suggest you get to know what is possible in your state and what role you are interested in.

    An re: prescriptive authority. You learn how to prescribe. For example, when I started, a mentor suggested I get to know one medication really well in each class of drugs and branch out from there. This worked for me. I guess in the beginning I second guessed my self a lot but like anything it gets easier with practice. I have at least one CNS friend who finds prescribing boring and is trying to do more therapy...

    I suggest you focus more on what you want to do and try not to be too scared by prescribing. you may find a role where you don't do it at all and you may find later on you are glad you have the option. Good luck!!
    mycall2nsg likes this.
  3. 0
    I have always been curious about the CNS role as it does not seem very common in my area. Can an MSN nurse trained as an NP be hired into a traditional CNS role at a hospital?
  4. 2
    All very good responses, and I enjoy reading everyone's different perspectives.

    I'm choosing the CNS role exactly because I don't want to be limited/pigeonholed into primary care positions (i.e. NPs). I believe with the CNS as a AP public health nurse in HIV/AIDS, I can diversify my skills, whether it's case management, working with healthcare agencies, grant writing, etc. Everyone is wanting the NP positions now, and I know it's tough to get a job in the Bay Area right now.

    Frankly, I wouldn't count out the CNS positions -- as we all know, what goes around, comes around.

    Ultimately, I believe you have to follow your passion and make your own pathway.
    traumaRUs and SHGR like this.
  5. 0
    Quote from woofyrn
    All very good responses, and I enjoy reading everyone's different perspectives.

    I'm choosing the CNS role exactly because I don't want to be limited/pigeonholed into primary care positions (i.e. NPs). I believe with the CNS as a AP public health nurse in HIV/AIDS, I can diversify my skills, whether it's case management, working with healthcare agencies, grant writing, etc. Everyone is wanting the NP positions now, and I know it's tough to get a job in the Bay Area right now.

    Frankly, I wouldn't count out the CNS positions -- as we all know, what goes around, comes around.

    Ultimately, I believe you have to follow your passion and make your own pathway.
    @woofyrn: any movement on CA granting prescriptive authority for the CNS. I think if the CNS goes back to being a broad role in all states it will ensure its survival.
  6. 0
    Quote from Psychcns
    @woofyrn: any movement on CA granting prescriptive authority for the CNS. I think if the CNS goes back to being a broad role in all states it will ensure its survival.
    Hi Psychcns! Honestly, I haven't really kept up with the battle (that may even be too generous a term) for prescriptive authority for CNS's in California. As others have stated, it seems the umbrella term "APRN" is currently in vogue to corral all the various roles under one title.

    However (and again, this is my opinion), it seems the CNS role hasn't quite been as vocal in demanding its "place at the table" as far as prescriptive authority goes. I believe that most (not all) CNS's don't quite see themselves as primary care practitioners, but more "specialists" (duh) in one particular area and consequently don't want to advocate for something which they either: 1) don't really care to do; or 2) feel a bit inadequately prepared to do.

    There's a real dichotomy in the NP vs. CNS camps, almost a defensive behavior when I"m talking with other students -- it's almost like the old "why didn't you just go to medical school instead of being a nurse" routine that I got from lots of people, being a male RN.

    Because that's not what I want to do.

    Edited to add:
    I suspect this lack of overwhelming demand from CNS's is interpreted by The Political Powers That Be, in addition to the usual Turf Wars by physicians (and not a few NP's), as proof positive to limit the numbers of people that are doling out drugs to people.
    Last edit by woofyrn on Mar 29
  7. 1
    A few years back the psych CNS in CA decided to not go for separate prescriptive authority as a psych group but instead to follow Oregon example and go for prescriptive authority for all CNS. At least this is what I understand from the Internet. Why Oregon CNS succeeded and California CNS isn't making more of a fuss is curious..
    woofyrn likes this.
  8. 1
    Any body still thinking of this route or am i by myself still. Do we have anybody in school for CNS currently and what do your instructrors have to say about it?

    After CNS, if i decided to pursue NP, does it mean start from scratch or do some classes from CNS count? I still feel i should go this route although it seems like the light at the end of the tunnel is too dim for now.
    traumaRUs likes this.
  9. 1
    Still here, still in CNS program with one semester left. My instructor is a full time CNS, she thinks the role will come back full force.
    If you decide to do NP after you can do a post-MSN FNP program, the 3 P's and your core courses would transfer.
    traumaRUs likes this.
  10. 0
    Quote from maria12
    Any body still thinking of this route or am i by myself still. Do we have anybody in school for CNS currently and what do your instructrors have to say about it?

    After CNS, if i decided to pursue NP, does it mean start from scratch or do some classes from CNS count? I still feel i should go this route although it seems like the light at the end of the tunnel is too dim for now.
    Depending on how everything transfers you should only have to do 2-3 courses in your NP specialty and a practicum


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