Clinical Nurse Specialist

Be aware that the DNP degree as a requirement for NP practice by 2015 is at the proposal stage at this point. Although it appears that this movement is headed towards becoming a mandatory requirement, master's prepared NP's will be grandfathered once the DNP requirement becomes a reality.

There are MSN nurses with NP preparation who work in the role of a CNS. However, these are only possible in states where there are no clear-cut requirement for a nurse to function as a CNS (such as the need to have formal training as a CNS as well as CNS certification). Be aware of your own state's regulations regarding this prior to setting your hopes on the idea that you can change between the two roles easily.

Actually, my state is a prime example of the scenario llg pointed out. The CNS role has no title protection in this state, hence, there are no specific state regulations as far as who can be called a CNS. However, most hospitals here recognize the benefit of having a master's prepared nurse who is able to function in the CNS role. Because of that, there are numerous job openings for CNS' in many of our hospitals. Unfortunately, the CNS programs have dwindled out because of the popularity of the NP role so that many hospitals are willing to hire any master's prepared nurse for their CNS vacancies even those who are trained as NP's.

Lastly, I would honestly be hesitant to recommend the CNL role to anyone. The role is quite new and I have yet to see a CNL job posting in any of the hospitals around here although there is one such program in one of our state universities. You should also remember that the CNL is not considered an advanced practice nurse role and that to me, transitioning from an NP to a CNL is somewhat of a step down professionally since the role is not considered advanced practice.

The AACN, the group that came up with the CNL idea, is saying that the CNL role is NOT a replacement for the CNS role. However, it is not surprising for the nursing and healthcare community to be suspicious that the CNS is being phased out as many of the CNL functions appear to be traditional CNS roles. However, I have yet to see a BON in any state come up with regulations regarding the CNL. It seems like it's a role written on paper but the actual utilization is yet to be proven.

I also don't think that CNS and NP roles are being merged into the DNP. You have to remember that the DNP, like the MSN, is a degree and does not designate a role. You can have a DNP with a CNS focus or a DNP with an NP focus for that matter.

It is also noteworthy that the current trend in APN certifcation is to clearly delineate what the different APN roles are using letters that clearly define the different tracks of advanced practice. Hence, ANCC has now changed their credentials to CNS-BC and _NP-BC for their APN titles. The certification body for women's health NP's have done the same.

The anesthesia community is proposing a DNAP. This seems to be similar to the DNP but focused in nurse anesthesia practice. The CNM community is the least open to idea of the DNP degree.

That is very good to know. I'm glad to hear of the "grandfatherering-in" process.