CNS! Is this a Dying Specialty!? - page 3

by Visuals

16,283 Views | 60 Comments

Okay guys, What's the deal with this specialty? 1) Is there a demand? 2) Anybody currently practicing wished they had done NP instead? 3) Anybody currently praciticing love they job? why?.....Hate it? why? 4) With... Read More


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    I am a happy CNS student, starting my 2nd yr this fall and I love it. There might not be much job openings compared to the NPs but I know I'll find great happiness in my CNS role.
    coupb8222 and Ahhphoey like this.
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    Wow, this was a great thread. I have always been interested in the CNS role versus NP and am fortunately now about to pursue that role. I actually already function in a CNS-type role as my hospital created a position for those who have a BSN or MSN to serve as a clinical resource for nurses, but the catch is we must get or begin pursuing a CNS within 2 years. The position requires us to participate in research, promote EBP, provide educational support, etc...and while it is a lot more challenging than I imagined, I love it.

    I have been keeping an eye out for CNS roles in different states as I probably will relocate in the next five years or so, and the NP jobs definitely outnumber the CNS. However, as someone else posted, the position maybe under a different title, so I'll need to just keep that in mind for the future.
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    Glad I decided to visit Allnurses today bc if not I would of missed out on this great discussion!
    Thanks everyone for their feedback. I am a new ACNS and my experience thus far has been similar to Trauma's. Here in Texas, it seems that most of the CNS roles are similar to NPs. A difference that I have noticed is that the CNSs tend to work more in specialized areas ( cardiology, neuro, ortho, etc...).

    It has been difficult to find a job as a ACNS, since I am limited to seeing only adult patients. And when applying for jobs, most specifically in smaller clinics/group practices, physicians will ask "what is a CNS'. Sad to say when explaining to them what a CNS is I have to resort to " its similar to an NP" .
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    I have been right there with you Leap of Faith: in IL, CNS, NP, CNM, CRNA are all advanced practice nurses. This is what we have to sign after our name and most people know APN is NP. Go figure.
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    Hello,

    I found this thread when I searched for NP vs. CNS. I have to say that you guys have brought up some really awesome points and I'm so glad that I am able to learn from and communicate with people who really know nursing and their profession.

    I took the MAT today and made a 423. The director of the MSN Peds program at my school of choice advised that I should be able to get into the program with no problem since the base MAT score needed is 400. I already have my BSN and will have been working in a Level 3 NICU for a year in October. I am a little bummed that Arkansas does not have a Neonatal graduate program, however I think I want to become RNC-NIC certified and do Peds as my graduate coursework. I may decide in 5 or 10 years that I really want to work with another age group besides neonates. I don't really see that happening, but the Neonatal role seems limiting, plus I can't afford to move or go to school out of state. I would like to start graduate school this coming Spring 2012 if everything works out for me appropriately.

    My problem (and why I'm posting here) is that I am having a huge personal struggle with choosing a track. I really, really like the idea of fulfilling the original CNS role as an educator, clinical practice expert, cost cutter, and working with nurses, staff, and patients as a whole to improve patient outcomes. However, I am also interested (and maybe a bit intimidated) by the NP role simply because I feel like I see more NP's and they seem more "marketable." I could be wrong about this, but that is just what I've noticed here in Arkansas. I was reading the Advanced Practice section of the Arkansas nursing board's website and it seems like Advanced Practice Nurses have 4 categories: ANP, CNS, CNM, and CRNA. CNS's are eligible for prescriptive authority, but I don't think they are eligible to sit for the ANP registry exam.

    So my main dilemma is what track to choose based on my interests. I also thought about doing the Masters of Science in Nursing Education with an emphasis on Peds, but I'm not sure if I would be able to sit for any exams with that title. I wouldn't mind being useful in an educator role to nursing students, but that is not my main goal. I am really just terrified and frightened right now at choosing the wrong track since graduate school takes so much time and effort.

    Any opinions would be greatly appreciated,
    Elizabeth
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    To reply Irish rainbow I would simply tell you that there is no focus that is WRONG TRACK, search your mind very well and decide on what you want to do and be informed. ....and I personally dont think there is a perfect track that fulfills your dream as a nurse especially as all roles are not well defined right now(interms of job responsibilities). Goodluck in your advancement.
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    I think that the wrong track is something where you end up being unhappy.

    I will reiterate though that as an APN, you can work as an educator, manager, change agent, etc.. However, if you stick to the "true" CNS role, crossing over to being an APN is not possible.

    In order to give yourself the best chance at a better job, choose the widest scope track possible.

    Can you shadow some CNS's to see what they do? Maybe shadow someone like llg who has a more traditional CNS role and then choose someone else who does the APN role?
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    Quote from traumaRUs
    However, if you stick to the "true" CNS role, crossing over to being an APN is not possible.
    I don't understand what you mean by this, trauma -- in every state I've been in over the years, CNSs have been considered advanced practice nurses (although there was some variation in whether Rx authority was available to them or not), and I've spent most of my CNS career delivering direct client care as a (child) psych CNS. Usually, the position(s) included spending some time in the other aspects of the CNS role, but I've always been predominantly a "hands-on" clinician in an advanced role (and that's what I was hired for).

    I understand that there are some states that don't formally differentiate CNSs from generalist RNs for licensure or practice purposes, but, AFAIK, it's not enough states to justify a blanket statement like your comment above ... Can you explain further what you meant? (Thanks.)
  9. 0
    Sure.

    I attended the same college of nursing for both my CNS post-MSN certificates so this is my only experience with this education. This is what I found:

    I was very, very surprized that fully 50% of their peds CNS graduates do not pursue any type of certification after school. This is because they wish to function in an MSN role versus APN role. Many of these (the 50% that don't take the exam) work in management, administration and/or Six Sigma (or other similar change agent).

    The true CNS role (with the spheres of influence) really is a change agent, educator, consultant, etc..

    The adult program that I did involved a lot of theory and ambiguous (at least to me who is a black and white person) and to me, at least, nonsense that had nothing to do with what I wanted from the program. The ANCC adult test that I took in 2006 was heavily focused on the spheres of influence, roles of the CNS (again heavy on the consultant role) and had few clinically relevant questions.

    When I took the peds CNS exam in March 2011, I found it to be much more clinically focused with few spheres of influence questions.

    I also want to point out that my program has now phased out the peds CNS program and has both an FNP and NNP program now in addition to an adult health CNS and CNL programs.

    I guess I also need to say that if you choose not to get certified or get certified and then practice in a nonclinical role, it makes it very hard to stay clinically focused and up to date.

    That is the real reason for my statement: that if you aren't in a job that is clinically focused and thus the APN role, then coming back to that role after a while (years or so), is very difficult.
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    Thanks so much for your replies. Everyone here has been so nice and given really good information and feedback.

    I did a Google search and found a chart that kind of breaks down the differences between the ANP and CNS role: http://resources.css.edu/academics/n...lescnsvsnp.pdf

    Would you guys agree with this chart or not? It seems that based on this chart a lot of the job duties can overlap between an ANP and CNS as long as they are both working in a inpatient hospital setting. What is the general consensus on this?

    I am still considering and thinking of what track to pick... I believe that whatever track I do pick I will definitely do the education track at the program I'm looking into... it's like a minor and is only 12 extra hours. But as far as CNS and ANP I am still torn on what I want to do.


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