CNS Question

Specialties CNS

Published

Hi,

The other day I took an VO order from our Ortho CNS. I usually deal with PA-C's, so after she finished giving me the order I asked which doctor she was with (thinking that I would have to make a notation of that on the order) she said she wasn't. So now I am wondering if CNS can work independently, or is it just a situation where the Doctor they are with only audits their charts/orders from time to time?

Thanks for your help!

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sirI, MSN, APRN, NP

17 Articles; 44,729 Posts

Specializes in Education, FP, LNC, Forensics, ED, OB.
Hi,

The other day I took an VO order from our Ortho CNS. I usually deal with PA-C's, so after she finished giving me the order I asked which doctor she was with (thinking that I would have to make a notation of that on the order) she said she wasn't. So now I am wondering if CNS can work independently, or is it just a situation where the Doctor they are with only audits their charts/orders from time to time?

Thanks for your help!

Hello, fireflyLPN,

Yes, CNS, NPs.....are able to work without physician supervision/presence in most states. (I am not familiar with Ohio.)

CNS/NP can have prescription privileges in most states as well. Some states require the physician to audit charts and there are some states that don't require physician involvement in the least. Many have their own private practices.

Jolie, BSN

6,375 Posts

Specializes in Maternal - Child Health.
Hi,

The other day I took an VO order from our Ortho CNS. I usually deal with PA-C's, so after she finished giving me the order I asked which doctor she was with (thinking that I would have to make a notation of that on the order) she said she wasn't. So now I am wondering if CNS can work independently, or is it just a situation where the Doctor they are with only audits their charts/orders from time to time?

Thanks for your help!

This issue is settled on a state to state basis. In IL, there are 4 categories of APN, (CNM, CRNA, NP and CNS). Each APN must have a collaborative agreement with a physician which spells out the frequency of collaboration, and the conditions under which the physician is to be consulted regarding patient care. This may be on a daily, weekly or monthly basis, depending on what both parties agree to. But the day to day patient care, prescribing, and ordering are left up to the APN, without the physician's co-signature.

fireflyLPN

81 Posts

Thank you so much for the replies! It all makes sense now.

sailornurse

1,231 Posts

Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.
This issue is settled on a state to state basis. In IL, there are 4 categories of APN, (CNM, CRNA, NP and CNS). Each APN must have a collaborative agreement with a physician which spells out the frequency of collaboration, and the conditions under which the physician is to be consulted regarding patient care. This may be on a daily, weekly or monthly basis, depending on what both parties agree to. But the day to day patient care, prescribing, and ordering are left up to the APN, without the physician's co-signature.

Not if you have independent practice which what New Mexico has. I am not required to have any physician at all. New Mexico NP's have full prescriptive

authority. No physician involvement at all.

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