Different roles for CNS's??? Come on guys share what you do! - page 5

by traumaRUs Admin

51,346 Views | 118 Comments

Good evening everyone! Those of us that are CNS's have a great variety of roles/jobs and I am curious just what everyone else does. I graduated in May with a post-MSN adult CNS. Currently, I work in a large nephrology practice... Read More


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    MollyMell - I would not assume that the degree gives you a CNS - I would get this clarified. GOod luck with your choice.
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    Sometimes many Rns want to try to get advance degrees but they really don't have a clue about where to begin. I was/am one that knows that bedside nursing was not the only thing I wanted to do. I just don't know which route to take but the above post are helpful. I never knew about the CNS routes just the NPS.
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    Glad to be of help.
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    Just an FYI...

    In VA, CNS's do not have RX priviliges. I am trying to decide on a CNS program versus NP as I see others on the board are too.

    For anyone out there researching this topic, you can contact your state board of nursing to find out the scope of practice in your state!
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    92mxmom - You are absolutely correct. Before comitting to school, ensure the degree and privledges that go with it are what you want. I always encourage nurses too to find out what the job situation is in the area. In some areas, NPs rule, in others, PAs and in others CNSs.
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    I've been a critical care nurse for >12 years with more focus on cardiovascular nursing, more recently, I'm working in a cardiac surgical ICU. I've been planning to pursue a degree in advance nursing practice. There are only two roles I'm looking into which I like to do: teach future nurses and/or novice nurses in the hospital. I like doing lectures and presentations, evaluating and designing orientation programs for new nurses. But at the same time, I admire and like the NPs (and their roles) that I worked with in the CSICU, as they assess patients, prescribe meds, order diagnostics, insert central lines and present "their patients" during multidisciplinary rounds much like the PAs and residents do. I haven't seen a CNS doing such a role in our unit. Most if not all CNS that I've met are engaged in teaching and staff development, a role more specific to MSN- education major. With that in mind, I have narrowed my choices either to practice "advanced bedside nursing" as what NPs do or "teach" as what nurse educators do (education major) but not as a CNS. The CNS role is just too vague for me to comprehend, is it a case manager, NP, educator, manager, reseacher? To me, these roles can be performed by almost any nurse who is certified or qualified in that particular field e.g. certified case manager, ACNP or CRNP and so on.
    Last edit by cedric2000 on Sep 29, '07
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    Quote from cedric2000
    . The CNS role is just too vague for me to comprehend, is it a case manager, NP, educator, manager, reseacher? To me, these roles can be performed by almost any nurse who is certified or qualified in that particular field e.g. certified case manager, ACNP or CRNP and so on.
    Good point. ... And that's actually the beauty of the CNS education and role. The original conception of the CNS role was that CNS's are prepared at the Master's level to be expert at "traditional" nursing roles -- doing the types of things that all nurses are legally allowed to do, but with the knowledge and experience to do them at an expert level. That's why NO states required special licensure for CNS's in the beginning. The role was not created to have prescription authority, etc. so no special license was needed.

    Later ... some CNS's wanted to expand the role to include some "physician externder" functions similar to those priveleges that NP's have. That required special licensure and some states (but not all, by any means) have gone that route to allow that.

    As one of the earlier CNS's, I always viewed my role as being a nurse with expertise in my chosen specialty (neonatal) whose function was to support the neonatal nurses I worked with and to help them provide the best nursing care possible. If that meant teaching them something, I taught them. If that meant doing a research project to develop some knowledge, I did research. If that meant designing or managing a new program, I did that. etc. etc. etc. I had a general education at the MSN level that prepared me to help the staff nurses with whatever they needed.

    I always loved the flexibility of the role and the fact that from one year to the next, my job would include a wide variety of activities to keep me stimulated and growing.
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    Thank you for the input llg, actually when I thought of going to graduate school, I only knew of two advanced tracks, either nursing administration e.g. manager, director, etc, and that of the CNS which for me, focuses more on the "clinical or bedside" part of nursing. I really thought that CNS' role are primarily or just focused on educating staff nurses at the bedside (with some hands-on demo) or in the classroom, not until I knew of other tracks e.g. NP and nurse educator and nurse anesthetist. The CNS that I met in our institution works more of that an educator/evaluator e.g. hospital clinical orientation, ACLS/BLS, nursing documentation, etc. I'm not particular if they've ever done any research here. The teaching side of it got my interest, and so I wanted to be a CNS initially. The question is, if I do CNS, will it be a guarantee that I can practice both worlds, as an educator and as an advanced clinical practitioner like the NPs? I have browsed a lot of CNS curricula, and when I compared it w/ that of the NPs, the latter have more of the sciences: anatomy, physio, patho, pharma, assessments, etc, that makes them look more competent as an advanced clinical practitioners. The nursing admin and NP curriculum for me are both on extremely opposite poles, while that of the CNS is a hybrid and can be found in the middle, same for the nurse educator at some degree, only that the educator is leaning more towards the admin side.
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    Quote from cedric2000
    The question is, if I do CNS, will it be a guarantee that I can practice both worlds, as an educator and as an advanced clinical practitioner like the NPs? I have browsed a lot of CNS curricula, and when I compared it w/ that of the NPs, the latter have more of the sciences: anatomy, physio, patho, pharma, assessments, etc, that makes them look more competent as an advanced clinical practitioners. The nursing admin and NP curriculum for me are both on extremely opposite poles, while that of the CNS is a hybrid and can be found in the middle, same for the nurse educator at some degree, only that the educator is leaning more towards the admin side.
    There are no guarantees. Individual employers can structure roles as they please as long as they stay within the Nurse Practice Act and employers can require whatever education, certifications, etc. they want. Similarly, schools change curricula every few years -- adding and deleting courses and/or modifying them to suit the current conditions.

    The best you can do is get the education that seems to be the best fit for your interests and future plans at the time -- and then be prepared to get additional education as the world keeps turning and conditions change.

    ... and try to enjoy yourself and help some people along the way.
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    llg has excellent commentary as usual! TY.


    It is always important to ensure that what education you get will allow you to do what you want. And you must also factor in your state's practice act as well as what the job market is. And, then if there is a chance that you might practice in another state, that too must be factored in.

    My current job as a CNS is definitely an APN - I see pts, manage their dialysis, BP, diabetes and pretty much any other problem they have. I prescribe meds, order and interpret test and refer to other providers for things I can't handle or don't have the expertise. I am fortunate that in IL, the CNS role is that of an APN - in fact we just got prescriptive authority for class II narcotics which is really helpful in my dialysis pts who also have chronic pain.

    In my new job, I will be back in the hospital and will have pretty much the same role - that of caring for patients.


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