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

Specialties CNS

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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 (11 MD's, 4 PA's, 3 NPs and me). The NPs run the outpatient chronic hemodialysis units. I am responsible for two units in the city - about 200 patients. Per Medicare guidelines, the APN's must see the patient three times per month and the MD once in order to bill the maximum. I also take ER and hospital call one weekend a month at two hospitals about 55 miles from where I live. This is only 0700-1900 on Sat/Sun. I really enjoy it and am learning so much. I have a collaborative agreement with all the doctors and have full prescribing/ordering capabilities. I also am credentialled at the three local hospitals and then the two distant ones where I take call.

So...who's next???

Can CNS or an NP work as a Hopitalist?

Is it dependent on the state you live in?

I would love to work as a hospitalist someday.....

Specializes in Nephrology, Cardiology, ER, ICU.

I think to some extent it is dependent on the state that you live in. I live in IL and here CNS is an APN with the exact practice act as an NP. However, in some states (MI for sure), the CNS is NOT considered an APN. Sad, hunh?

I think to some extent it is dependent on the state that you live in. I live in IL and here CNS is an APN with the exact practice act as an NP. However, in some states (MI for sure), the CNS is NOT considered an APN. Sad, hunh?

Kinda silly since from my house on Lake Michingan I could drive from Michigan through NW Indiana and into Chicago in an hour and 30 minutes!

Yep, 3 states in 90 minuts with hospitals in all of them.

TraumaRUs, these folks need to get their act together before pups like me graduate!:lol2:

Specializes in Intensive Care Nursi.

I'm starting as an APN in Pain Management in January. I'll be working with an MD who's in solo practice. This is new for her. She had been in a group Anesthesiology practice, but then went for Family Practice training and has now set up a solo practice in pain management. She is planning on Pain Managment consultations, Palliative Care, and Hospice. I will be working in her office and seeing all of her patients in the hospital. I will also see the Hospice patients in the inpatient hospice unit (which she set up). She said she is training me to do everything that she does except, of course, the epidurals. She is so excited about teaching me and working together!!!!

I will see patients independently in the office. I will make rounds on all inpatients independently. She is training me and we will be working together side by side for about 3 months or however long it takes to know her habits. We are also both HIGHLY interested in holistic care. This is my special area and she has little experience or knowledge about it. She wants to learn from me and have me initiate holistic care for the office as well as apply it independently with our patients.

I am also setting up an independent business in holistic care. I am starting with a website with resources for the public and I plan on teaching the public and eventually nurses. My first class will be in January 2007. I am teaching the public about Bach Flower Essences (which the MD I'm starting to work with wants to know about and help her use in the office. She doesn't know anything about it except that she's sees it as a promising treatment, but wants to work with someone who knows how to diagnose and prescribe it.) (I'm certified at a basic level at this point, but plan to continue my education in this area.) I'm also a Reiki Practitioner. I have also studied many other areas of holistic care, as well as Metaphysics. She has recently gotten priviledges at 2 area hospitals and is starting to receive referrels. She didn't know how long it would take to start and estimated it would take longer than this. She needs me to start over 2 months sooner than her original estimate. We are going to do some remarkable things together. I graduated almost 30 years ago from an MS program in the CNS track. There was no NP program at that time. Nurses continue to shoot themselves in the foot about education. Other healthcare professionals don't care which degree you have. They want to know what you are interested in and what do you want to do. I just had a thought--I should put this in the NP Forum also.

I am: APN-BC, Adult Health

Specializes in Intensive Care Nursi.

I've just read through more of the posts. I noticed that CNS is not an APN in all states!!!!! I'm in Illinois and as someone previously noted in Illinois the CNSs, NPs, CRNAs, Nurse Midwives are all APNs with the same license. I also have prescriptive ability (an additional license which required the signature of the MD I'm working with). She was interested in either a Physician's Assistant or an APN. Since I can have prescriptive ability in Illinois, including Controlled Substances she was able to choose me to work with her. I feel very bad that this is not the case in all states. The public really needs to know what nurses do and what APNs do and can do in the future. And I agree with the post that states she tells the patients that she is a CNS. I have a similar situation. Everyone assumes I'm an NP.

Specializes in Accepted...Master's Entry Program, 2008!.

I've recently started looking around for another PCP for myself (not too happy with my current one), and I've started to see APNs popping up in nearly every doctor's office. NPs are infiltrating the field, which is a good thing!

I've decided to make my next PCP a Nurse Practitioner, since I feel the doctors really don't listen anymore.

Specializes in Nephrology, Cardiology, ER, ICU.

tropical fish - thanks for the wonderful post. That sounds like a wonderful job too! May I ask where you are working in IL?? I live near Peoria and the APN opportunities are sporifice to say the least.

mvanzzz - congrats on choosing an APN for your healthcare needs.

I'm so glad I found this post! I'm a 20 year old BSN Student. I'm very interested in grad school and the CNS profession, but it's hard to find information out there from from actual practicing CNSs.

Any ideas on where I can find information on the licensing of CNS and all APNs state by state. I live/go to school in St Louis, and would probably be interested in practicing in both Missouri and Illinois. I'm curious about how the details (prescriptive authority, collaberation, etc.) vary in each.

Specializes in Nephrology, Cardiology, ER, ICU.

Hi and welcome. llg is another CNS who is very active on this board. Then...there are many very active NPs: Siri, pinoyNP, etc.

IL is one of the more progressive states. We have the same practice act that the NPs do. The same prescriptive authority (everything but schedule 2's), the same collaborative agreement. It is important to look at what other states offer too because some states (GA for instance) do not recognize CNS's as APNs.

Specializes in Intensive Care Nursi.

In Illinois the CNS is an APN. I took the AACN exam for Clinical Specialist in Adult Health. Then applied for an APN license with the state of Illinois. The application asks for minimal information (I already have an RN license in Illinois.). Once you have the APN license you can obtain the Controlled Substance license. An MD must sign a form indicating collaborative practice. I did not have to send in a copy of the collaborative agreement, but it must be on file in the MD's office. When I applied for my APN license I sent everything in at once: the application for APN license, the application for Controlled Substance license, and the MD form indicating collaborative agreement and which controlled substance classifications are included in the collaborative agreement. In Illinois the APN license is covered under the same practice for Clinical Specialist, Nurse Practitioner, Certified Nurse Midwife, and Certified Nurse Anesthetist. The application process was very simple. I filled out the forms, wrote 2 checks (one for the APN license and one for the controlled substance license), and had the MD fill out the appropriate form and sent everything together per FedEx ground delivery. I don't know whether there are programs that support prescriptive ability or not. My application was never questioned and the application gives no indication of any exceptions or special programs needed.

Specializes in Education, FP, LNC, Forensics, ED, OB.
i'm so glad i found this post! i'm a 20 year old bsn student. i'm very interested in grad school and the cns profession, but it's hard to find information out there from from actual practicing cnss.

any ideas on where i can find information on the licensing of cns and all apns state by state. i live/go to school in st louis, and would probably be interested in practicing in both missouri and illinois. i'm curious about how the details (prescriptive authority, collaberation, etc.) vary in each.

hello, missouribsnstudent and welcome to allnurses.com

here is a link to each state bon where you should be able to get the information you need about the apn:

http://www.board-of-nursing.com/

this link is specific for the apn in mo:

http://pr.mo.gov/nursing-advanced-practice.asp

and, this one for il:

http://www.ilga.gov/commission/jcar/admincode/068/06801305sections.html

good luck with your career choice. we hope you enjoy allnurses. come back when you can.

Hi, I am somewhat new to this, and I was just wondering; can a cns prescribe medications?

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