Do Clinical Nurse Specialists Have Flexibility?

Reds,
I was a critical care CNS for 8 years before going back for additiional education to become certified as a NP. Yes as a CNS you will have the potential for complete control and flexibility in your schedule. It all depends on how you position yourself in the organization. It is imperative that you set this up right from the beginning.
If you are employed by a hospital you will want to report directly to either the DON or a Director of Nursing over your area. Never report directly to a head nurse ( nurse manager) as you will have likely power struggles and since you will most likely not have actual authority you will have a difficult time effecting change unless the nurse manager always agrees with your ideas. Also, you are the clinical expert and your decisions for care, education, training etc, are determined by clinical assessments based on your expert assessments. THe nurse manager will in all liklihood have less education than you and will be more focused on staffing & budget issues. So you need to be able to both report to a director who can help prevent conflict and take both sides into consideration. You will hopefully not have an adversarial relationship with the nurse manager but in reality there will be differences in opinion and it will never work to your advantage because you lack the authority to make decisions .
If you work for a physician then you will want to establish the degree of flexibility early on as well. In all liklihood he or she will be agreeable to whatever you suggest, within reason. They are most concerned with getting the job done and will look at you as a professional who can determine the best way to get it done. Think about what is important to you in terms of flexibility when you are discussing the job. If leaving early occasionally, or taking your kids to a dentist appointment, or going out to lunch is important then discuss that with your employer. I found that most of the time if you are reasonable in your requests upfront you will be happier later on.
Lastly, the CNS role is very exciting and challenging and can be pretty much what you make of it. Good luck!