[QUOTE=sistasoul;4148490] Would becoming a CNS fit into a career where I could spend more time with my patients at the bedside while using more of a science/ pathophysiology approach in my care?
Maybe, but not necessarily. Some CNS's maintain a lot of patient contact, but a lot do not. Many spend a lot of time doing staff development, evaulating care, developing policies, developing new programs, etc. A lot depends upon the region where you live and they type of patient contact you are looking for.
I think it will help you think this through by separating the concepts of "advanced education" and "advanced role" as you plan your career. What a person "learns and knows" is different from what a person "does." As you look at possible career paths, focus on the functions of the specific roles separately from the type of education they receive. Focus on what types of jobs people with different titles do. The jobs available to people with different types of education vary slightly from one location to another. So, you'll have to investigate your home area by talking with people "in the know" about your region and specialty.
For example, in my neck of the woods ... the people with the most direct patient contact are the staff nurses. CNS's are used as staff development educators, project managers, evaluators of care, and as consultants and coaches for the staff nurses dealing with difficult cases. A staff nurse will consult with a CNS on a difficult case and the CNS will help that nurse with assessment and sometimes with a few specific interventions. So there is some patient care in that role, but it is intermittent and episodic. There are some CNS's who function in roles such as "trach coordinator" or "diabetes educator" who have regular ongoing relationships with patients. What types of jobs are available in your are for a CNS? That is the question.
Nurse Practitioners have a lot of patient contact ... but those jobs are usually in out-patient settings. Are you interested in working in an out-patient setting. CRNA's usually need/study the strongest foundation in science and physiology. Is that a role that interests you?
Also, there are nurses who work as staff nurses with MSN's. They want the education ... but they prefer the job of staff nurse. That's OK. Staff nursing offers lots of flexibility and the pay can be reasonable when compared to the compensation of some advanced roles. That's particularly true in hospitals that have clinical ladders and/or pay differentials for nurses with advanced education, certification, precepting, etc. That may be a good option for you if none of the advanced roles really appeal to you.
I applaud you for exploring the various possibilities before investing in the education. Far too many people invest in education without investigating thoroughly first -- and end up with an expensive degree that doesn't qualify for jobs they actually like. Good luck to you!