Limited CNS schools should I be worried?

  1. 1 I was wondering why are there so many NP schools and only a limited amount of CNS schools? Should I worry about the future of the CNS? Or am I just paranoid then tell me that. Maybe I am thinking way too much which is weird but I am usually not an over-thinker. I went on the NACNS website and saw all the institutions that had programs. I was alarmed because there is not as much choice compared to the NP schools. I saw how some schools on the list no longer offered programs or change the CNS to a doctorate.

    I am asking because I really think that the role of CNS would be a perfect fit. I always wanted to advance in nursing but never got excited about administration, education, nurse practitioner, informatics, etc until I learned about the CNS role. Truly I am surprised I am even excited about it. I always wanted to go back to school for nursing but didn't feel like I wanted to just concentrate in one role. I love how CNS encompasses a lot because I don't want to be pigeon holed into a certain job/title in nursing. I just get worried when I see a plethora of NP schools and a handful of CNS. I also am worried about the CNL programs. From what I understood I thought the CNS use to do the CNL role? I wouldn't mind having a job that fits the CNL program but have want to have the advanced nursing knowlege. I live in a state where CNS are considered APRN. I can't forecast my future, but am pretty sure that I won't relocate out of state.

    Well I just want to hear some feedback. I have been a nurse for eight years and won't reach retirement till 75 (looks like now ) so I have a few decades of work in the field of nursing.
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  3. Visit  tyloo profile page

    About tyloo

    tyloo has '12' year(s) of experience. From 'SC'; 36 Years Old; Joined Feb '09; Posts: 125; Likes: 303.

    20 Comments so far...

  4. Visit  traumaRUs profile page
    3
    I'm an adult health CNS, just finished a peds CNS program this year and I would have chosen the NP route if I had thought about it.

    I live in a state where CNS is an APN too and that's the role I'm in. The CNL role (IMHO) is not a viable role for the long haul - I think the business of healthcare will soon eliminate that role.

    However, the NP role is where the future is at, again IMHO. The CNS role is so blurred and the education that I received was way too heavy on theory, research and being a change agent that when I went to get a job, it was very hard. The CNS role was the first one let go at the hospitals where I worked if they didn't work in an APN role.

    I would see what type of APN/MSN your hospitals are hiring - talk to administrators to see where they see the future of your area going and go from there.

    You can't do too much research before you begin grad school.
    NRSKarenRN, tyloo, and blueheaven like this.
  5. Visit  blueheaven profile page
    1
    I would like to go forward with my education (currently working on BSN online). My employer has told me that they will reinburse me for MSN in administration, informatics, or teaching only. I have no desire for any of these three areas!

    Jaime, like you, I will be working until I'm a lot older and grayer!!
    tyloo likes this.
  6. Visit  tyloo profile page
    0
    Thank you trauma for your advice. I am doing search engines for jobs directly related to CNS. I also will contact my local hospitals' HR departments to see how they utilize the CNS in their institution. I am leaning towards the staff development role or nurse clinical instructor. I don't want exclusive educator degree because I want to learn more nursing curriculum beyond what I got in my BSN. Thanks for your post!! I have a lot to think about and many more years to figure it out too. I have many years to figure it out and have to remind myself not to get anxious and jump into a wrong program.
  7. Visit  Christen, ANP profile page
    0
    IMO, the inconsistent recognization of the role of CNS from state to state is a big problem. In Ga, CNS was just recognized as an APN, but can only function pretty much as an educator / admin, no prescriptive authority, can't see pts. NPs are NPs across the board, with more minor variations in scope from state to state.
  8. Visit  jahra profile page
    0
    Not everyone wants to be a NP for various reasons. It is discouraging
    if the CNS role starts to errode away. Like, jaimeg40, I have been researching
    the CNS options. I like the way the CNS description has different
    roles and to me it appears to complement some of my past experiences....

    The ever changing merry go round of nursing education requirements
    can be confusing , no wonder why states have inconsistancy in
    recognizing the CNS role.

    Personally if I were younger and could afford it, I think I would choose the
    PA route over an NP . Seems a direct path and a wider scope of practice.


    "Well I just want to hear some feedback. I have been a nurse for eight years and won't reach retirement till 75 (looks like now ) so I have a few decades of work in the field of nursing. "

    I feel old.............. Best wishes from a nurse with over 20 years experience-where does the time go.
    Last edit by jahra on Dec 28, '10
  9. Visit  llg profile page
    2
    I loved the original CNS role many years ago -- not "advanced practice" in the sense of providing primary care to patients -- but "advanced practice" in the sense of leading nursing staff to provide the best care possible, evaluating practice, creating new programs, etc.

    But the role got fragmented as different sub-groups of CNS's tried to take it in different directions. States conceptualized the role differently and placed different restrictions and requirements on the use of the CNS title. Schools stopped their programs as graduates struggled to find jobs in a market that was inconsistent. It was a perfectly good role ruined by intra-professional squabbling over what the role should be.

    My hospital has 4 openings for CNS's right now (and always has at least 1 open position), but we can't find anyone to hire as none of the schools in our region offer CNS preparation. They all switched to NP programs -- and all those NP grads have trouble finding jobs.

    It's so sad. It was a great role.
    NRSKarenRN and jahra like this.
  10. Visit  Christen, ANP profile page
    1
    Agreed, I was in the CNS track for my first semester or two of APN school, almost started a dual CNS / NP program because I thought the two roles really complemented each other, but the job market in my area is very tight for CNS. Like, they're the first to get cut during a budget crisis, and I like making money and paying my billz! I love being a NP though, and the educator / CNS-wannabe in me works well with getting my patients on the same page as me I think.
    jahra likes this.
  11. Visit  jahra profile page
    0
    [quote=llg;4702815] Schools stopped their programs as graduates struggled to find jobs in a market that was inconsistent. It was a perfectly good role ruined by intra-professional squabbling over what the role should be.
    quote]


    Unfortunately, nursing seems to have many situations where this squabbling takes place over roles,etc.
    The sad part that I have seen is that some of these decisions are made not at the clinical level
    but by nursing education and nursing association executives..

    I know the role was not formal when I started practice, but a colleague who was certified in medical area was a wonderful educator,
    resource person and a times trouble shooter for us.

    As always , its the patients that lose out....
  12. Visit  elkpark profile page
    1
    Quote from llg
    I loved the original CNS role many years ago -- not "advanced practice" in the sense of providing primary care to patients -- but "advanced practice" in the sense of leading nursing staff to provide the best care possible, evaluating practice, creating new programs, etc.

    But the role got fragmented as different sub-groups of CNS's tried to take it in different directions. States conceptualized the role differently and placed different restrictions and requirements on the use of the CNS title. Schools stopped their programs as graduates struggled to find jobs in a market that was inconsistent. It was a perfectly good role ruined by intra-professional squabbling over what the role should be.

    My hospital has 4 openings for CNS's right now (and always has at least 1 open position), but we can't find anyone to hire as none of the schools in our region offer CNS preparation. They all switched to NP programs -- and all those NP grads have trouble finding jobs.

    It's so sad. It was a great role.
    Psych CNSs have always been prepared as direct care clinicians (psychotherapists) who provided "hands on" psychiatric care to clients (without having Rx authority), above and beyond the scope of practice of generalist RNs. The leadership/educator/change agent aspect of the role was considered secondary to the advanced clinical practice.

    I agree that it's v. sad to see what has happened in recent years to the role across the board. I'm particularly offended by the push within nursing to redefine "advanced practice" as meaning, exclusively, having Rx authority, and "demote" CNSs without it to no longer being considered advanced practice nurses. IMO, CNSs are the ones truly practicing advanced practice nursing, and the other advanced practice roles are practicing "medicine lite." (I realize that's not a popular position in nursing, however ).

    llg -- your hospital isn't looking for a psych CNS, is it??
    NRSKarenRN likes this.
  13. Visit  llg profile page
    0
    For anyone reading this who is new to the CNS discussion threads ... elkpark and I have been discussing these things for a long time. We come from very different CNS backgrounds and viewpoints, but we have always remained friendly as we discuss thesse things. That said ...

    You're right. The Psych CNS's always wanted Rx authority, unlike the other CNS's. Back in the old days, the Psych CNS's were the "different" ones who pushed to expand the CNS role to include that aspect of practice. The other specialties had established a clear distinction between the CNS and NP roles and wanted to maintain them as 2 separate roles. But in the name of "flexibility" and "inclusivity," they supported the Rx authority addition to the CNS role and that started to creep Rx authority and primary care into other CNS's who were having trouble finding CNS jobs and wanted to take some NP jobs that were open. Once the lines blurred ... everyone just went their own way and did their own thing ... and then there was no clear role to defend.

    ... And no, we're not looking for a Psych CNS. We are a children's hospital and need people with pediatric experience (peds med/surg, peds ED, peds surgery, peds ICU). We need people to be clinical leaders, program evaluators, staff development, research, etc. -- you know, traditional CNS functions. We have plenty of PNP's around, but they are not prepared to work with staff to provide inpatient services and improve inpatient care.
  14. Visit  traumaRUs profile page
    0
    Log and elk park - you are what is so good about the CNS role. Thanks so much for your takes on this.
  15. Visit  llg profile page
    0
    Re-reading my previous post, it seems a little harsh. I was a part of all that years ago -- and it still hurts to think about the role that I helped to pioneer get all blurred by everyone involved trying to "be all things to all people."

    Everyone had the best of intentions, but by allowing too much overlap/merging with the NP role, the CNS role got lost -- and what CNS's (without the primary care, Rx authority) can bring to the health care system got under-valued and cut from lots of budgets. Now when we need people with those "traditional, original" CNS skills, we don't have them -- and they create a new role, CNL, that includes some of those skills but not all -- and disenfranchise the existing CNS's in the process.

    It's all just so sad.


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