Hi and welcome. I'm an adult health CNS who works in an NP-role. My first thoughts to choosing are:
1. What does your state practice act say? For instance, in IL, a CNS, NP, CNM and CRNA are all lumped together under the umbrella of advanced practice nurse. This means that as a CNS I have the same prescriptive authority and responsibility as any other APN in IL. However, some states (GA for instance) do not recognize CNS as an APN. This severely limits your income potential because you can not get reimbursed for services, thereby limiting your productivity.
2. What type of role do you want? Many of my fellow classmates function in an educator role versus a true APN role. If education is your focus, then the CNS role might be the better choice.
3. If you want a true APN role, like seeing patients, assessing them, ordering tests, interpreting the tests, prescribing, etc., than the NP role might be better. However, this could not be true also if you live in a state where the CNS is recognized as an APN.
As to clinicals, the ANCC provides certification for both CNS and NPs. NPs do have nother option for certification too but both agencies require similar amounts of clinicals which is at least 500 hours. No hours can be awarded while working or receivng pay nor can they be retrospective. Here is the website: http://www.nursingworld.org/ancc/
I hope this helps you to make a good decision. If nothing else, I hope maybe I've provided some info that will make you think of other questions. I've only been a CNS for one year and so far it has its ups and downs. I do enjoy the autonomy but the job market in my area is extremely tight and I really find that I would like more variety than I currently have.