A friend from NP school works inpatient oncology at a major medical center in NYC. She works primarily with BMT patients, but also with other cancers. She sees patients daily, does procedures, and generally serves as a hospitalist for these patients. She thinks it's the best of both worlds-she does hands on care, but also has the autonomy and skills to direct their care. She's an adult NP and did extra clinical hours in Oncology. You can also obtain a Palliative Care specialty as an NP and work inpatient. From what I've seen in my area, the CNS presence on patient floors has diminished or disappeared due to budget cuts. The few CNLs I know are administrative and are not involved in direct patient care. I know that role is still evolving and opportunities may change in time.