CNS vs. NP role in Texas?

[solneeshka, BSN, RN]

I'm interested in pursuring an advanced practice degree and have discovered on the CNS section of this site that the differences in the roles of the CNS vs. the NP vary a great deal from state-to-state. Are there any CNSs or NPs out there who can enlighten us as to the distinctions between the two functions in our great state?

[carachel2]

A CNS in Texas is recognized as an advanced practice nurse, but usually performs in more of an education or advisory role. I've always thought it was kind of a murky explanation. Here is a clip from a website. I am in classes regularly in my NP program with CNSs who are going back to school to get a postmasters certification to become NPs. It looks like some CNSs have prescriptive authority, but I've yet to meet one.

Clinical Nurse Specialists are registered nurses, who have graduate level nursing preparation at the master's or doctoral level as a CNS. They are clinical experts in evidence-based nursing practice within a specialty area, treating and managing the health concerns of patients and populations. The CNS specialty may be focused on individuals, populations, settings, type of care, type of problem, or diagnostic systems subspecialty. CNSs practice autonomously and integrate knowledge of disease and medical treatments into the assessment, diagnosis, and treatment of patients' illnesses. These nurses design, implement, and evaluate both patient-specific and population-based programs of care. CNSs provide leadership in advanced the practice of nursing to achieve quality and cost-effective patient outcomes as well as provide leadership of multidisciplinary groups in designing and implementing innovative alternative solutions that address system problems and/or patient care issues. In many jurisdictions, CNSs, as direct care providers, perform comprehensive health assessments, develop differential diagnoses, and may have prescriptive authority. Prescriptive authority allows them to provide pharmacologic and nonpharmacologic treatments and order diagnostic and laboratory tests in addressing and managing specialty health problems of patients and populations. CNSs serve as patient advocates, consultants, and researchers in various settings.

[infusionRN]

I am an infusion nurse who re-entered a year ago after taking a refresher course with PHES. in Houston. I am looking into CNS vs. APN also. From what I read the CNS can prescribe in limited circumstances in a speciality area. How I made up my mind (I am going to do the NP) is the CNS cannot bill. So, if you want to be able to ever practice independently or work somewhere that you can bill Medicare or insurance you need to do NP. I am looking at several programs in the state. Also, limited CNS programs in Texas and lots of national confusion over the role (go to National Council of Board of Nursing www.ncsbn.org ) They have several statements about it on there. If the national board is confused I don't want any part of it. Too much time and money to waste. Let me know where you land. I am applying for Fall 2009.

[akanini, MSN, RN]

I'm curious to know what are the usual hours and salary for a CNS in the Houston area?

[HouTx, BSN, MSN, EdD]

CNS 'hours' would depend upon the job that they are filling.

In my organization, CNS' are usually hired into education positions. But we also have a few in Quality-related & care management roles. Their work involves analysis of specific types of interventions or care management pathways. Most of our care managers for specialty service lines are CNS's.

We don't employ any NPs, but it isn't uncommon for physicians to do so. I know of a local endocrinologist that has a 'parnership' arrangement with his NP. She gets a % of the net revenue rather than a specific salary.