Anybody feels they still wanna go the CNS route?

rudycoon · Sep 20, 2013

Same here

Trauma Columnist · Sep 20, 2013

Totally agree this is a key component of your choice. Have you checked with your states APN organization? What about the hospitals in the area where you work?

What role do you wish to fulfill?

I'm a dual-certified CNS: both adult and peds and as an APN in my state, there are job opportunities. However, it is in the APN role. The hospitals in my area use the CNS in the APN role since we can fill both a "traditional" CNS role (change agent, educator) as well as be a provider.

SteveDE · Feb 9, 2014

I've been wondering a similar thing. I do diabetes education, really enjoy it and starting to move into some case management responsibilities, but I've been thinking about going back to school. I'm just not sold on the NP role being what I want for my career, but would being a CNS be worth it and continue doing what I'm doing with education and case management?

tyloo · Feb 9, 2014

I have searched for positions nationwide and there are many traditional CNS positions. These jobs are speciality based. I see a lot for critical care, oncology, ER, and OR. If you don't practice these specialities or are unwilling to relocate then you may want to reconsider. SteveDE- I saw one position for a clinical nurse specialist specific for diabetes at UNC Health Care- Chapel Hill.

The CNS degree provides you with a general background in research, direct care expertise, patient education, staff education, consultation, system leadership, and collaboration. You can go for jobs that are not labeled CNS such as management, staff development, quality improvement, and such. The broadness of the role is a double edged sword. It makes it hard to define what the role is but on the other hand you can make a role fit for you. I love this role because it is broad and it is practicing nursing at an advanced level. That is why I got the degree.

I would advise anyone that wants to diagnose and prescribe that they can with the CNS in some states, however just go to NP school.

Good luck.

meanmaryjean, DNP, RN · Feb 9, 2014

I'm writing my goals essay this weekend for a post-master's CNS program. (My MSN is in Education). We have an active CNS group in our hospital, and they drive nursing research and practice change. It's a perfect dovetail for my love of research, teaching and patient care.

tyloo · Feb 9, 2014

I'm writing my goals essay this weekend for a post-master's CNS program. (My MSN is in Education). We have an active CNS group in our hospital, and they drive nursing research and practice change. It's a perfect dovetail for my love of research, teaching and patient care.

I wish more hospitals were like yours! Congrats on going back to school!

SHGR, MSN, RN, CNS · Feb 11, 2014

I've been wondering a similar thing. I do diabetes education, really enjoy it and starting to move into some case management responsibilities, but I've been thinking about going back to school. I'm just not sold on the NP role being what I want for my career, but would being a CNS be worth it and continue doing what I'm doing with education and case management?

It seems like the CNS is still a good fit with DM. There are quite a few DM CNSs where I live. SteveDE, I think that you and I have some similarities- case management is my fallback for after I graduate in December. The overlap of DM and case management is "disease management" .

stepbystep12, BSN, DNP · Feb 23, 2014

The reason i don't want to go the NP route is because i would like to practice in the advanced nursing level but not to prescribe. Prescribing is what keeps me from the NP route. I thing all other APRN roles requires prescribing.

Psychcns · Mar 10, 2014

The reason i don't want to go the NP route is because i would like to practice in the advanced nursing level but not to prescribe. Prescribing is what keeps me from the NP route. I thing all other APRN roles requires prescribing.

Hi Maria

Can I ask why you would not want prescriptive authority. I am not sure it is required- it would depend on the role.. What I like about the CNS role is that you can be a provider in many states ((diagnose and prescribe) as well as be a change agent manager educator and other things. I like the option to move around a bit.

stepbystep12, BSN, DNP · Mar 11, 2014

Hey Psychcns,

Thanks for asking.

I just feel like prescribing is too much of a responsibility. Is it not required for all NP roles? I dont know much about the CNS role but from the little i know about it i like it much even though its less dollars than the NP. Do you prescribe and how do you like it? You can PM me more. Thanks once again.

Psychcns · Mar 11, 2014

I think prescriptive authority for advanced practice nurses is here to stay. I don't think it is mandatory and it would not make sense in many roles. ie educator, manager, even case manager. Prescriptive authority fits well with the provider role or for psych CNS who does psychotherapy with medications.

The CNS role seems the least uniform of the advanced practice roles across the country. Right now it seems state dependent and at least 16 states do not allow CNS to have prescriptive authority at all. But without prescriptive authority, your job prospects are less. It almost seems discriminatory that I can prescribe in one state and not the one right next to it.

I like prescribing but when I became a CNS prescribing was new. I think there is increased responsibility (compared to RN) in all the advanced practice roles. I think diagnosing and psychotherapy take more skill but right now there are a lot of jobs for prescribers. Prescribing includes diagnosing.

I think CNS will make a comeback. Or maybe the NP will dominate. I have known at least one NP who was a nurse manager. (not prescribing). In some facilities they have eliminated CNS educator roles and instead hire managers with CNS. As health care changes it will be interesting to see how the CNS fares. New advanced practice roles will likely develop. In the meantime, I suggest you get to know what is possible in your state and what role you are interested in.

An re: prescriptive authority. You learn how to prescribe. For example, when I started, a mentor suggested I get to know one medication really well in each class of drugs and branch out from there. This worked for me. I guess in the beginning I second guessed my self a lot but like anything it gets easier with practice. I have at least one CNS friend who finds prescribing boring and is trying to do more therapy...

I suggest you focus more on what you want to do and try not to be too scared by prescribing. you may find a role where you don't do it at all and you may find later on you are glad you have the option. Good luck!!