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Becoming NICU CNS

I had a few questions for the NICU nurses out there...

My situation is that I am currently in an entry level Master's program. I am about to finish my last semester and take the NCLEX this Spring. After this we have the option to continue PT/FT for our NP and/or CNS. I would really love to be a NICU nurse, and eventually a neonatal CNS. I realize that even though I may get the CNS certification in a couple of years, I do not have the experience to consider myself a true neonatal CNS. Therefore, I plan to gladly work in the NICU as a nurse for some time, and look forward to the learning experience (which I know I'll love).

My question is, does it matter what specific CNS degree you get? I'm not quite sure what exactly it takes to be an "expert" as a NICU CNS should be. For example, if I have a parent-child CNS but have worked a few years in the NICU, would this be sufficient? Or would I need to find a program specific to neonatal CNS? (A neonatal CNS degree is extremely rare and difficult to find!)

My school offers a parent-child CNS, as well as a pediatric NP, or both. I am just wondering what the best route would be for me in order to reach my ultinmate goal (without having to move!).

Any information would be greatly appreciated!!


Specializes in NICU.

Or would I need to find a program specific to neonatal CNS? (A neonatal CNS degree is extremely rare and difficult to find!)

If you haven't already looked at NNP programs, you might check them out. Where I am, I've noticed that many NNP programs prepare the student to become both an NNP and a CNS.


Specializes in NICU.

Oops! Just reread and saw that you have a choice between PNP and Parent-Child CNS. I'm not familiar with APN's who have those degrees working in NICU, but others may be.

llg, PhD, RN

Specializes in Nursing Professional Development.

I've known several Neonatal CNS's with their MSN in Maternal-Child or something similar. After a few years of working in NICU's, taking the neonatal certification exam, etc. they do just fine. In fact, I know of no MSN that is particularly focused on the NICU CNS role. Most neonatal CNS's I have known have come to the job from a relevant, but not exactly "Neonatal CNS tracks" in their educational program.

However ... you need to be aware that in some states, the CNS groups have tried to make the CNS title restricted to only those people who have graduated from official CNS tracks or APN tracks within their academic programs. That may work in some specialties, but it doesn't suit the specialty of neonatal well. The NNP and the Neonatal CNS roles are so different that they don't blend as well -- and most people interested in one are not interested in the other. So, in states where they try to regulate the use of the CNS title in a very strict way, you can end up with some awkwardness in the neonatal field.

What often happens is that hospitals simply bypass the attempts at regulation and strict conforming. They have people in CNS-type roles, but use different titles for the position. For example, at my hospital, we don't have CNS's -- but each unit has a Master's-prepared "Clinical Practice and Education Specialist" who has a role that combines the CNS role with some staff development functions.

If you can be flexible -- and are able to cope with the ambiguity -- neonatal CNS roles can be very satisfying. I was one for 14 years.

prmenrs, RN

Specializes in NICU, Infection Control.

I know of an RN who wanted to pursue CNS in NICU; she created her own program. She had gone to San Diego State for her BSN, so she sat down w/her faculty advisor(s) and figured out what she needed to do.

I think this would be an unusual thing to do, but it worked in that case. (early 90's)

Can an NNP take on a neo CNS role?

I guess I'm just trying to figure out which degree to go for. This is one of the difficulties about being in an entry Masters program, knowing what to do when you haven't worked FT yet as an RN. I have a pretty good idea that a neo CNS is what I want to do, as I believe this is what I would enjoy and fits me best, but the route to get there is fuzzy.

I'm not sure whether to stay where I am or to go seek a program which is more defined towards neonatology. I have the ability at this point to stay in school if need be.

At my program, I'm not sure whether to get both the parent-child CNS and PNP just in case and tack on those extra 2-3 courses... or would the PNP not be of use, and I should leave the NNP for some future point. And just do that parent-child CNS and go with my plan of working NICU a few years, and hold off on any NP.

It's tough when it's "fuzzy".

prmenrs, RN

Specializes in NICU, Infection Control.

Most NNP courses won't consider you w/o significant experience in NICU @ staff level.

Not sure about the CNS requirements, but it would be difficult to be credible w/o "trench" level as well. It might even be difficult to find a job.

My suggestion would be to graduate, work @ least 2 or 3 years, 5 would be better, then make a decision re: NNP vs CNS. That's jmho.

This may sound a little dumb but can you work as a NP in a neonatal unit if you have a master's degree in a speciality other than neonatology? I am finding it hard to find BA/MSN programs that offer neonatology. I have found most schools won't even let you think about applying, and then there are those that give you the option of applying, getting your BSN, and working for a few years with the understanding you can come back to get your MSN.

Can someone explain what APN means? I know CNS is clinical nurse specialist?

Does anyone know if there is a list some where of what schools offer a program in neonatology? I thought that one of the neonatal websites would list something but I haven't had any luck finding anything.


Specializes in NICU, CVICU.

I worked with a girl about a year ago that went to Vanderbilt and got her BSN and NNP (MSN?) before she had any experience at all. Worked in the NICU for a year and then went to an NNP job at a large level III NICU here in Houston.

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