Background: I graduated with a bachelors degree in Chemistry from SUNY Geneseo with 3.04. Just finishing up my 1st year of ADN with a 3.71. I currently work as a HUC on a neuroscience floor that also receives a lot of regular medicine patients. I know the value of working on a med-surg type of floor as a graduate nurse, and I can see how much I would learn, but I also see the poor staffing (sometimes to the point of it being unsafe), and high amount of stress and turn over that goes on on our floor as well as any other med-surg floor in the hospital. After my first semester of nursing school, I was pretty set on wanting to go on and get my masters as a CNS. I love the role they play, but have also been told how they are the first to get laid off and pay is not that much better. I've been encouraged by lots of seasoned nurses and instructors that going the CRNA route would be best for me and my background. I'm a 23 year old female, unmarried/single and I don't want to have kids until my late 20s. I've enjoyed caring for my patients on the med-surg floors I've had clinical on, but I don't like the idea of having 4-6, sometimes 7 if staffing is bad. We don't get to do a critical care rotation but I'm trying to see if they will do a special elective as they have in the past.
Anyways my question is do you think it's ok for a graduate nurse to go straight into an ICU to get that experience before applying to CRNA school? The hospital I work at takes new grads. Part of me just feels like I should get a year of med-surg, but some people have said it doesn't matter and I should just go for it. Also, my GPA is weak from undergrad, I realize. I got a C+ in biochem, B's in orgo, B's in physical chemistry, a C is analytical chem....my program was brutal, and my school is known for chem and physics majors having the lowest GPA's (oh C's in physics as well...I HATED PHYSICS). I still feel very comfortable with math, and its one of my strengths (minus like differential equations). Also, I know I wouldn't like the NP role...I don't like the idea of charting all day long or working in a family practice.
Nursing is only one sphere of CNS practice. To give the least complex explanation, I would Google 'CNS 3 spheres of influence'-patient, nurse, and system. This will explain that as one of the 4 types of APRNS, we diagnose, treat and care for a population of patients from wellness to acute illness inclusive of health promotion and disease prevention, prescribe, educate patients and families, and act as mentors to nursing staff, and much more.
This is not to say that some CNSs have much more of a clinical role and interest and practice more in the patient sphere, while others practice more in the organization/nursing sphere and act as change agents and mentors. This is likely the 'non diagnosing and prescribing' role you describe (which in some states without rx auth is what some CNSs do). But I assure you CNS practice is alive and well in all permutations of the 3 spheres where allowable.
In response to your stance of presuming all other states are like your own, I would love to presume my state was like some others and afforded full practice authority for all APRNs, but alas it is not so. I honestly find educating others about the CNS role is one of the most challenging parts of becoming one, because different areas of the US are so divergent at this time, as we discussed earlier about some states only having recently accepted 'CNS' as a protected title that requires an MSN in CNS studies to utilize. May the consensus mode help us all!
How is it so incorrect? As I have been told and have read, the CNS (at least for my state and presumably for others) is an APRN who has trained and been certified to provide increased knowledge for nurses. They are a clinical specialist, i.e. acute, adult, peds, etc. They don't order anything, diagnose anything, or bill for anything but rather serve a consultant or educator role - generally.
I've spent most of my career as a child psych CNS in direct clinical practice with kids and families, diagnosing and treating psychiatric disorders; just not with medication. I'm sorry to hear CNSs are so poorly utilized in your state, but it is a mistake to generalize from any one state to the entire country.
I've spent most of my career as a child psych CNS in direct clinical practice with kids and families, diagnosing and treating psychiatric disorders; just not with medication. I'm sorry to hear CNSs are so poorly utilized in your state, but it is a mistake to generalize from any one state to the entire country.
Perhaps this is yet another failure by professional nursing. The educational preparation, i.e. curricula, between institutions, let alone states, varies too greatly as does the scope of practice per credential.
The charting anesthesia providers give usually isn't that detailed or lengthy. It seems like the higher you go on the totem pole the less charting you do.
This is also a highly inaccurate and incorrect statement. I work in informatics and am part of the team that built the documentation tools for many areas including anesthesia, and with the advent of the electronic medical record, they are now more likely to chart MORE than ever. The detail of the EMR is astounding and boundless. There is no area in an acute setting that requires you to chart LESS. Especially in the OR.
Perhaps this is yet another failure by professional nursing. The educational preparation, i.e. curricula, between institutions, let alone states, varies too greatly as does the scope of practice per credential.
This is what the consensus model and LACE (licensure, accreditation, certification, and education) will regulate and standardize across the board.
mommy.19, MSN, RN, APRN
262 Posts
Nursing is only one sphere of CNS practice. To give the least complex explanation, I would Google 'CNS 3 spheres of influence'-patient, nurse, and system. This will explain that as one of the 4 types of APRNS, we diagnose, treat and care for a population of patients from wellness to acute illness inclusive of health promotion and disease prevention, prescribe, educate patients and families, and act as mentors to nursing staff, and much more.
This is not to say that some CNSs have much more of a clinical role and interest and practice more in the patient sphere, while others practice more in the organization/nursing sphere and act as change agents and mentors. This is likely the 'non diagnosing and prescribing' role you describe (which in some states without rx auth is what some CNSs do). But I assure you CNS practice is alive and well in all permutations of the 3 spheres where allowable.
In response to your stance of presuming all other states are like your own, I would love to presume my state was like some others and afforded full practice authority for all APRNs, but alas it is not so. I honestly find educating others about the CNS role is one of the most challenging parts of becoming one, because different areas of the US are so divergent at this time, as we discussed earlier about some states only having recently accepted 'CNS' as a protected title that requires an MSN in CNS studies to utilize. May the consensus mode help us all!