Different roles for CNS's??? Come on guys share what you do! - page 8

Good evening everyone! Those of us that are CNS's have a great variety of roles/jobs and I am curious just what everyone else does. I graduated in May with a post-MSN adult CNS. Currently, I work in... Read More

  1. by   holiday2525
    I really appricruate tgis topic. I am graduating with my BSn in Dec. and was thinking about my MSN with either an APN or CSN. Now I understand things better. I am really interesting in an APN in pysch. But have never been able to speak to someone who has this.

    How does one decide what type of nurse one wants to be? I don't know where I will be happy. IS this common?
  2. by   traumaRUs
    Hello101 - I have a role similar to yours: I work in nephrology and am an adult health CNS. In our large practice, there are 15 MDs, 3 PAs, 3 FNPs and me! The mid-levels do the same job and we all bill the same also.

    Much depends on your state's nurse practice act - there are some states where CNS is NOT recognized as an APN.

    BTW - I see many chronic patients and many of them call me "doc!" Bet your NP colleague would be floored by that. For many of my inner city patients, it is a term of respect - they absolutely know I'm not a physician.

    Good luck....I do have one NP that I see occasionally who ALWAYS has something snide to say - I just ignore her.
  3. by   deb18
    Hi. I graduated in Fl. from a psych cns program but at that time, I could (and did) become licensed as an ARNP (advanced registered nurse practitioner) in psych in florida. at that time we did not have to be certified to be an advanced nurse. Now we do. I have worked as an associate professor and now am in private practice as a nurse practitioner/cns. I cannot really call myself a cns because I am not licensed as such in Florida. when i take/pass the ancc than I can become dual licensed. I see patients for medication management and therapy. My role, as such, is not any different than the NP that is in the office.
  4. by   traumaRUs
    Thanks for sharing Deb. Sounds very interesting. Your education is as a CNS but you are taking the NP exam?

    I'm an adult health CNS and am back in school for the peds/family CNS so that I can see a broader spectrum of pts.
  5. by   deb18
    I cannot sit for the np exam because education is as a cns, so I am taking the cns exam. i know you will do well with the peds
  6. by   ROLO
    Re: Different roles for CNS's??? Come on guys share what you do!
    "I am a CNS and most physicians I know look as CNS as an educator or researcher. I work for a doctor and function as an NP (diagnosis, prescribe, bill etc). The doctor who hired me knew that I was an ANP and did not care what if I was a CNS, NP, or PA...as long as I know my stuff and able to bill..I was happy that she gave me that chance and prove myself. It's sad to say but I had a hard time with fellow NP at the hospital who feels that I needed to go back to the NP program to do what I'm doing now. I remember hearing comments that "she's not an NP, she's a CNS"...(a lot of hosp staff has a habit or thinks I'm an NP so they will say I am an NP and that when the other NP hears this...They would correct them and made it known that I was a CNS. Which I do introduce myself as an APN/CNS...but still they see me as an NP. It is getting better that the NP are not "making side remarks"...I do my job and take care of my patients and I enjoy what I do. Any CNS who function as an NP out their with similar experience? Where I work there is only 2 others who function like the NP as a CNS."

    Sorry about the failure to recognize the CNS (we need to change that!), but I think it is cool that your physician has voiced his expectations of you as an MSN, has certain expectations of you, and is assisting you in your growth --very cool!
    Last edit by ROLO on Dec 16, '09
  7. by   ROLO
    So, what advice do you have on creating a position as an ED CNS? I've been an ED staff nurse for most of my 18 years, plus I am a paramedic, so I think it is fair to say that I am pretty well-rounded in emergency care. I am entering my last year of school (adult/geri CNS). I work and live in "Mayberry" (as in the "Andy Griffith Show"), a small town, where I am known as the "male nurse," and there are almost NO APNs in the area (there's a couple of FNPs, and NO CNSs that I know of). HOW DO I CREATE MY PRACTICE?! I know what I want to do: I want to see ED pts as needed; but, if it is "slow," then the docs can do their thing (seeing pts), and I can work on some education, or research, or whatever. Then, as it gets busy, and pt flow is interrupted, I can make my way back into the ED clinical area, doing whatever needs to be done, so that pts are seen quickly and safely.

    Any feedback? That was just a quick summary, and I didn't mean to minimize any CNS importance.
  8. by   traumaRUs
    Hi Rolo - as an APN, its all about billing. If your hospital credentials you to see pts without a physician going behind you to see the pt, then you are a viable entity. If however, the MD has to repeat everything you do, you are not viable or billable.

    While I agree the flow of the ER is very important, improving the flow can be managed by an RN, don't need an APN.
  9. by   ROLO
    traumaRUs, I just wanted to thank you for all your kind words & support! I could have sent you a private message, but I wanted to post for the benefit of others. I checked in with our state board again, via phone, as I like to do from time to time, eventhough I have read through the guidelines --it is sometimes nice talking to someone from there and getting that verbal interpretation of what everything means. I wish I had gotten the young lady's name, cause she was very nice & helpful, and seemed very knowledgeable about APN practice in Indiana.

    She told me what I had gathered from my previous conversations: APNs "are not licensed" in Indiana, but work "as an extension of their RN license;" there is no differentiation in NP and CNS practice; CNSs may prescribe, but, of course, that is after a pharmacology course, proper application, etc.; the determining factor of practice is one's collaborative agreement.

    She said that she, too, has read some of the nursing web sites, and is also surprised by the various types of APN practice and how they vary from state to state --nevertheless, she seems to know Indiana practice, and she made sure that I understood by listening to me repeat what she had said & making that verifcation.

    It is funny: I had accessed the guidelines of CNS and NP practice via the internet. THEY WERE EXACTLY THE SAME at one time. Then, they were updated, and the CNS guidelines were changed in some areas --I'm talking the old text was lined-through, and then new text was written in, so that one could see old AND new guidelines. When I read through the new, they were basically saying the same thing they did before, only kind of re-worded.... That's what facilitated my calling the Indiana BON the first time, cause I was thinking, "AREN'T THEY SAYING THE SAME THING?!"

    So, with that being said, I stayed up way too late last night, reading the DNP boards... WOW! I don't want to comment too much on those boards, but there are some heated discussions there! It is amazing with the current state of healthcare that many healthcare professionals are still very territorial...that it is getting more difficult to practice (lots of classes & lots of clinicals, for one thing)...and limitations on practice that some states have imposed on certain APNs (failure to acknowledge, can't prescribe, etc.). Point of bringing all of this up? I kept thinking, as I was reading those boards, is it worth it to complete my MSN?! ...cause I have no idea where healthcare is headed.

    Thanks traumaRUs, whispera, and others for your time!
    Last edit by ROLO on Dec 22, '09 : Reason: misspelling
  10. by   traumaRUs
    Thanks for the kind words!

    I think pursuing an MSN is never wasted - no matter what track you choose. By doing your homework, hopefully you will avoid the issues I've had because I didn't do my homework.

    Take care.
  11. by   allsmiles2008
    TraumaRUs... thanks for a great and very informative thread!!
  12. by   enoRN
    That really sounds like a lot of responsibility. I am planning becoming a CNS soon.
  13. by   kinlabelle
    I live in Knoxville, TN. I'm planning to start my MSN in this coming Fall. My goal is to become Geriatric NP but where I will be going to school they just have a CNS program. I was not familiar with the program, since that I applied over there, I have been doing a lot of research about CNS. The school told me that I can still become a GNP by taking and passing the ANCC and take some post-graduated classes. Is anybody has an advice or suggestions?