I want to continue on with school... but which route?

  1. Hi everyone, thank you to those who respond with their input!

    I want to go back to school (grad school, I have my BSN), I'm an RN with 3 years experience, I currently work in a rehab/sub-acute hospital (Vents, LVAD, PD etc). Just so you know my background.

    I'm pretty much interested in NP or CNS. I am more interested in staying in the hospital setting until I'm older and then I'd like to work in a clinic or possibly find a way to teach - but I suppose that would take more education and that will be for a later thought :P

    I live in Massachusetts, and I've been trying to read up the job descriptions on both NP and CNS and they seem pretty interchangeable from the descriptions on job postings, but I've had a hard time finding something specific to read online.

    I LOVE the thought of being an educator for nurses/medical staff or a patient educator or resource person (I'm hoping by the time I'm done with school I'll have a few years on a regular medical floor), but I'm not that interested in just working under a doctor, writing rx's or working in administration)... but just getting an master's in education online or something doesn't seem like enough for me. I'd still like the option of more than just education, but I'm not sure what else I want to do, and I want more opportunities.

    Obviously I'll still do more research and hopefully shadow a bit if I can, but I'd still love more opinions and I do love this site.

    Thank you so much!
  2. Visit JSBoston profile page

    About JSBoston

    Joined: Sep '09; Posts: 145; Likes: 281
    RN; from US
    Specialty: 5 year(s) of experience in Med/Surg/Onc, LTAC


  3. by   traumaRUs
    The true CNS role is one of the spheres: patient/client sphere, nurses/nursing practice sphere and organization/system sphere.

    What it translates into is: we do a lot of things.

    I'm an adult health CNS (since May 2006) and I work in nephrology. I see pts, diagnoses them, write Rx's, order tests, intepret tests, etc.. My role is delineated much by my state practice act. In IL, NP/CNS/CNM/CRNA are all lumped into the APN title.
    My co-workers (we do the same exact job) are FNPs, PAs and me.

    I wanted an APN role but like you, wanted more options as I got older too.

    If you want to stay in the hospital, I would look around to see what kinds of jobs you like, shadow them, ask about their credentials and go from there.

    Hope this helps.

    llg is a CNS who does a lot of other roles so I bet she'll be along to tell you what she does. She has had some amazing experiences.
  4. by   llg
    After being a staff nurse for 2 years, I went to school, got my MSN and became a CNS (back before that role required certification). After 10 year of being a Neonatal CNS, I went back to school again and got a PhD. I've spent almost all of my career working in hospitals in roles that have combined CNS and Staff Development functions. Over the span of my 30+ year career, I have had roles focusing on the following things:

    1. Staff Development (orientation, on-going education, etc.)
    2. Clinical consultation
    3. Implementing changes in clinical practice (writing policies & procedures and seeing that they get implemented ... evaluating their effectiveness, etc.)
    4. Lead parent support groups
    5. Done discharge planning & teaching
    6. Done "a little" management
    7. Implemented new programs (started a scholarship program, started and run a nursing student extern program
    8. Coordinated student activity in my hospital
    9. Done a little research
    10. Served on more committees and task forces than I can count

    In short, my general education as a CNS made me suitable for a variety of jobs -- but not anything involving medical diagnosis/treatment. That limitation was fine with me because I never had any interest in being a primary care provider. Please don't be offended anyone ... Some of my best friends are NP's and I receive care from NP's gladly ... but if I had wanted to do that kind of work, I would have become a physician. I have always been more drawn to leading the delivery of traditional nursing care than to the direct provision of care in an expanded/extended role.

    Currently, my role focuses on research & evidence-based practice, running my extern program, being the liaison with the area nursing schools, and teaching within the staff development department. I have decided to become certified in the field of "Nursing Professional Development" to solidify my expertise in the development of nurses beyond their basic entry into the profession.

    The general education of my CNS education was a good fit for me -- as I can cope with the ambiguity of some of these roles and be flexible enough to switch my job focus ocassionally.

    Good luck with whatever you decide!
  5. by   traumaRUs
    llg - thanks so much for the contribution. No one would ever be offended by you - lol

    I enjoy knowing what other CNS's do and this is what makes a good choice for a wide variety of nurses.
  6. by   JSBoston
    Thank you for the responses!

    I did read most of the top thread about what different roles there are for a CNS, but I lost interest with most of the other replies and comments.

    I do not think I am interested in being a primary care provider either. I just don't have an interest in diagnosing. GREAT for those that do, but I'd rather find another angle that doesn't involve being a provider or sitting behind a desk being in management. I want to be MORE than a floor nurse, but still stay in contact with hospitals and patients and not on an outpatient basis.

    I'm going to an information session at a possible school next week, and hopefully I can meet with some advisor and figure out some stuff too.

    Thank you again!
  7. by   MedicineCNS
    I do a variety of things.... My hospital didn't have a CNS before me so they let me do whatever would give the nurses and patients in Medicine and Surgery the best benefit. I LOVE my job.

    1.I have a heart for new grads so I coach with new grads or nurses new to the hospital if they are not performing well.
    2. I lecture at various events and the School of Nursing etc.
    3. Patient management go to codes and RRT calls to help support staff.
    4. Mentor other nurses to go back to school or too evaluate their career goals.
    5. Performance Improvement-how to reduce falls, pressure ulcers, mislabeled specis, etc.
    6. Clinical Transformation/Cost savings projects
    7. I am involved in a research study.
    8. Some admin meetings

    My job is different every few weeks somethings fall off, some things come up. I always can stay busy. I think CNSs will start to catch on again because hospitals are doing so much to save money through the CNS as opposed to generating new charges (NPs) there is also not many of us floating around
  8. by   traumaRUs
    MedicineCNS - thanks for the input. Can I ask:

    1. How large a hospital do you work in?
    2. What state are you in and do CNS' in your state have prescriptive authority and are they considered an APN? (In IL where I live, CNS, NP, CNM and CRNA are all lumped together under the practice act as APNs and we do have prescriptive authority, DEA numbers and NPI numbers.

    It sounds like your job is great!
  9. by   MedicineCNS
    Sure! The hospital is 250 beds, in am In VA. Yes we are APNs, but no prescriptive authority which is irritating but it's a conservative state. Hopefully that will change! I am very lucky to be in this role.
  10. by   traumaRUs
    Sounds like a great fit for you.

    My nursing background is mostly ER and I miss the chaos of that type of environment.
  11. by   Joe NightingMale
    How much of the CNS role is administration?

    I'm curious because that's something I'd like to avoid.

    I'm very good with being patient, but not so good at being confrontational, and if I had to deal with a problem nurse that could be an issue. And as a floor nurse I've seen plenty of directives from the administration that really aren't practical to implement, however good they seem in committee.
  12. by   MedicineCNS
    When I started in this role it was 30% admin. No hiring firing or discipline though. I mean meeting with directors hospital driven "things"(not just initiatives in my units). I asked to come off of some of those things and now it is 10%.
  13. by   jahra
    Julie, please give us an update. Have you selected a path for
    further nursing education??