Public Health/Community Clinical Nurse Specialist

Good question...sorry for delay in answering. Thanks to colleague below for discussion lead.

I took the ANCC specialty exam to become an ANCC board certified Clinical Nurse Specialist in 2008 after completing my Advanced Community Health Nursing degree (MSN). This allowed me to become licensed as an Advanced Practice Nurse (CNS) in my state. Unfortunately this national board exam no longer exists. I am able to maintain my certification and licensure as long as I continue to obtain scope related continuing education and renew my certification in a timely manner. The certification can now be at a bachelor or Master level but you are not able to become an advanced practice nurse anymore.

My ACHN graduate degree is less common now due to changes in advance practice nursing and the public health transitional focus to the MPH generalist degree. Anyone can earn an MPH degree. As a nurse, my public health scope was always as a public health nurse which is why I did not choose an MPH.

The last two years I have been receiving additional training to transition to the scope of Psychiatric Mental Health Nurse Practitioner. I will graduate in May and take a new board exam for PMHNP which will involve a change in my Advanced Practice Nursing licensure.

I will always have a passion for public health. I have just found a much needed specialty of practice where I can still apply population based health and work with an individual focused direct care context.

Hi PF,

It is good to know there are others out there passionate about public health. Since my original posting, there have been considerable changes in advance practice nursing related to the PHCNS. See my more lengthy posting about this these changes.

I am wondering if I will continue to maintain my PHCNS certification with a new scope a practice nearly completed as a Psychiatric Nurse Practitioner.

Hang in there and keep up the passion!

Check out my other more lengthy posting about my transition from PHCNS to PMHNP...

Absolutely! The practice of medicine is a collaborative effort between Physicians, Advance Practice Nurses, and Physician Assistants. Some would even include the integration of Behavioral Health Clinicians as part of the medical team.

Good question. You are correct that an RN with an MPH is NOT an APRN. To be an APRN you must have an appropriate board examination in Advanced Practice Nursing and be recognized by your state board of nursing practice act to be licensed as such.

The practice role of a PHCNS depends on the setting, state board of nursing and APN Practice Act.

I am licensed in my state as a CNS, APRN, with prescriptive authority. I am also a licensed RN.

I think if you put out a survey to the few PHCNS that probably still exist, there might be a surprising mix of clinical and non-clinical roles with this credential.

I just saw your post and interest in community health. There are some variations depending on the degree. There are some community health degrees that focus on all nonclinical roles such as health education and promotion, assessment, etc. They are not always nursing focused however.

When my graduate college ended their ACHN program, it transitioned into the Advanced Practice Public Health Nurse Practitioner program. This competencies of this curriculum integrate population health and individual health into an NP direct care role. I think this curriculum would have been the best way to go for me years ago if it had been available...but times and experiences change over time.

It was my 15 years in public health safety net clinics and an FQHC that lead to me returning for additional training and specialization in the psychiatric NP arena.

Don't lose hope...your passion will lead you to where you want to be. Thank you for contributing to the updates on the status of the Advanced Public Health Nurse discussion.

I was a little disappointed when my degree and PHCNS-BC credential retired one year after I received it. Although I have been able to maintain my APRN, PHCNS for 10 years through continuing education, certification and license renewals, I wish my school could have transitioned to the Public Health Nurse Practitioner a little sooner. If I had known the change was coming, I would have stayed and transitioned to the new program.

Your education and experience are what you make of it. My MSN and PHCNS-BC credential still helped me to get great experience in a federally qualified health center (FQHC) in a public health department for seven years. It also lead to increase knowledge and experience in the integration of Primary Care and Behavioral Health. I will graduate and take boards to become a Psychiatric Mental Health Nurse Practitioner in May.

Best wishes to you in your endeavors!