CNS: Admin > Clinical?

elkpark · Aug 31, 2018

How are you defining "hands-on clinical nursing"? I can't speak to any specific, individual CNS program, but I've been a psych CNS for almost 25 years, and the psych CNS has always been a direct care role. Traditionally, we were trained as psychotherapists. I was surprised to learn only after I began participating on this site that the same is not true of other CNS specialties, that they do a lot more education and supervision, and not much direct, "hands-on" care. In recent years, there has been a lot of blurring between the CNS and NP role, many states now offer rx authority to psych CNSs, and many are functioning in a similar role to psych NPs.

I've spent my career doing psychiatric evaluations and psychotherapy in inpatient and outpatient settings, as well as working as a psychiatric hospital surveyor for my state and CMS for a few years. I've also taught psychiatric nursing as a faculty member in an ADN and a BSN program. I've provided clinical supervision for graduate students in the mental health disciplines, and I've provided inservice education on psychiatric topics for nursing staff.

The CNS is probably the most versatile of the advanced practice roles; we are prepared to be good at most everything. It's a shame that the role is being valued less and less by employers and facilities as time goes on.

ETA: Wait a minute, what do you mean, you're "looking at a psych CNS program"? The ANCC eliminated the psych CNS credential several years ago, and you can no longer get certified as a (new) psych CNS. I thought all the programs had been eliminated. Who is still offering a psych CNS program, and what's the point if you can't get certified? Is someone else (other than the ANCC) now offering a national certification? I know the NACNS has talked about that in the past, after the ANCC "retired" all the psych CNS certifications, but I didn't think it had happened.

Trauma Columnist · Aug 31, 2018

I am not a psych CNS but rather an adult and peds CNS. Elkpark is right on with concerns regarding the CNS role. I've been a CNS for 12+ years now and was trained/educated as an advanced practice nurse. I have the same scope of practice as the NP. However, due to the consensus model, I'm also able to be credentialed at hospitals because my education encompassed acute, chronic, geriatric and then I did another peds CNS program.

psych nurse in training · Aug 31, 2018

Hi elkpark,

Apparently the California board of nursing certifies psych cns nurses. By hands on I mean direct care with patients. I like the higher level planning and coordination of care, too, but I want my main job to be direct care. Thanks for the input.

elkpark · Aug 31, 2018

Hi elkpark,
Apparently the California board of nursing certifies psych cns nurses. By hands on I mean direct care with patients. I like the higher level planning and coordination of care, too, but I want my main job to be direct care. Thanks for the input.

So, are you saying that CA schools still offer psych CNS degrees? Be aware that, if you go that route and get certified by the state of CA BRN, that credential will not be transferable to any other state. You won't be able to get national certification as a psych CNS (since the national certification doesn't exist anymore; those of us who are already certified (by the ANCC) as psych CNSs are able to renew and maintain our existing certification, but it's no longer possible for "new" people to become certified as psych CNSs). And the chances of finding a position (in another state) that doesn't require national certification are slim.

What schools are still offering psych CNS programs?

psych nurse in training · Sep 1, 2018

San Francisco State University is the only one I'm aware of. They don't advertise it on their website, but the application includes it as an option. I called and confirmed with their nursing admissions officer.

My ultimate goal is to be an APRN with prescriptive authority. Either the laws will change, or I will eventually become a Psych NP. Other than that, the Psych CNS sounds really good. I don't have any intention of working in another state, but it's good to know there isn't reciprocity for Psych CNSs who don't have a national certification.

Trauma Columnist · Sep 2, 2018

CNS and NP are two separate APRN roles. If you become a CNS, its not automatic that you become an NP. You would need to do a post-MSN pysch NP program with the required 500+ hours of clinical

WestCoastSunRN, MSN, CNS · Sep 14, 2018

The CNS is probably the most versatile of the advanced practice roles; we are prepared to be good at most everything. It's a shame that the role is being valued less and less by employers and facilities as time goes on.
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I totally agree -- CNS most versatile and underutilized APRN role. I am happy to be pursuing my education as a CNS. It's true that I can't know my exact career trajectory with this degree -- it is the degree and preparation that most fits with what I want to do and builds upon the hard-earned experience of the bedside nurse. But I am spending a fraction of what many APRN programs cost to obtain a degree that will open a lot of doors for me. They may not specifically be CNS doors (though in my area and in my specialty, CNSes are still very much a thing).

The CNS was sort of the super-hero nurse for me, when I was growing up as a nurse. I really hope we can make a case, professionally and institutionally, for this role to be reprised to its former glory.