CNS, an APRN role on life support?

by matthewandrew matthewandrew, NP Member Nurse

Specializes in Family Nursing & Psychiatry. Has 10 years experience.

Hardly anyone else posts here. Do nurses still want to be clinical nurse specialists? This is such a unique nursing role, I hope it’s able to adapt to a changing healthcare environment. 

adventure_rn, BSN

Specializes in NICU, PICU. 1 Article; 1,538 Posts

A bunch of schools are closing their programs, which isn't helping.

In my experience, hospitals/practices are only willing to pay a provider salary if they're getting reimbursed for something that only a provider can do (I.e. billing for consults, procedures, orders/prescriptions etc.) CNSs can do those things, but they have a more limited breadth of 'billable' abilities than NPs, so employers may prefer NPs.

As for much of the rest of the CNS role (reviewing literature to advise on policies, teaching, research, etc.)--those activities are super-important, but don't legally have to be done by an advanced practice provider. Pretty much any RN with adequate time, training, and experience is able to do them. Therefore, it's way cheaper for a hospital to move existing RNs into educator or research roles, and pawn the literature reviews/policy changes onto managers and committees.

So yes, in theory, the CNS role is great, and the work they do is really important. However, hospitals may be squeezing them out when they can get an NP who is more billable to do patient care, and an RN who is cheaper to do the 'practice improvement' piece.

If you look back at the older posts in this forum, you can see that people in the CNS role have seen this coming for years.



58 Posts

Weird.....Nursing invented a role that we thought we needed, but no other part of the healthcare delivery machine wanted, nobody (including nurses) really understood, and the idea tanked. 


traumaRUs, MSN, APRN, CNS

Specializes in Nephrology, Cardiology, ER, ICU. Has 30 years experience. 164 Articles; 21,178 Posts

I'm an adult CNS (2006) and peds CNS (2011) and I function solely as an APRN who sees pts, bills for my services. I do nothing like the "true" CNS role. That role IMHO is obsolete. Nowadays as an APRN you need to earn your keep and though you do help lower costs by being a "true CNS", its not quantifiable. 


Also, as a CNS, I did clinicals in acute care, among other areas and in my area, the hospitals will credential me over an FNP for inpt roles due to LACE and the role delineation between involving NP specialties.