CNS! Is this a Dying Specialty!?

missvictoriat · May 27, 2011

I think it is a role "in trouble" because schools have not supported it lately. Many have switched their programs to prepare CNL's instead.
I never wanted to be an NP and do "primary care" of patients. I always wanted to focus on supporting staff nurses through staff development and providing leadership to clinical projects designed to improve nursing practice. That made the traditional CNS role the best fit for me. NP's don't get the advanced education in staff development, project management, change theories, etc. that CNS's do. NP education is focused on the provision of primary care -- and mostly in an outpatient setting (though some APN progms do include in-patient care now.)
As the traditional CNS role became muddled with attempts to combine it with the NP role and education, it became much less attractive to me. So I switched my focus to staff develoment, research, and evidence-based practice -- getting my PhD and certified in Nursing Professional Development. I work in a hospital doing stuff that is consistent with an advanced, but traditional, CNS role.

This is a very good explanation of what a CNS is and does. I've never truly understood a CNS' role. I do now. THANK YOU. This thread is very interesting.

elkpark · May 27, 2011

I always thought of MSN-prepared nurses as being APNs, whether they were certified or not. In fact, I thought the point to the ANCC's APRN, BC credential was to designate those who were certified, from the APRN's (without BC) who weren't certified. I thought both APRNs and APRN, BCs were APNs. I thought anyone with a MSN was an APN.

The four advanced practice roles are clinical nurse specialist, nurse midwife, nurse practitioner, and nurse anesthetist. That's it for advanced practice. There are lots of other MSN concentrations "out there," and lots of individuals with MSNs (in those other concentrations) who aren't advanced practice nurses.

Whispera, MSN, RN · May 27, 2011

When I was in grad school (for an MSN) there were some specializing in Administration and a few other non-direct-contact specialties. Are those the ones not considered to be APNs? We were all told we would be CNSs on graduation, even them.

I think I'm getting bogged down in details, actually. I know what I can do and that's enough for me. :)

irish_rainbow, BSN, MSN, DNP, NP · May 27, 2011

I have good news! After researching and talking with the director of the program I am interested in, I have learned some new information which I think will be helpful for me. The school I am interested in has "post-graduate" studies. So basically, if I decide to do the Pediatric CNS track, I can go back and do post grad studies to sit for my APN license if I want to. This makes me less fearful of choosing the wrong track since it's easily remedied should I change my mind at any time. The post grad studies can range from about 3-5 semesters, which isn't too bad considering you'd be getting a whole other certification. Also, there are only about 3 classes that are actually different between the Peds CNS and Peds PNP... now the Peds Acute NP is a little different between both, I believe.

In all of my research, I have to say that it does seem the two titles have intertwined over the years and it can get extremely confusing when trying to define what exactly these specialities really are. I think a lot of it does depend upon the state in which you practice, the school you attended, and the facility in which you work. Where I work they are simply called Advanced Practice Partners and have a huge range of duties depending on what a particular unit has hired them for.

I really appreciate everyone's help and discussion on this issue... you guys are so awesome and nice! :-)

Trauma Columnist · May 28, 2011

Hmmm....Advanced Practice PARTNERS - uh not a title I'd want to work under.

Just another confusing name to what should be Advanced Practice Nurses.

enoRN · May 28, 2011

Hmmm....Advanced Practice PARTNERS - uh not a title I'd want to work under.
Just another confusing name to what should be Advanced Practice Nurses.

These shows how much nursing needs a real DEFINITION through all the refinemnt over the years:idea:

Trauma Columnist · May 28, 2011

Yes - I agree.

The APRN consensus model via ANCC and ANA seems to be addressing this.

bsnanat2 · Aug 18, 2011

Must admit I have not read every comment in this thread but plan to. Just wanted to add that in reading the new Consensus Model, CNS really seems to be the best way to go. I am doing research on advanced practice programs and which route to take. CNS is starting to look good because the Consensus Model emphasizes patient acuity as the defining factor in who can treat what, no matter what the setting (inpatient or outpatient). Primary care NP's need to make sure they are dealing with primary care type problems and acute care NP's need to make sure they are not doing primary care. The CNS though can treat across the primary to acute care spectrum within their population, peds or adult (adolescent through geriatric). CNS is starting to look pretty good especially since Georgia now gives CNS's prescriptive authority.

duttyprofessor · Sep 1, 2011

Hey everyone! I'm extremely new to this site, this being my first actual post, but I found this thread/board through a search and wanted to dive in.

I'm taking prerequisites for a pediatric CNS program that's going to re-open next fall and during this time of uncertainty (will it open? is the program going to be viable?), I want to get some answers. I've been mentored a bit by a surgical CNS and another pediatric CNS who graduated 1.5 years ago and through conversations with them about what they do, it's right up my alley: policy change in the hospital, educating staff on the latest stuff, performing some varieties of research, etc. My passions are pediatric pain and integrative health (CAM therapies and the like), so I plan on bringing freshness to whatever I do.

You all have provided a few on this thread already and I thank you for it.

However, one of the first questions addressed (I think) was regarding the DNP.

Ongoing from here on out, do you think the DNP role is similar enough to both the CNS and the NP that it will start taking CNS jobs? With my passion for advanced practice and interest in widespread change, is the DNP something I should look at prior to the MSN since there are some BSN-to-DNP programs that exist?

Thanks for any information any of you can offer!

Namaste,

Chris

gardentulip27 · Nov 30, 2011

Yes it is dying and yes go for NP. They are retiring many CNS certifications. What a profession! Have never heard of doctors, or pharmacists or lawyers, retiring their "certifications". OMG

Trauma Columnist · Nov 30, 2011

Agree with you Gardentulip!

And...since CNS's can only be certified via ANCC, we are at their mercy.

I would never advise anyone contemplating grad school to go for CNS.

enoRN · Nov 30, 2011

I completely disagree!!!