CNS or NP

MGMR · Jun 14, 2018

I have this same problem in terms of choosing between the two degrees, except I still do want to perform patient care at the bedside. Without a doubt, there are many more job opportunities for Nurse Practitioners than for Clinical Nurse Specialists. Even in areas that utilize CNS's, there is usually only one per unit at most, or one per specialty service. For example, there might be one neonatal CNS for the entire NICU, but they may also employ a handful of NNP's. Also in areas of the country or hospitals that don't use CNS's, they typically will fill those roles with NP's (or anyone with a MSN) because most people feel that the NP degree is a catch all: provider, educator, etc.

It's a shame because I believe in getting the education for the job you want to perform in, and getting your NP teaches you how to be a provider, but it might not prepare you well for roles in education, leadership, etc. But if the jobs don't exist, people are going to just get their NP because they don't want to waste their time and money.

MurseJJ · Jun 14, 2018

Hello all!! I am an almost BSN prepared RN looking go into a master's program. I really want to be a CNS and work with nurses and leaders as opposed to patients, but I also really want to make sure that I have a marketable career skill as well. There are CNS's in my hospital, though not many. I will not be staying in my current state of residence for too many years after grad school either. As much as I don't particularly want to do direct patient care any longer, I certainly don't want to go through the time, effort and financial commitment to come out on the other side as a very well educated bed side nurse.
When I look at job opportunities, their just seem to be so many more for NP's. My thoughts are since the CNS and NP are both APRN and have the same educational basis, perhaps my best bet is to get my CNS and if I cannot get a great job as a CNS go back and take clinicals for my NP.... Or get an NP and look for work as a CNS? I realize they are different jobs...

Even if you do CNS you could always apply for positions that are related to the CNS competencies but may not specifically be titled CNS (i.e. quality and safety specialist, professional development, even management). Especially if you aren't interested in direct patient care.

But i agree with you and MGMR, I go through this dilemma all the time. Although NP is interesting to me, I'm much more interested in being a "nurse specialist" and "nurse expert", and working with nurses and leaders (and being a clinical leader). I'd like to maintain some contact with the clinical setting and practice, though I'd be fine with less of that than being at the bedside or as an NP. At the moment I'll be starting an MSN in leadership in the Fall (luckily reimbursed by the job), and will decide after that what to do (may do a CNS DNP or possibly a PhD program, who knows, haha).

Trauma Columnist · Jun 14, 2018

I'm an adult and peds CNS. Here's my take on it:

1. I live in IL where CNS scope of practice = NP scope of practice.

2. I'm an APRN with full Rx authority

3. As the consensus model moves forward, FNPs are NOT being credentialed as inpt providers because their focus is outpt primary care.

4. CNS can function in many roles as above posters have stated.

5. CNS in my area can apply for NP jobs and most employers know who/what we are.

6. The consensus model has eliminated many CNS certifications so choose wisely. Both my adult and peds CNS certs are now "retired" so I must keep them current because re-testing is not an option.

Best wishes in your choice....

gptgrl · Jun 14, 2018

Have you considered applying to a CNS/NP dual track school such as University of Maryland, Penn, or University of Virginia? LSU doesn't advertise it, but, I know they will let you do a dual track as well.

llg, PhD, RN · Jun 14, 2018

This is one of the things I have hated about the recent developments in nursing education. Academic degrees are being tailored to closely to match a specific job (and only 1 job). In the olden days, you could get an MSN in a specialty and have plenty of flexibility within the curriculum to prepare yourself for a variety of roles.

For example, my MSN was in perinatal nursing (with a focus on NICU, not the maternity side). By taking only a few extra courses, I was eligible for Neonatal CNS jobs, management jobs, teaching jobs, staff development jobs, etc. -- lots of choices. Over the years, I have had jobs in all of those categories, based on that MSN.

Times change: employer's needs change: people change. I believe that ideally, higher education should prepare graduates to be flexible in their roles to be able to thrive in a changing world -- not locked into a specific role with specific job tasks. By focusing our MSN's too much on "specific job training" and less on "generalized higher education," we are not doing the graduates, or the world any favors.

That's my $.02 on the subject.

Advanced Practice Columnist / Guide · Jun 15, 2018

I agree that graduate education should leave room for flexibility based on the student's career goals and nursing should not be the exception in most cases. However, both the CNS and NP roles have evolved over time and with the push for some CNS' to align their practice to NP's by including diagnosing, prescribing, and treating, which ultimately led to some states adopting identical Scopes of Practice statements for NP's and CNS'.

We owe it to the public or the consumers of health care to ensure that the product of these programs are competent providers who have received specialized and focused training in their chosen fields. Having said this, if we were to establish both NP's and CNS' as providers, we need to hone in on the CNL role as the de facto replacement for what the CNS programs used to be: a flexible graduate school trained nurse that can assume various nursing-based expertise in a variety of hospital unit-based roles.

MGMR · Jun 15, 2018

I agree that graduate education should leave room for flexibility based on the student's career goals and nursing should not be the exception in most cases. However, both the CNS and NP roles have evolved over time and with the push for some CNS' to align their practice to NP's by including diagnosing, prescribing, and treating, which ultimately led to some states adopting identical Scopes of Practice statements for NP's and CNS'.
We owe it to the public or the consumers of health care to ensure that the product of these programs are competent providers who have received specialized and focused training in their chosen fields. Having said this, if we were to establish both NP's and CNS' as providers, we need to hone in on the CNL role as the de facto replacement for what the CNS programs used to be: a flexible graduate school trained nurse that can assume various nursing-based expertise in a variety of hospital unit-based roles.

I completely agree. I think that one of the main downfalls of the CNS profession was that it tried to be too "flexible" as a general APRN able to perform in many roles, including provider. I think the CNS degree in itself is a flexible APRN role, and didn't need to muddy the waters by creating confusing with the NP degree.

PICCRN79 · Jun 26, 2018

Thank you for your insight. I am applying to the University of South Alabama for summer 2019 CNS. I know if I follow my desired career path, the rest will work itself out.