CNS or RN degree? - Advice needed!

Trauma Columnist · Oct 1, 2009

Well, I'm an adult health CNS (since 2006) and a nurse since 1992. A CNS by definition is an expert in a certain specialty or population base. How does the school meet this goal?

caliotter3 · Oct 1, 2009

I am not really up on this situation. I always thought that part of the process of obtaining the CNS designation included X amount of paid experience to accompany the education and test requirements. I know that there are direct entry MSN programs that grant the degree and I believe that coming out of such a program would not provide much of an edge in the job market if one has no experience to market. JMT

Newbie7 · Oct 1, 2009

Well, I'm an adult health CNS (since 2006) and a nurse since 1992. A CNS by definition is an expert in a certain specialty or population base. How does the school meet this goal?

This program is for those who have degrees in non-nursing areas and first year you study to be an RN and two years after you study CNS areas. I am considering Psych/Mental health NP program too (gain alternative program for those who have no nursing experience but with graduate degrees). My biggest concern is whether I could land a job readily after a degree with relatively little experience. I would imagine hospitals would rather hire less specialized RNs with less pay than specialized nurses. I would appreciate any information you may be able to provide. Thanks.

Trauma Columnist · Oct 1, 2009

Hopefully there will be some folks come along that have done this type of program. My concern, in this economy is that nurses of all levels are having a difficult times finding jobs. What is the job outlook in your area? Or are you free to move?

Newbie7 · Oct 1, 2009

Hopefully there will be some folks come along that have done this type of program. My concern, in this economy is that nurses of all levels are having a difficult times finding jobs. What is the job outlook in your area? Or are you free to move?

That is my main concern too. I am in Austin, texas and I am not willing to move. Getting an advanced degree like CNS and NP would limit my employabilities, wouldn't it? I just did a search in a local newspaper. A lot of jobs came up under RNs but only one under NP. I guess I could work as an RN even with an NP licensure?

Trauma Columnist · Oct 2, 2009

There are several discussion threads here about APNs working as RNs after they get licensed as an APN:

https://allnurses.com/nurse-practitioners-np/nps-second-jobs-417071.html

Is a CNS in TX an advanced practice nurse? By that, I mean, do they see pts, treat pts, write scripts, like a NP or are they a "change agent" or educator or work in some other non-clinical way?

That might affect your job opportunities too.

Newbie7 · Oct 2, 2009

Many thanks traumaRUs. I read your blog and your life story is very inspiring. I feel more certain about what I should do now. Thanks again.

Whispera, MSN, RN · Oct 2, 2009

i'm a psych cns. i wouldn't have dreamed of practicing as a cns without having a few years of nursing under my belt. i just didn't know anywhere near enough about the real side of the work to be competent in doing it.

there are oodles more rns than cnss. in general hospitals where i've worked, there would be 0-1 cns per specialty area and rns filled all the other jobs. in psych hospitals there were no cnss and a few general nps who did historys and physicals and monitored medical treatment. in private practice, with a doctor, you might be the only cns or np with him or her while there would be a few rns and maybe a few other staff members. lots of places don't have cnss or nps at all. you could call places near you to see if they have people in those jobs or not.

also, while you might get a cns through your education, to get the ability to bill for your services (or to have your facility bill for your work, to medicare and other insurances), you often have to be certified as a cns, and that doesn't happen without work experience, so doing the work your degree would qualify you for might not be possible.

on the other hand, if you are a cns, you surely can work as an rn, but, you will be held to the standards of a cns, which are higher. it's not necessarily a legally safe position to be in.

i think you'd do well to get an rn, work awhile, and then go for the advanced degree if you decide you want it, maybe in an rn-msn program.

finally, being a psych cns can be very similar to being a psych np. it all depends on where you work. i don't see an advantage of one over the other.

Newbie7 · Oct 2, 2009

i'm a psych cns. i wouldn't have dreamed of practicing as a cns without having a few years of nursing under my belt. i just didn't know anywhere near enough about the real side of the work to be competent in doing it.
there are oodles more rns than cnss. where general where i've worked, there would be 0-1 cns per specialty area and rns filled all the other jobs. in psych hospitals there were no cnss and a few general nps who did historys and physicals and monitored medical treatment. in private practice, with a doctor, you might be the only cns or np with him or her while there would be a few rns and maybe a few other staff members. lots of places don't have cnss or nps at all. you could call places near you to see if they have people in those jobs or not.
also, while you might get a cns through your education, to get the ability to bill for your services (or to have your facility bill for your work, to medicare and other insurances), you often have to be certified as a cns, and that doesn't happen without work experience, so doing the work your degree would qualify you for might not be possible.
on the other hand, if you are a cns, you surely can work as an rn, but, you will be held to the standards of a cns, which are higher. it's not necessarily a legally safe position to be in.
i think you'd do well to get an rn, work awhile, and then go for the advanced degree if you decide you want it, maybe in an rn-msn program.
finally, being a psych cns can be very similar to being a psych np. it all depends on where you work. i don't see an advantage of one over the other.

thanks whispera. your post is very informative.

Whispera, MSN, RN · Oct 2, 2009

There's a new television show on where there's a master's degree prepared nurse (who has no experience) working with the experienced. without a master's degree, nurses. I have to chuckle when I see her worrying that she doesn't know things, and falling apart over things the other nurses can handle easily. I can't remember the name of the show, but I think the situation fits in with what you're asking about. It just takes time to know how to do things!

NICU_babyRN, BSN, RN · Nov 16, 2009

Is it a CNS or a CNL degree? There is a Clinical Nurse LEADER program out there too. If you have no experience as an RN, even WITH a CNS degree one would probably have a tough time getting a position as a CNS.