CNS or RN degree? - Advice needed!

Specialties CNS

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Hello--I am a pre-nursing student faced with a tough decision and I would like some input from experienced nurses before I make the decision. I can apply to either ADN program to be an RN or to direct entry MSN program to be a CNS. I like the idea of becoming a specialized nurse as a CNS but I am somewhat unsure about the job market of CNSs compared to RNs. I would imagine it would be much easier to get a job as an RN than a CNS? Also, as someone who has not been a nurse, what is it like to complete a 3 year program and work as a CNS along with RNs with years of experience? Seems like you might need lots of experience before you become a specialist, but these direct entry degrees says in 3 years I'll be a CNS. I would appreciate if anyone can provide some real experience on this before I make the daunting decision. Thank you.

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.

trauma, I fully realize you didn't mean anything derogatory but, as an old-school CNS, I feel the need to point out that a lot of us feel that the CNS role is the true advanced practice nursing role, and the NP role is more "medicine lite." I'm always bothered by statements that suggest that "advanced practice" equals "writing scrips." As a psych CNS, I have "seen" and "treated" clients for years, without writing scrips. I've never had prescriptive authority (although I've practiced in states where I could have gotten it), don't want it, and wouldn't take it if you tried to give it to me -- and I assure you my direct care, hands-on clinical practice is definitely "advanced," by the standards and definitions of the larger nursing community. Lots of CNSs work in direct client care; remember, the "C" in CNS stands for "clinical" -- we are clinical experts in our specialty.

I'm aware that there is a movement in some areas to redefine "advanced practice nursing" as only including nurses with prescriptive authority, and I'm v. offended by that. I'm also unhappy, personally, about the recent and increasing blurring of the CNS and NP roles/practices, and think that is a significant loss for nursing. I don't mean to suggest that the CNS role is better or more important that the other advanced practice roles -- I just hate to see us get "demoted," even if it's only in a passing comment, and I try to always speak up. :)

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Specializes in Nephrology, Cardiology, ER, ICU.

I sincerely apologize Elkpark - you are right - I meant no offense at all!

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I sincerely apologize Elkpark - you are right - I meant no offense at all!

No need to apologize -- as I said, I realize you didn't mean any harm or offense. I just always try to speak up for the CNS role, esp. when a comment is made that could be misinterpreted by people who are just working on figuring all this stuff out. :)

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Specializes in L&D.

Hi Newbie,

I'm an AE student at UT (where I am assuming you are considering the AE MSN program as well, as you are also in Austin?) and I hope I can shed a little light for you. I'm in my foundation year and will sit for my nursing boards in September of this year. I am currently in the maternity track, but intend to switch over to Adult Health CNS. Any of the MSN degrees in the AE program will garner you an advantage--eventually. However, like any other job, you start from the bottom and work your way up; that includes with the CNS. We have had instructors who also went through the AE program themselves and many of them did floor nursing for a year or two before going on to truly work as a CNS.

The thing about an accelerated program like this is that there is not much emphasis on skills like you would get if you apply for an ADN degree to get your RN through somewhere like ACC. What they do is prepare us for leadership and management roles. Yes, you do learn your skills, but skills are something that come with time. Here, they train us how to think critically. With an ADN RN, yeah you'll get a job, but you only be able to advance so far. So I guess it just comes down to what your long-term goals are. Plus, you can always change your mind later and go back to school!

And yes, in Texas, CNS's are recognized as APNs and many do have prescriptive authority, although you may opt out if you so choose.

Hope that helps!

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Hi Newbi7,

I am actually a graduate of the program you are considering. I have been a RN for 5 years and have decided not to use my CNS degree due to the experience issues and the job market. My salary is pretty comfortable as a RN and I enjoy my job a lot! I have to agree with the above post. Let me give you some additional information. The program teaches you to be a CNS but there are not very many of those positions available in Austin. Most of the hospitals have gotten rid of CNS nurses in an effort to cut cost. There are however a number of NP jobs out there in local clinics. (Google Austin Advance Practice Nurses. It is a local APN nursing society with job postings) In the AE-CNS program you can take an additional course and get your prescription privaleges. So in a sense you can work like an NP as a CNS. However you run into the problem of experience. If your prescirbing medications you need to be the expert in your area to be safe. A couple of my friends were able to find jobs as a CNS with prescription privaleges straight out of school. The ones who were successful though had mentoring physcians who were willing to work with them as they learned their new role. Most physcians though need an advance practice nurse who can hit the ground running. As nurses we often have to draw on our experience to help us make clinical decisions. (MDs have 4 years of med school + 4 years residency, we get 2 with a masters degree) I would suggest you get your associates degree with ACC which is cheaper. I know there is a wait list for that program but it is a very good nursing program. After that work for a few years as an RN. This will give you some valuable experience and help you decide what area of nursing you want to specialize in. After that take a bridge program for a bachelors degree. You can finish that in a year or less and then go straight on to a NP masters program.

Hope this helps.

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I'm so glad I found this thread because I'm trying to decide the same thing! I am worried about getting the CNS and working with very experienced RNs because I'd have this advanced degree without any of their experience. And I know that I would probably work as a RN for a long time before I could even use the CNS. Plus, it seems like the UT program doesn't focus enough on clinical rotations from what I got at their Info Session. I could be wrong.

[On a side note, I already have a degree from UT, and in my opinion, UT does a really great job as advertising itself as the best in everything and expects that you'll land a job because you went to UT... but I'm just bitter...]

I think I'd rather go to UTHSCSA and go through their accelerated BSN, get experience, then get my MSN. But I also know that it is difficult to find a job as a new grad RN...

Oh, what to do!

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Specializes in Nephrology, Cardiology, ER, ICU.

My vote would be with the ABSN then MSN in a couple of years.

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Specializes in Not too many areas I haven't dipped into.

I am lost...I thought to be a CNS you had to be a BSN?

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Specializes in Nephrology, Cardiology, ER, ICU.

No, there are direct entry (DE) programs where if you have a bachelors in an unrelated field and you ARE NOT an RN, you can complete these programs and get your RN in a year, then an MSN with specialty focus like CNS or NP.

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I am lost...I thought to be a CNS you had to be a BSN?

In any APN speciality... with only ONE exception.. there are a lot programs you can enter as a HS grad.. and exit a CNS or NP.

Scary huh?

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Specializes in medical.
No, there are direct entry (DE) programs where if you have a bachelors in an unrelated field and you ARE NOT an RN, you can complete these programs and get your RN in a year, then an MSN with specialty focus like CNS or NP.

Wow, that's pretty scare to go to school for just 1 year to become RN and go straight for master's without having any health-care experience. It is almost ridiculous to me that it is allowed.

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