CNS title

Depends on what state you're in. I"ve been places were CNS was a job title.

ok thank you! I was just curious because I hadn't heard of that before.

I know that some people have confusion between a clinical nurse leader (CNL) and a clinical nurse specialist (CNS).

Both the CNL and CNS are graduate-degree prepared roles but the CNL is considered a generalist and is not an advanced practice registered nurse (APRN). The CNL is a newer role and combines aspects of education and leadership at the level of a clinical microsystem (specific unit or department) while the CNS is an APRN that has a specific population foci and may be functioning in an educational or clinical capacity depending on where they are employed.

The whole thing can get kind of hairy because CNS is a category of APRN but not every state recognizes this and the level of independent practice and ability to prescribe medications/treatments for patients greatly varies across the US. CNS is also a job title in some facilities and, as some users have mentioned, there are times when someone may have that job title but are not actually a CNS (they may have an MSN but it could be in nursing leadership or education etc.) or they may be in the process of becoming a CNS but not have completed their graduate degree yet. I am not saying that is right or should be the practice but it is the current state of affairs. On the flip side of that, I have also seen cases where there is a position for a CNL (or a "nurse educator") posted and it is actually being filled by a CNS because of the fact that the CNS role has been around longer and that there may be few candidates available with the graduate degree focusing on CNL.

If you are a CNS, it may depend on where you earned your graduate degree as to what type of position you gravitate toward. I say that because the CNS programs in my area have created students who are looking to be clinical educators either in academic settings or healthcare facilities and the students are not focusing as much on providing care to patients as APRN clinicians (i.e. diagnosing conditions and prescribing medications/treatments) because the only CNS role that is allowed to function in that capacity in my state are psychiatric/mental health CNS (PMHCNS).

Sadly, I think that this creates some role confusion both within the nursing community and even more so when trying to explain this to other healthcare disciplines. I would also venture to say (only based on my casual observation) that out of the APRN roles the CNS sometimes gets the short end of the stick because when people think about and discuss APRN roles most often you will hear nurse practitioner (NP), certified registered nurse anesthetist (CRNA), and certified nurse midwife (CNM) but sometimes the CNS will get left out accidently or not included in the discussion because of the inconsistencies in legislation surrounding independent practice and ability to prescribe medications/treatments in the United States. To the OP, hopefully this was able to clear some things up or I might have just made it even more confusing?

!Chris

http://www.nacns.org/docs/TitleProtectionTable.pdf

Here is a list of CNS title protection by state, in case you were curious! I too run into individuals with the title "Clinical Nurse Specialist", who are RNs with varying levels of academic preparation.

Yup at some facilities it is a job title where the holder's do not even hold a graduate degree.