CNS vs. CNL

Psychcns · Jan 18, 2012

It seems like this new cnl role was once filled by people with cns. Cns roles were eliminated. Are any hospitals implementing the cnl now? How is it different from a charge nurse? It seems like a reworking of cns, primary nurse and charge nurse responsibilities. Will every pt have a cnl?--in addition to or instead of a primary nurse and charge nurse

bsnanat2 · Jan 19, 2012

CNL = another academic creation, a jedi mind-trick designed to give validity, weight and credibility to the Masters level entry into nursing. New nurses with no experience are granted "extra value" by virtue of being dubbed "Clinical Nurse Leaders", instead of calling it what it is: a new RN with no more experience than a diploma, adn or bsn prepared nurse. Direct-entry MSN programs should be titled as regular pre-licensure programs for those with a previous BS degree. Better yet, they should simply grant another BS because "MSN" comes with the rightful assumption that there is education AND experience behind it. How can one be a Clinical Leader when they have never practiced in that field? I would be wary of presenting myself as an "expert and leader" without any field experience to back it up (and NO!, clinicals don't count!)

As for CNL programs that take practicing RN's, it appears that they are seeking a way to fill the void created by those who saw the CNS bedside role as unnecessary and pushed to promote it to primarily an NP-like role. The traditional CNS role has always been needed. Every unit has a "go to" person who has the most knowledge and experience and just "gets it." The CNS is this person "supercharged." Academics will never say that they were wrong to downplay the need for the CNS, so they'll just create a cheaper version of it and call it the CNL.

Bottom line? Direct-entry CNL = no initial added value, but down the road, yes - just like any new nurse, they will eventually

practice up to the level of their education.

Traditional entry CNL = essentially the same function of CNS in the past.

CNS = Clinical Leader and treatment expert in that field with Advanced Practice training and abilities.

The nurse's nurse and the physician's resource.

Psychcns · Jan 19, 2012

Well said, bsnanet. Last I worked in mgt in 2000, we developed a clinical leader position. Minimum requirement was bsn and 5 years exp In clinical area and leadership skills. Main role was charge nurse and working with mgr to meet goals of unit:ie education,precepting new staff, cost containment,and quality improvement.

llg, PhD, RN · Jan 19, 2012

Yes. Well said. bsnanet. I was an "old school, tradiational CNS" back in the days before they tried to merge the NP and CNS roles. I agree with you views on that aspect completely. The role has always been needed -- it was just the easiest one to cut from the budget whenever money got tight. Then when they started merging the NP and CNS roles, a lot of us weren't interested in doing medical management and we drifted away. We found other roles (such as Nursing Professional Development).

Then they realized they needed the old CNS's back -- and couldn't admit that they had made a mistake. And the schools had this population of 2nd degree students who didn't qualify for undergraduate financial aid. So they had to make a direct-entry program at the graduate level to get these students into the system with graduate financial aid. Hence, the creation of an MSN level entry program to fulfill many of the functions of us old CNS's.

It has been so sad to watch ... though I do like some of the courses that are included in most CNL curricula I have seen. They seem relevant to the role functions -- and SHOULD have been included in CNS programs (instead of all that medical management stuff they started to add).

Franjcamp · Jan 20, 2012

I know that this may be addressed in another thread, but if someone could either answer my question, or direct me to an answer, I would appreciate it.
I know that a CNL is more of a generalist than a CNS, but what does this really mean? I know that in CNL training, in obtaining your MSN, you still have clinical rotations, and become an "expert" in a field.... but currently I work as an RN in a level III NICU, and would preferably stay with babies, or at the least, pediatrics. I feel that the program offered close to me that offers training to become a CNL is better for me due to the length, and online options, but I am unsure if the degree itself would be better as CNS or a CNL?
SOOOOO
My main question is: What in the world is the real difference between a CNS and a CNL?
Thanks!
Amanda
There seems to be alot of animosity toward the role of the CNL. I am in this program and look forward to graduating in the next 5 months. I agree with some of what you are saying. I am in a class of 18 well seasoned nurses and one person who has a BS in another science. At least 12 of us have 20+ years of experience. I have to say that I personally resent the way the programs will let in anyone with a BS in, but then I realize the P.A. programs are set up the same way. And do you realize the P.A.s make 10-20,000 more a year than a NP or CNS? The cirriculum we follow for the first year is nearly the same as the N.P.'s and the CNS's. We take advanced pathophys, advanced pharmacology, advanced physical assessments, etc. The second year however we have examined the business perspective of this field. You are right in the fact that experience is the best teacher. It doesn't matter if you are the brightest in your class if you don't have the experience to back up your degree. When I try to explain the role of the CNL all I can say is what I have been told. We are basically risk analyst, outcomes manager, and educators. The good thing about the program I am in it has been designed so if we decide to become Nurse Practitioners or Clinical Nurse Specialist we will only have to go to school one more year.

elkpark · Jan 20, 2012

CNL = another academic creation, a jedi mind-trick designed to give validity, weight and credibility to the Masters level entry into nursing. New nurses with no experience are granted "extra value" by virtue of being dubbed "Clinical Nurse Leaders", instead of calling it what it is: a new RN with no more experience than a diploma, adn or bsn prepared nurse. Direct-entry MSN programs should be titled as regular pre-licensure programs for those with a previous BS degree. Better yet, they should simply grant another BS because "MSN" comes with the rightful assumption that there is education AND experience behind it. How can one be a Clinical Leader when they have never practiced in that field? I would be wary of presenting myself as an "expert and leader" without any field experience to back it up (and NO!, clinicals don't count!)
As for CNL programs that take practicing RN's, it appears that they are seeking a way to fill the void created by those who saw the CNS bedside role as unnecessary and pushed to promote it to primarily an NP-like role. The traditional CNS role has always been needed. Every unit has a "go to" person who has the most knowledge and experience and just "gets it." The CNS is this person "supercharged." Academics will never say that they were wrong to downplay the need for the CNS, so they'll just create a cheaper version of it and call it the CNL.
Bottom line? Direct-entry CNL = no initial added value, but down the road, yes - just like any new nurse, they will eventually
practice up to the level of their education.
Traditional entry CNL = essentially the same function of CNS in the past.
CNS = Clinical Leader and treatment expert in that field with Advanced Practice training and abilities.
The nurse's nurse and the physician's resource.

Add me to the list of those agreeing completely woth you.

Psychcns · Jan 20, 2012

People graduating from diploma programs were confident in their skills because in senior year they were working three shifts per week.--they graduated with experience. The CNL is a fine step past BSN, especially if it bridges to APRN but Experience matters. Academics don't seem to realize this.

Franjcamp · Jan 21, 2012

I totally agree with that statement. Recently I made a comment on one of our discussions in my MSN program that I appreciated any good nurse whether she be RN or LPN because experience was the key to performance and one of my professors made a snotty remark that if that was true then why bother with a higher degree. EXPERIENCE HAS ALWAYS BEEN THE BEST TEACHER.

SHGR, MSN, RN, CNS · Jan 21, 2012

bsnanat2-- I agree with you 100%. My MSN program has several NP and CNS tracks, but very few CNS students. The reason I'm in an NP track- and not the CNS track which is where it seems I should be- is the lack of job prospects.

It's sad that employers don't seem to value the CNS role.

But it's the truth.

Trauma Columnist · Jan 22, 2012

While I agree with you theory Franjcamp - education is the new key to success in this world of Magnet status, reimbursement issues, and hospital politics.

llg, PhD, RN · Jan 22, 2012

I totally agree with that statement. Recently I made a comment on one of our discussions in my MSN program that I appreciated any good nurse whether she be RN or LPN because experience was the key to performance and one of my professors made a snotty remark that if that was true then why bother with a higher degree. EXPERIENCE HAS ALWAYS BEEN THE BEST TEACHER.

I agree that experience can be a great teacher -- but the best learning occurs when experience is enriched by "book learning." The best outcomes occur when both are combined.

Just as people with only academic knowledge only can flounder in practice, people with no academic can flounder with their practice, too. The key is to have both kinds of knowledge. We need to recognize the importance of both types of knowledge -- rather than continue to be divisive in valueing only one or the other.

Franjcamp · Jan 24, 2012

I did not mean to sound unappreciative of education, but I value my past experience in the field of nursing also. Many nurses will admit they graduated and didn't have a clue as to how to function as a nurse. I will admit for 20 years I did not understand why nurses pursued higher degrees. By the end of my BSN I realized how much I hadn't learned in my ADN program. Now that I am coming to a end of my MSN program, I am proud to say I have learned so much. A higher education is definitely worth pursing.