Difference between Nurse Practitioner and Clinical Nurse Specialist

Published

I currently have a BS in Health Science and am enrolled in an ASN program. My academic advisor as well as my aunt (who is an RN) have told me to skip the RN-BSN and the RN-MSN path and go straight for my DNP when the time comes. So I've been researching these programs, but keep running into the same thing. Every school website I've visited lists the specialties offered at their school, but the same specialty is listed for both NP's and CNS'.

So for example:

Nurse Practitioners

  • Pediatrics
  • Acute care
  • Family Care

Clinical Nurse Specialists

  • Pediatrics
  • Acute Care
  • Family Care

So, Im just wondering if anybody could tell me what the difference is between the two?

Up Vote Up Vote ×
Specializes in Emergency Nursing.

I can't verify the accuracy of this information but it sounds legit. This seems to apply to Canada, but the same may also apply to the US of A.

"The main difference between a clinical nurse specialist and a nurse practitioner is in the nursing scope of practice.

A Clinical Nurse Specialist works under the legislated scope of practice for a registered nurse but has advanced education. Roles and responsibilities are varied depending on the job description and the setting in which the nurse is working.

A Nurse Practitioner works under a separate scope of practice and can perform certain functions and tasks that are outside of the scope of practice of a registered nurse, including a clinical nurse specialist. In Canada there is a separate exam for licensing as a nurse practitioner. A clinical nurse specialist on the other hand is not required to write an extra exam in order to be licensed.

A nursing assistant is not a type of nurse in Canada. All nursing programs now lead to a university degree which is required to entrance to the profession."

Source: WikiAnswers - What is the difference between a Clinical Nurse Specialist and a Nurse Practitioner

Up Vote Up Vote ×

Okay, I understand.

So a NP is the more advanced of the two, meaning they are allowed to write prescriptions, etc and the CNS is not?

Up Vote Up Vote ×
Specializes in Emergency Nursing.

That is the way I read that. Scope of practice does vary from state to state I would check your state's BON site it may have more information.

Up Vote Up Vote ×
Specializes in NICU.

Both CNS and NP are Advanced Practice Nurses. The scope of practice is different where the CNS functions in a more educational and managerial role of an actual nursing unit, its staff and patients. For example, a CNS may be in charge of didactic education for all new hires in one unit, but she may also teach clinicals for as part of faculty (with a DNP or PhD sometimes teaching in conjunction). The CNS is a Clinical Nurse Specialist meaning she has clinical specialization in one field be it neonatal, pediatric, adult critical care, gero....The CNS does not manage patient care on a daily basis although she CAN function in the role of an RN-for example:

CNS is one of the managers on the unit (not necessarily unit director although that is one role CNS can partake in). The unit is short staffed and in dire need of an RN. The CNS MAY step in and function as an RN in this case.

The NP is a practitioner who has an advanced role in management of patients. She can diagnose and prescribe (in most states) and she (or he) works alongside a doctor. In some states (Iowa is one taht comes to mind), the NP can actually practice independently and does not need a doctor by her side.

The ability of an NP to perform certain procedures is completely dependent on her field of practice. For example:

A Adult NP would not be able to perform a Neonatal umbilical catheterization! On the flipside, a Neonatal NP would also not be able to place a PICC line on an adult patient but she frequently inserts PICC lines in infants and neonates!

The roles are quite different!

Up Vote Up Vote ×
Specializes in Critical Care, Postpartum.

Also in some states (not all), NPs can practice independently. My goal is to be an FNP, so I like going into the NP forum located in the "Specialty" tab. Great NPs in there help with any questions you may have.

Up Vote Up Vote ×

Thanks so much for the help (especially you, NICU)!

I was always sure that I wanted to be a NP, but after seeing all the CNS listings I got confused.

But you guys helped make it clear and confirm that an NP IS what I want to be. I guess since they're both listed as advanced practice, I wasnt sure if I was headed in the right direction, and just needed some clarification...

Up Vote Up Vote ×
Specializes in NICU.

If NP is really where you want to go, definately do a DNP. There are talks in some states to cut out NPs and only have DNPs! Of course any NPs at the time would be grandfathered in, but look into it!

Up Vote Up Vote ×
Specializes in Education, FP, LNC, Forensics, ED, OB.

Check out this thread in the CNS forum for help between the two:

Different roles for CNS's??? Come on guys share what you do! - Nursing for Nurses

Up Vote Up Vote ×

There are a bunch of existing threads here about the differences and similarities between NPs and CNSs. Historically, the roles were quite different and there was clear distinction between the two, but, in recent years, with so many states offering Rx authority to CNSs, the line has become pretty blurry. Witness the many grad programs that now offer combined NP/CNS programs in the different specialties, with graduates eligible to sit either certification exam (or both).

Up Vote Up Vote ×
Specializes in Med/Surg, Geriatrics.
Okay, I understand.

So a NP is the more advanced of the two, meaning they are allowed to write prescriptions, etc and the CNS is not?

As already stated, there are many threads about this issue but I just want to make the point that NPs are not "more advanced" they just have a different focus of practice. Additionally, the educational background is the same but the difference is in clinicals.

Up Vote Up Vote ×
Check out this thread in the CNS forum for help between the two:

Different roles for CNS's??? Come on guys share what you do! - Nursing for Nurses

Thanks, sirI. I looked at the thread and now Im somewhat more confused than before, LOL! I didnt read it all obviously, but there didnt seem to be much of a difference, just depends on which state you live in.

I want to be able to practice independently and alongside rather than beneath a physician. I knew that NP's could do this but was unsure about CNS'. Actually, I had never even heard of a CNS before I started to research RN-DNP programs...

Up Vote Up Vote ×
+ Add a Comment