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

elkpark · Apr 15, 2008

Hi everyone,I have been accepted to SFSU's Generic Masters program, accelerated RN followed by CNS in
Pediatrics. I am trying to gather more information as to what opportunities would be
available to me with this degree. I've read all of the posts but I still can't seem to get a firm grasp of the
CNS role. This is a second career for me, coming from a desk job, I am interested in
hands on patients care and working with families. I also have a strong interest in
science, especially physiology. What are some of the pros and cons of the CNS degree? Thanks!

I would turn your question around and ask you, what do you want to do with your career and what degree do you need to help you do that and reach your goals? How did you decide that you want a peds CNS MSN if you don't know what peds CNSs do and what you can do with that degree? Maybe you need to do more research before you make a decision, because it's an important and expensive decision that you're making. I'm not making any comment about the direct-entry MSN programs in general, pro or con, but I have known a number of people who became NPs, CNMs, etc., through direct-entry programs without any experience in nursing, and then discovered, after they had completed a very expensive and demanding MSN program, that they didn't like being an NP, CNM, whatever, and found themselves with a degree and "career" they didn't want, and a huge load of student loans that they still have to repay ...

Is there some reason why you can't just pursue basic RN licensure, work as an RN for a while, get a better feel for what opportunities are out there, and then make a better-informed decision about furthering your career?

llg, PhD, RN · Apr 15, 2008

I'm not making any comment about the direct-entry MSN programs in general, pro or con, but I have known a number of people who became NPs, CNMs, etc., through direct-entry programs without any experience in nursing, and then discovered, after they had completed a very expensive and demanding MSN program, that they didn't like being an NP, CNM, whatever, and found themselves with a degree and "career" they didn't want, and a huge load of student loans that they still have to repay ...

I have the same concern as elkpark. Once you get some experience as an RN, you'll be in a better position to choose an advanced practice path. If the generic MSN program is right for you, then go for it, by all means. You'll be a step ahead. But I suggest working as an RN a year or so before investing in advanced role education. I too have encountered many people who regreted making such a big investment prematurely.

The CNS role is essentially a "generic role" that focuses at an advanced level on a specific population. What distiguishes the role is its flexibility. Instead of preparing you to perform 1 or 2 specific job functions, a CNS education prepares you to fulfill a variety of job functions that require advanced knowledge of nursing processes related to a specific patient population. A CNS is prepared to provide to provide direct nursing care, be a resource for staff, teach, manage a program, research, evaluate care, etc. for the population selected (e.g. pediatrics).

So, the role does look a little different from place to place ... person to person ... as the needs and the interests of individuals are not the same everywhere. The CNS must be able to design their own role based on the needs of her employer and the needs of patients and nursing staff she works with. That's another reason why it is good to have some clinical experience prior to becoming a CNS. It takes someone "mature in their practice" to have the judgment necessary to create and modify their role to suit the situation.

Om3155 · Apr 15, 2008

Thanks for the replies.

In response to "How did you decide that you want a peds CNS MSN if you don't know what peds CNSs do and what you can do with that degree?" I know I want to work with children, from my past experiences, I am completely sure about this. Since this is a second career for me I am limited as to where I could apply and SFSU is close by and affordable. I have been researching online here, and other sites as well as speaking to professors and other nurses. I will look into shadowing a Pediatric CNS.

I posed the question to find out more about specific personal likes and dislikes about the role. Because I do not want to go through the program and be unhappy with the role. BTW, I am also considering an accelerated BSN program.

Thanks again.

elkpark · Apr 15, 2008

Plenty of people have long, full careers as pediatric nurses without going to graduate school -- there are many options in pediatric nursing besides getting an MSN and becoming a pedi CNS, and there are much less expensive and demanding ways to get into nursing than direct-entry programs. I'm not particularly trying to discourage you; just encouraging you to look at all your options and not lock yourself into a particular path too early.

I don't understand your comment about how "since this is a second career for me I am limited as to where I could apply." There is no reason that second-career people can't apply to and get accepted into "regular" ADN or BSN nursing programs; you also mentioned the possibility of an accelerated BSN program.

We're getting kinda off-topic, so I'll shut up now ...

Om3155 · Apr 15, 2008

Ok..so we are now officially off topic! I was really just asking about your personal likes and dislikes about the role. Because I am trying to find out ,more than I know now, about the role. This is only one source.

I know you are not discouraging me-and this is what I am doing, looking into all my options. And before posting here I have looked at them all, believe me.

So what do you like and dislike about your role?

ricknick92 · Jul 20, 2008

Hi, I am also a CNS and am practicing in staff education. Here in NY a CNS does not have prescriptive priveleges and the jobs do not seem to be too numerous. There are positions in Manhattan and they mostly consist of specialty areas where it seems the CNS covers hospital units and does everything from policies to inservice as well as patient and family eduction (I couldn't speak to exactly what hey do in the hospital)

hello101 · Sep 7, 2008

I am a CNS and most physicians I know look as CNS as an educator or researcher. I work for a doctor and function as an NP (diagnosis, prescribe, bill etc). The doctor who hired me knew that I was an ANP and did not care what if I was a CNS, NP, or PA...as long as I know my stuff and able to bill..I was happy that she gave me that chance and prove myself. It's sad to say but I had a hard time with fellow NP at the hospital who feels that I needed to go back to the NP program to do what I'm doing now. I remember hearing comments that "she's not an NP, she's a CNS"...(a lot of hosp staff has a habit or thinks I'm an NP so they will say I am an NP and that when the other NP hears this...They would correct them and made it known that I was a CNS. Which I do introduce myself as an APN/CNS...but still they see me as an NP. It is getting better that the NP are not "making side remarks"...I do my job and take care of my patients and I enjoy what I do. Any CNS who function as an NP out their with similar experience? Where I work there is only 2 others who function like the NP as a CNS.

holiday2525 · Sep 7, 2008

I really appricruate tgis topic. I am graduating with my BSn in Dec. and was thinking about my MSN with either an APN or CSN. Now I understand things better. I am really interesting in an APN in pysch. But have never been able to speak to someone who has this.

How does one decide what type of nurse one wants to be? I don't know where I will be happy. IS this common?

Trauma Columnist · Sep 8, 2008

Hello101 - I have a role similar to yours: I work in nephrology and am an adult health CNS. In our large practice, there are 15 MDs, 3 PAs, 3 FNPs and me! The mid-levels do the same job and we all bill the same also.

Much depends on your state's nurse practice act - there are some states where CNS is NOT recognized as an APN.

BTW - I see many chronic patients and many of them call me "doc!" Bet your NP colleague would be floored by that. For many of my inner city patients, it is a term of respect - they absolutely know I'm not a physician.

Good luck....I do have one NP that I see occasionally who ALWAYS has something snide to say - I just ignore her.

deb18 · May 18, 2009

Hi. I graduated in Fl. from a psych cns program but at that time, I could (and did) become licensed as an ARNP (advanced registered nurse practitioner) in psych in florida. at that time we did not have to be certified to be an advanced nurse. Now we do. I have worked as an associate professor and now am in private practice as a nurse practitioner/cns. I cannot really call myself a cns because I am not licensed as such in Florida. when i take/pass the ancc than I can become dual licensed. I see patients for medication management and therapy. My role, as such, is not any different than the NP that is in the office.

Trauma Columnist · May 18, 2009

Thanks for sharing Deb. Sounds very interesting. Your education is as a CNS but you are taking the NP exam?

I'm an adult health CNS and am back in school for the peds/family CNS so that I can see a broader spectrum of pts.

deb18 · May 18, 2009

I cannot sit for the np exam because education is as a cns, so I am taking the cns exam. i know you will do well with the peds