Don't want to leave the bedside but interested in an advance degree

[sistasoul]

I am an ADN educated RN. I also have a BS in Finance. I love direct patient care but would love to further my education. I do not want management as I know this is not a strength of mine and don't enjoy that type of work. I love the bedside care but also like the science/pathophys portion of nursing. I have been a nurse for 11 months on a neuro/ortho floor and have learned a tremendous amount in this time frame and am looking forward to learning more. I am finding that I am not getting a whole lot of time with my patients because of all of the many directions a staff nurse is pulled. Would becoming a CNS fit into a career where I could spend more time with my patients at the bedside while using more of a science/ pathophysiology approach in my care?

Are there any schools on line? I live in NH and have tried to research schools offering a CNS tract but have not found any nearby. I would be interested in adult care or the care of the elderly. I just love my old peeps.

Thnk you for any help or advice.

[llg, PhD, RN]

Would becoming a CNS fit into a career where I could spend more time with my patients at the bedside while using more of a science/ pathophysiology approach in my care?

QUOTE]

Maybe, but not necessarily. Some CNS's maintain a lot of patient contact, but a lot do not. Many spend a lot of time doing staff development, evaulating care, developing policies, developing new programs, etc. A lot depends upon the region where you live and they type of patient contact you are looking for.

I think it will help you think this through by separating the concepts of "advanced education" and "advanced role" as you plan your career. What a person "learns and knows" is different from what a person "does." As you look at possible career paths, focus on the functions of the specific roles separately from the type of education they receive. Focus on what types of jobs people with different titles do. The jobs available to people with different types of education vary slightly from one location to another. So, you'll have to investigate your home area by talking with people "in the know" about your region and specialty.

For example, in my neck of the woods ... the people with the most direct patient contact are the staff nurses. CNS's are used as staff development educators, project managers, evaluators of care, and as consultants and coaches for the staff nurses dealing with difficult cases. A staff nurse will consult with a CNS on a difficult case and the CNS will help that nurse with assessment and sometimes with a few specific interventions. So there is some patient care in that role, but it is intermittent and episodic. There are some CNS's who function in roles such as "trach coordinator" or "diabetes educator" who have regular ongoing relationships with patients. What types of jobs are available in your are for a CNS? That is the question.

Nurse Practitioners have a lot of patient contact ... but those jobs are usually in out-patient settings. Are you interested in working in an out-patient setting. CRNA's usually need/study the strongest foundation in science and physiology. Is that a role that interests you?

Also, there are nurses who work as staff nurses with MSN's. They want the education ... but they prefer the job of staff nurse. That's OK. Staff nursing offers lots of flexibility and the pay can be reasonable when compared to the compensation of some advanced roles. That's particularly true in hospitals that have clinical ladders and/or pay differentials for nurses with advanced education, certification, precepting, etc. That may be a good option for you if none of the advanced roles really appeal to you.

I applaud you for exploring the various possibilities before investing in the education. Far too many people invest in education without investigating thoroughly first -- and end up with an expensive degree that doesn't qualify for jobs they actually like. Good luck to you!

[traumaRUs, MSN, APRN]

llg is right on!

Find out what CNS's are used for in your area and tailor your education. In my area (central IL) there is a huge blurring of the lines between CNS and NP - we are all covered under the exam same scope of practice.

I work in a 15 MD, 6-midlevel nephrology practice. Our of the five mid-levels, 2 are PAs', 3 are FNPs, and I'm an adult health CNS. We all do the same exact job: take care of nephrology pts in the hospital and in dialysis units.

However, I wished I had considered the narrow scope of an adult health CNS: I'm now in school for a peds CNS so that I can see the entire range of ages.

[crpRN]

Far too many people invest in education without investigating thoroughly first -- and end up with an expensive degree that doesn't qualify for jobs they actually like.

llg, this is the exact dilemma I am finding myself in! I pursued grad school because I wanted to learn more, but I applied to and was accepted into a PNP program at a very expensive private school...with no idea what I wanted to do when I graduated. School has been good for me though; I certainly have learned more about myself and what I am truly interested in. I'm about halfway done and am now considering switching to the Peds CNS program since that seems like a better fit for my goals & personality. I do not envision myself as a PNP, seeing/diagnosing/treating/following patients in an office setting. I too would like to remain somewhat at the bedside as a resource for staff, and I feel that a CNS certification will allow me to do just that while also incorporating other fun stuff such as staff development/education/research for new policies etc.

sistasoul: No matter what, a Master's degree is going to open doors for you...at least that's what I'm telling myself, haha. In this economy, it's definitely important to be the most marketable version of yourself that you can be...and a MSN will help facilitate that.

Good luck sistasoul!

crpRN