Fate of the CNS degree

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I am currently a bedside nurse, interested in an advanced degree to start next year. I know the common routes, and np and NP schools are popping up everywhere, accepting everyone. Education, academically, does not pay enough for my lifestyle with kids and traveling. Nurse practitioner is losing its appeal to me with the way the health system is in America. The ag CNS degree excited me over two years ago, and it still does, but it's fate is up in the air because of the emergence of tons of NPs.

What are people's opinions on where the CNS degree will be in 10 years? All opinions welcome.

Sauce, although mostly true, I'm hardly lazy. That's all I am going to give your response as you know nothing about me. I was looking for opinions and I got yours.

Insurance companies pay less on readmissions. One way to prevent readmissions is education. To truly educate a patient takes time. Time your boss doesn't like you to spend. I get the business model perfectly fine I came from the business world.

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eh it wasnt directed at you, just the people in general who don't seem to understand that high quality preventive care is too difficult to measure since there are too many variables. there will always be battles between points of interest between payers and providers. We may as well get used to it and try to scrape as much cash as we can while treating patients well. Capitalism baby. You dont need a provider to educate a patient, at least not in non-person specific types of information, such as general management of X illness. You can have an educator do that in groups of patients, and we have the internet. while I don't mind educating patients as long as time is merciful I will not spend 45 minutes going over stuff with one patient that can be done by internet education or group education by a diabetes educator or some other person, or that can be explained in pamplets. For information which can be considered patient-specific, then yes, I will educate the patient on that to the best of my ability. but general info, not so much past a few minutes. This is planet Earth and life is real here, Nursing school takes place on Mars where life is all hugs, kisses, and candy bars.

It is not time worthy to do that.

Just think if the president had to give a personalized state of the union to each person in Merca. You get the point.

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The CNSs in my hospital are well respected, and it's what made me search for this thread... I was really excited about going this route, researching programs, etc, and now I'm starting to get nervous.

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Specializes in psych, addictions, hospice, education.

Just to comment on meanmaryjean's posting here....I'm in Indiana, am a CNS, and have prescriptive authority.

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Specializes in Family Nurse Practitioner.

Medicine is a service. Do your job, do it quickly, get paid. Holistic care? Holistic care shouldn't take any longer than ''regular care." But then again holistic care is just a tag-phrase made up by nurses to try to make what they do distinct from physicians.

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I agree and think many seem to hide beihnd the hand holding shtick to finesse positive feedback from their patients rather than actually becoming skilled and efficient at what they do.

Although much to my chagrin there also seems to be many who don't care if they make top dollar but I do so I operate like a physician, earn my peer's respect which means more to me, and make more than most NPs I know.

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Specializes in CNS, PMHNP, EMS, ER, Instructor.

Like many of the other posters, I am also a CNS. I think that it all depends on where you want to work and what you want to do - that is the way all careers should be chosen. But I would be cautious on going into the CNS role - I just don't see a great future for the profession. The only university in Idaho that offered the CNS certificate recently stopped doing so because no-one had applied for several years.

I remember my professor telling me that originally when the Consensus Model was being developed that CNS's were not even going to be included as APRNs. I also believe the CNS role has been diluted by the Clinical Nurse Leader role - NP's have the political clout - CNS's, like educators (which I also do), have no political clout.

I think if you work in a large enough hospital that can appreciate the differences in roles between a CNS and a NP, then a CNS is a viable option. But I will wager in a budget crunch CNS's will also probably be the first practitioners let go - a CNS's outcomes, while related to research and quality, often fall to the wayside when a NP's outcomes more closely align with dollar signs.

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Specializes in NICU, ICU, PICU, Academia.
Just to comment on meanmaryjean's posting here....I'm in Indiana, am a CNS, and have prescriptive authority.

Really? Is that a recent thing? Because I was under the impression that we were one of 'those' states. Hmmm.....

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Specializes in psych, addictions, hospice, education.

meanmaryjean....I got prescriptive authority in 2005.

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Specializes in Nephrology, Cardiology, ER, ICU.

Here you go:

[TABLE=class: datatablepop, width: 970]

[TR]

[TH=colspan: 2, align: center]INDIANA[/TH]

[/TR]

[TR]

[TD]Who can prescribe?[/TD]

[TD]NP, CNM, CRNA, CNS[/TD]

[/TR]

[TR]

[TD]Are controlled substances included?[/TD]

[TD]Yes; schedule III-V (see key points)[/TD]

[/TR]

[TR]

[TD]Requirements for controlled substances?[/TD]

[TD]DEA # and Indiana CSR[/TD]

[/TR]

[TR]

[TD]Collaborative practice agreement?[/TD]

[TD]Yes; WCPA (see key points)[/TD]

[/TR]

[TR]

[TD]Who grants prescriptive authority?[/TD]

[TD]BON with approval of BOM[/TD]

[/TR]

[TR]

[TD=colspan: 2]Key points : Prescriptive authority requires a WCPA. Prescribing is limited to APN and collaborating physician scope of practice. No schedule III-IV controlled substances can be prescribed for weight loss.

http://www.in.gov/pla/files/Indiana_State_Controlled_Substances_Registration(2).pdf

And this:

The analysis of statutes and regulations by Lyon and Minarik[5] revealed that of the 26 states that specifically authorize the CNS to practice as a CNS, 15 of those states provide the option for prescriptive authority (Arkansas, Colorado, Idaho, Indiana, Louisiana, Minnesota, Missouri, Nevada, New Jersey, New Mexico, North Dakota, Ohio, Oklahoma, Texas, Wisconsin, and South Carolina). Additionally, of the 7 states that only recognize psychiatric-mental health CNSs, four authorize prescriptive authority (Florida, Massachusetts, Vermont, and Minnesota). In all instances where a CNS can obtain prescriptive authority there are requirements for additional course work in pharmacodynamics and pharmacotherapeutics. The coursework requirements in pharmacology are the same as those required of NPs. In the case of Rhode Island, a psychiatric-mental health CNS must obtain certification as an NP to obtain prescriptive privileges.

3 of 3http://www.medscape.com/viewarticle/455980_3

[/TD]

[/TR]

[/TABLE]

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Specializes in Nephrology, Cardiology, ER, ICU.

Totally weird formatting - but it looks like like it occurred in 2001?

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Who cares about prescriptive authority in 10 years 1/5 people in america will probably be able to write non-narcs. might as well make all drugs OTC and let people google the stuff they need to take. they will prob get better results than the majority-weakly educated nurse practitioners for profits pump.

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Specializes in Psychiatric Nursing.

Sauce. You couldn't be more negative. It sounds like you hate your profession. How can you stand it?

Regarding prescriptive authority: for some of us educated as CNS it limits where we can work? I also think that for the CNS role to survive, the role has to include prescriptive authority.

in 10 years the political landscape of health care will be different and I wouldn't be surprised if if there are more OTC meds with pharmacists answering questions.

I think that most people,when they are ill would prefer being seen and evaluated by a provider than only using Google to self treat.

A lot can happen in 10 years.

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