FNP vs NP vs CNS

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Hello, I am very new to allnurses so I apologize if this has been asked before or if it is in the wrong forum. I will be graduating in December 2015 with my BSN. I plan to work for a year or two and then go back to graduate school. However, I am not sure what graduate degree to pursue. When I finally do attain my graduate degree I would like to work in a hospital, at the patient bedside, involved in direct patient care, along side physicians, PA, etc. My question is this: which graduate degree should I pursue? From my reading I have gathered that CNS seem less marketable than a FNP. However, I am not sure if an FNP degree would allow me to work where I want to work. If anyone could enlighten me with this information I would greatly appreciate it. Thank you in advance.

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Specializes in Family Nurse Practitioner.

I think they are or have done away with CNS so becoming a nurse practitioner is probably what you will be getting. If you want to work in a hospital a NP specialty such as Acute Care NP would likely be your best bet. Good luck.

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I think they are or have done away with CNS so becoming a nurse practitioner is probably what you will be getting. If you want to work in a hospital a NP specialty such as Acute Care NP would likely be your best bet. Good luck.

This is absolute misinformation. CNS programs are still widely available and there are many jobs for CNSs. NACNS :: National Association of Clinical Nurse Specialists is a great resource for information if you are curious about this APRN role.

You should also read the consensus model and understand that APRNs are certifying by population now, rather than by setting. It is true that FNPs are not geared to work in critical/acute/urgent care if their program does not include acute care education, but this can vary by state and program.

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Specializes in Family Nurse Practitioner.
This is absolute misinformation. CNS programs are still widely available and there are many jobs for CNSs. NACNS :: National Association of Clinical Nurse Specialists is a great resource for information if you are curious about this APRN role.

You should also read the consensus model and understand that APRNs are certifying by population now, rather than by setting. It is true that FNPs are not geared to work in critical/acute/urgent care if their program does not include acute care education, but this can vary by state and program.

Interesting, thanks. It was my understanding they aren't graduating CNS any longer, perhaps just my school or psych CNS? I do know in the hospitals where I work they are only used in psychiatry in a social work type capacity because they can't prescribe and the pay isn't great. Perhaps again this is just my area. Thanks again for the information.

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Unfortunately some states do not allow CNSs for rx auth, which is what causes many CNSs who do not wish to relocate to return to school and become licensed as NPs, California and NY especially. There are varied levels of restriction in each state. For example in Oklahoma, practice is not supervised but for rx, 'collaboration' is required-- which is a very loosely defined relationship and leaves leeway for predatory physician oversight.

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As the other posters have commented, I think the ACNP better fits your practice interests than FNP. There are still acute care CNS programs (ie. UVA's program) but I think they are more geared towards staff development and serving as an advanced nurse in a consultative and bedside leader role. I would recommend that you put off graduate school for a few years until you have better defined your interests. I would also recommend shadowing advanced practice nurses in varying roles. I had a similar goals in my pre-licensure stage and thought I wanted to become a CRNA until actually working as a nurse and finding that NP better fit my clinical interests at the time. Graduate school is an expensive and timely endeavor and you want to make the right decision the first time.

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Interesting, thanks. It was my understanding they aren't graduating CNS any longer, perhaps just my school or psych CNS? I do know in the hospitals where I work they are only used in psychiatry in a social work type capacity because they can't prescribe and the pay isn't great. Perhaps again this is just my area. Thanks again for the information.

The ANCC "retired" the psych CNS credential; the others are still around. CNSs have rx authority in close to half of US states, the last time I checked. In my experience as a psych CNS (without rx authority) for many years, the pay is typically less than an NP, but quite a bit more than social workers.

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According to the consensus model, accredited APRN programs must be focused in one of the 6 populations. Setting-based programs are being phased out and the exams retired. Acute care programs are moving toward adult or adult/gero programs mostly it seems.

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Specializes in Nephrology, Cardiology, ER, ICU.

Several CNS exams are retiring in Dec 2015:

Adult Health CNS

Pediatric CNS

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Specializes in Emergency Nursing.

As many of us know the Psychiatric-Mental Health, Clinical Nurse Specialist (PMHCNS) credential has been retired and as traumaRUs alluded to many of the CNS certification exams are being retired. I found a link to a nice chart that helps to summarize the changes (APRN Cert. FAQ). I think that this is a bigger discussion on what the role of the CNS is versus the role of the NP but with new roles and degrees (Clinical Nurse Leader [CNL] and Doctorate of Nursing Practice [DNP]). We will find that the advanced practice nursing roles will have to be reexamined and we will likely continue to see changes in field of graduate-level nursing practice. With that in mind, I have a feeling that the NP role is here to stay and you may be better off pursuing that role than the CNS, if only for career stability IMO.

!Chris :specs:

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I wonder what evidence, other than anecdotal, everyone cites for thinking the CNS role is less viable or more limiting than the NP role?

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Specializes in Family Nurse Practitioner.
I wonder what evidence, other than anecdotal, everyone cites for thinking the CNS role is less viable or more limiting than the NP role?

Well if they are in a state that doesn't have prescriptive authority that sure sounds fairly limiting, no evidence needed, right?

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