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.

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

If they have no interest in prescriptive authority, not very limiting. I never understand this fascination so many people have with pushing pills. It's hardly the be-all and end-all of nursing practice.

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CNSs have rx auth in the majority of states, one only needs to check NCBSN to garner that information.

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Specializes in Family Nurse Practitioner.
If they have no interest in prescriptive authority, not very limiting. I never understand this fascination so many people have with pushing pills. It's hardly the be-all and end-all of nursing practice.

Trust me I'm no pill pusher. In fact I usually am heading in the opposite direction and weeding through the plethora of unnecessary medications that aren't needed however I happen to love the results I have when someone who is extremely sick and not responding to therapy alone, think true Bipolar or Schizophrenia, and we find a medication that really improves their quality of life.

In my area being able to prescribe, CNS' can't, is at worth approx 50% more in salary as well as unlimited job opportunities so that is what I meant by limiting. Unfortunately at this time the psych CNSs at my hospital are relegated to duties that social workers perform. The ones I know well are feeling marginalized and are unhappy but unfortunately they are heading into the last few years of their careers and are resigned to just get through it.

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Specializes in Family Nurse Practitioner.
CNSs have rx auth in the majority of states, one only needs to check NCBSN to garner that information.

But not in all states, not in mine, the map I saw looked like maybe 16 states?. In Delaware the one I am familiar with they can't prescribe any class II meds so that is limiting. I have nothing against CNS' in fact have a dear friend who is one and please feel free to pursue whatever you feel is appropriate. You asked and I'm adding my two cents and clearly not even worth that much, lol.

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I agree, I know many CNSs in California specifically who are going back to school for NP so they can prescribe. But this is not the majority. I really hope that our mission for implementing the consensus model aids our cause in lobbying for free practice for APRNs. I know it seems like in some states it may never happen.

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Specializes in Family Nurse Practitioner.
I agree, I know many CNSs in California specifically who are going back to school for NP so they can prescribe. But this is not the majority. I really hope that our mission for implementing the consensus model aids our cause in lobbying for free practice for APRNs. I know it seems like in some states it may never happen.

I believe it is so important to be involved in your state's NP or CNS organization and harness the power in numbers. That is how things get done. Trust me after working 50-60 hours a week the last thing I feel like doing is adding another meeting or task to my list but I do it because I want to keep our profession's momentum. The states with the most privileges are the ones with the most powerful organizations, in my experience. Think California RNs, they got it going on!

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I agree, and I think this is one of the biggest limiting factors.

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As for California nurses having it going on, they certainly do not have it going on as far as NP practice which is in the serious dark ages and is and remains very restrictive. I find this rather strange because of the nursing unions and wonder all of the time how could the NP profession remain so stagnant as far as full practice authority.......California is not a full practice authority state for NPs and they are leaving as a result. I have wanted to leave Kansas because the pay here leaves much to be desired, however, it is one of the states where NPs are having more autonomy and the laws seem to be increasing towards complete independence here probably in the next few years. Here is where I will remain unless I marry and have to relocate.........

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Specializes in ICU.
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.

To the OP- if you know you want to be involved in direct patient care, working side-by-side with physicians, in an inpatient setting- you should look into acute care NP. This is now split between adult/gero and peds. You can choose an AGACNP program or a PACNP(?) program. A lot of hospitals still use FNPs in the hospital...but I think this is slowly changing (since an FNP isn't trained in acute/critical care the way an ACNP is). So look into the hospitals in the area you hope to eventually practice and see who they tend to employ most often. You can use that to help guide your decision.

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Specializes in Family Nurse Practitioner.
As for California nurses having it going on, they certainly do not have it going on as far as NP practice which is in the serious dark ages and is and remains very restrictive. I find this rather strange because of the nursing unions and wonder all of the time how could the NP profession remain so stagnant as far as full practice authority.......California is not a full practice authority state for NPs and they are leaving as a result. I have wanted to leave Kansas because the pay here leaves much to be desired, however, it is one of the states where NPs are having more autonomy and the laws seem to be increasing towards complete independence here probably in the next few years. Here is where I will remain unless I marry and have to relocate.........

That is lousy. I figured since the California RNs, to my understanding, were so organized and powerful that NPs there would be also.

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