Help with a School Assignment . . .

Trauma Columnist · Feb 24, 2008

okay - here goes: judi

first off, please tell us your area of expertise and what exactly your role is where you work. i am an adult health cns working in a large (15 md, 9 mid-level providers) nephrology practice

how does your job help the patient? i work for the most part with chronic hemodialysis patients and serve as their advocate in the healthcare system. i do their medical management including htn, dm, etc and refer out to the appropriate specialities

is there a specialty where being a cns is more valuable?there has a blurring of the lines of the cns scope of practice. in il, where i practice, there is no difference between a cns, np, cnm, crna. we are all licensed as advanced practice nurses (apn)

who do you report to?the physician who cares for the pt.

do you supervise anyone?my actual workplace most of the day is the dialysis unit. however, i am employed by the nephrology group. i am a guest in the dialysis units so while i dont' supervise people, i certainly do collaborate with the rns and techs.

does your expertise help make hospital policy or for one particular unit?no, i am not in a true cns role

is the position more of a distractive function?definitely not. medicare (which funds dialysis in the us since the 1970's states that the pts must be seen on dialysis four times per month and one of those times must be a physician. the other three visits can be a mid-level provider. our visits are very cost effective - saving our physicians time and effort but garnering 85% of the cost paid to the md.

what are the educational requirements?in il, you must have an msn and then pass a test.

what made you decide to pursue the cns?this is probably an answer that i shouldn't admit to but i did the cns because it was what was offered at the affilated school of nursing of the hospital where i worked. i would have preferred an np degree.

where did you attend classes?in central il

did it meet your expectations?yes, i did a post-msn certificate program.

has the credential opened any doors?definitely

how have you used it in your career?i currently work as an apn and also have had the opportunity to teach.

would you recommend it and if so, why?yes but with the caveat that you need to research how your state uses cnss and does that coincide with what you want.

what about being a cns differs from another nurse, for example, a critical care nurse?we are the extension of the physician and the apn role is more medically based.

what are the benefits of being a cns?prestige, autonomy, the ability to provide care.

does being a cns take you away from the bedside?i really enjoyed bedside nursing and yes, i don't do much anymore. however, i will always consider myself a nurse no matter how much education i have.

are there more supervisory duties as a cns?again, in my role as an apn, i do not directly supervise. however, i also more cognizant of things that need to be changed and i have the authority to do so.

describe a day in the life of a cns.i get to the first dialysis unit usually around 7 am, see anywhere from 19-32 pts and then go to the next unit and see more pts. they may have problems ranging from hypotension on dialysis to diabetic foot ulcers to no problems at all. i also field calls about labs that need action, pharmacy calls for refills to changing prescriptions. i usually get done about 4-5 pm. i do have much flexibility. i usually work 40-55 hours per week. i take call one weekend out of four at two hospitals where i must see the entire practice's patients - usually 10-20 patients many of them in the icus.

C_Skwared · Feb 25, 2008

Thank You so much for your prompt response!