NP vs CNS

U.S.A. Missouri

Published

I'm currently in school to become a psych NP. I've looked at the Missouri board of nursing website and saw that there were a number of CNSs registered but only 1 NP in St. Louis. I was wondering if anyone has information regarding why there would be more CNSs vs. NPs in St. Louis.

I called the board of nursing and was told that both could prescribe medications and that she thought there was more of one than another due to insurance reimbursement issues and recommended I call the certifying body to ask questions.

I checked the website of the certifying body and it looks to me like the CNS position may be more educational and the NP more direct care. I haven't followed up with a phone call yet.

Just wondering if any of you out there have thoughts on this.......I'm planning on working in St. Louis when I graduate.

Thanks

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The first thought that springs to mind is that the psych NP role has only been developed in the last several years, while the psych CNS role was the original advanced practice nursing role, and psych CNSs have been around for several decades. I'm sure that, all over the country, there are MANY more psych CNSs than psych NPs. (I'm not criticizing you personally in any way, but don't they teach people this stuff in school???)

I also don't know where people get this "CNS is more educational and NP is more direct care" stuff -- apparently, that is true for many of the med-surg CNS specialties, but psych CNSs have always been trained to be psychotherapists -- to provide direct care (up until lately; now, it seems, they are primarily being trained to push pills). Every CNS job I've had over the many years I've been doing this has been as a direct care provider, in both inpatient and outpatient settings, and the same is true of all the other psych CNSs I've known. I've been asked many times to develop and present staff inservices on specific topics, and take on other types of specific educational/administrative projects, but my job was direct care ...

Best wishes with your schooling. :)

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Specializes in Education, FP, LNC, Forensics, ED, OB.

Hello, km2066,

Most of the RNs seeking the Psych advanced practice role are CNS in my area. I do not have stats, but, I think this is the norm.

Anyone else have comments/stats for your area?

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the first thought that springs to mind is that the psych np role has only been developed in the last several years, while the psych cns role was the original advanced practice nursing role, and psych cnss have been around for several decades. i'm sure that, all over the country, there are many more psych cnss than psych nps. (i'm not criticizing you personally in any way, but don't they teach people this stuff in school???)

thanks for the reply. i've just started the psych program so they may teach this in school, but you never know....this may be why there are more than one than another. one of the reasons i asked is because there are two test options with the credentialing center (that's what it looks like to me but i haven't looked into it beyond looking at the website).

i also don't know where people get this "cns is more educational and np is more direct care" stuff -- apparently, that is true for many of the med-surg cns specialties, but psych cnss have always been trained to be psychotherapists -- to provide direct care (up until lately; now, it seems, they are primarily being trained to push pills). every cns job i've had over the many years i've been doing this has been as a direct care provider, in both inpatient and outpatient settings, and the same is true of all the other psych cnss i've known. i've been asked many times to develop and present staff inservices on specific topics, and take on other types of specific educational/administrative projects, but my job was direct care ...

the reason why i said it appeared that cns was more direct care was based on the description provided by the credentaling center....it's good to hear that this isn't true!

best wishes with your schooling. :)

:rolleyes:

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Thanks for the reply. I've just started the psych program so they may teach this in school, but you never know....This may be why there are more than one than another. One of the reasons I asked is because there are two test options with the credentialing center (that's what it looks like to me but I haven't looked into it beyond looking at the website).

Yes, there are two test options; the psych CNS certification exam has been around forever, and the psych NP exam/certification has just been developed within the last few years. It seems that more and more schools these days are offering grad programs that claim to prepare you for either exam, and, with so many states offering Rx authority to CNSs as well as NPs now, it's not really clear to me what the significant difference between the two roles is supposed to be these days (I haven't had any compelling reason to investigate this). If the psych nursing grad programs are now preparing students for either the psych CNS or NP role, then the programs are radically different from what they were when I took my degree ...

The reason why I said it appeared that CNS was more direct care was based on the description provided by the credentaling center....It's good to hear that this isn't true!

Was the website talking about psych CNSs, or just CNSs vs. NPs in general? Because I was not aware of this until I starting participating on this board, but, from what I read on this board, CNSs in the med-surg specialties apparently do mostly do education/staff development stuff. Psych CNSs, though, have always been trained and practiced as psychotherapists, doing direct "hands-on" work with clients.

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