Please clear some things about CNS for me!

Sort of ... but not quite. It IS your skills that are being hired. But in this case, your skills encompass a wide range of organizational and role function skills as well as clinical skills. A CNS education includes knowledge and skills related to education, management, research, etc. that can be used by an employer in a variety of ways. For example, I was an expert in neonatal ICU nursing. My graduate education also taught me a little about education and management. So ... I was prepared to be a leader in a NICU -- able to provide expert patient care when needed -- but also able to teach others how to provide expert care, assess the needs of the unit (as well as the patient), evaluate the quality of the care provided by myself and othes, establish new programs, develop new policies and procedures, etc.

A CNS is usually hired to assure that the patients are receiving the best care possible -- not only by directly providing that care to the patients, but also by helping others to provide great care. A CNS works with others to improve their practice by role modeling, teaching, developing new programs, establishing new procedures, educating staff, etc. You do whatever needs to be done to assure the best care. That's why it varies from time to time, place to place.

Again, ITA. Another example: At one point in my career, I was hired by a larg, busy medical center to be the CNS for the child/adolescent psych program (I'm a child psych CNS). My job included providing inpatient individual and group psychotherapy to the kids admitted to the program and doing outpatient psychiatric assessments (which the medical center offered (free) as a service to the community). I was heavily involved in developing a new child inpatient psych unit. I also chaired the QI committe for the department, did some work on developing policies and procedures (tried to do as little of that as possible! :chuckle) and programming for the unit(s), and developed and presented some inservices on child/adol development and child/adol psych nursing to the nursing staff to improve their skills and knowledge (in addition to informally mentoring the nursing staff). I was also "loaned" to the OB deparment of the medical center to help develop and implement a community support group for pregnant teens and their families (working with the OB nurses -- they requested someone from psych to be involved, and it made the most sense to management for me to be that person). The medical center would occasionally ask me to do presentations for community groups on mental health issues (when the hospital got a request for this). I was also the liaison between our kids' psych program and the community-based outpatient mental health centers in the area, and was their contact person when one of their clients needed to be admitted to one of our units. Our department manager involved me in interviewing and deciding on hiring staff. I did some clinical supervision of graduate students in nursing and counseling, and some guest lecturing on child psych nursing at a couple if the local nursing programs. I also worked with the public relations department of the medical center to write and produce our packet of outreach/"marketing" materials about our child/adol psych programs. And there were probably other things I did that I'm not recalling offhand ...

Most of this was not in my written job description, or discussed in the interview process prior to my taking the job -- these were needs that arose and/or were identified by me or by management after I was there. Some of these things were mandated to me by management; some of them I took on voluntarily (and the medical center was v. nice about letting me do "extra" activities (things that weren't requirements of my job but benefitted the community or reflected well on the medical center) on "company time").

This example may be an unusually broad range of activities for a (single) CNS position -- I don't know; it's certainly the broadest range I've experienced in my career. But it illustrates how many possibilities there actually are under the general umbrella of "CNS." The flexibility is pretty much limited only by your own goals and interests (and those of available employers, of course ...) You can pretty much make of the role whatever you want it to be -- that's what really appeals to me about it.