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Serious illness: More seen by NP or CNS?

Posted

Specializes in Med surg, cardiac, case management. Has 4 years experience.

I've thought about becoming an ACNP, because I like complex illness and the ICU atmosphere and don't really care for primary care and prevention.

However, I've heard from some ACNPs and it seems that they primarily deal with less serious illnesses at the clinic...ie giving a stress test to someone with angina...rather than more serious illnesses at the hospital...ie adjusting a vasoactive drip on someone with cardiogenic shock. At least that's the impression I got.

Which makes me wonder if maybe a CNS role with a critical care focus would be better, more likely to be hospital-focused and more likely to be hands-on with the sicker patients.

traumaRUs, MSN, APRN, CNS

Specializes in Nephrology, Cardiology, ER, ICU. Has 27 years experience.

I think much depends on where you are practicing and what the job description is. In IL, there is no differentiation between APNs: CNS and NP have the same exact nurse practice act. I work in a nephrology practice and titrate appropriate renal meds in the ICU, at the hospitals where I practice, there are intensivists so I don't do much without a courtesy call to them.

In the ER, I see more of the medical pts because at this particular hospital, I'm not credentialled to suture - go figure.

I've thought about becoming an ACNP, because I like complex illness and the ICU atmosphere and don't really care for primary care and prevention.

However, I've heard from some ACNPs and it seems that they primarily deal with less serious illnesses at the clinic...ie giving a stress test to someone with angina...rather than more serious illnesses at the hospital...ie adjusting a vasoactive drip on someone with cardiogenic shock. At least that's the impression I got.

Which makes me wonder if maybe a CNS role with a critical care focus would be better, more likely to be hospital-focused and more likely to be hands-on with the sicker patients.

Our ACNPs manage patients in the ICU along with the resident team. Basically some of the sickest patients in the house. Of course this is in a state where CNS is not an APN outside of PMHCNS. The one complaint is that there practice tends to be more procedurally oriented than the residents depending on the time of year.

David Carpenter, PA-C

llg, PhD, RN

Specializes in Nursing Professional Development. Has 44 years experience.

It depends a lot on where you live and what your specialty is. In my area, most NP's work in outpatient settings -- or as care coordinators for physicians. The CNS's generally work in the hospitals. There are a few exceptions to that, however.

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