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Discussion

What am I?

Help. I am having an identity crisis. I don't know what I am. Am I a CNS or NP? My story follows: My MSN is as a community mental health clinical nurse specialist. During my schooling I took a few additional courses that qualified my to apply for a psych NP license in my state. At that time we did not need to be certified (ANCC) to be licensed as an NP. I have been working as a psych np in private practice for over 10 years. I decided to become certified and am waiting to hear from ANCC so I can take the psych clinical specialist certification as my alma matre said I could not take the psych np test. So:once I take the test and pass it, am I then a CNS as well as an NP? I am confused. And I wonder what it would take for me to be able to sit for the psych NP test. Or do I need it? I am interested in a change of work place due to family circumstances and it seems the psych np is more in demand. I am having a nursing identity crisis. Now I know what people who have gender identity issues may feel like. Thanks;)

Featured Replies

  • Experts

Wow - what an issue! Does your state allow CNS's to prescribe? What is the difference in practice act in your state between NP and CNS?

  • Experts

This is a question you need to ask your BON. In my state, you cannot practice as either a CNS or an NP without national certification.

  • Author

No,CNS's do not have prescriptive authority here. But, because I am licensed as a nurse practitioner (they did not have CNS licensure when I graduated). I do prescribe and have been over 10 years. I did take the 3 extra courses needed for an NP but cannot test (to my knowledge) as an NP for ANCC. I may be looking to move out of state and wonder where I stand out of state as well as in state. Now, for a CNS or NP license you need certification but did not when I graduated (about 100 years ago it seems lol) so I was grandfathered in. thanks deb

  • Experts

Hmmm. Would a new state grandfather you also?

  • Experts

It's my understanding that, typically, "new" states do not "grandfather in" people coming into the state -- you either meet the (current) qualifications or you don't. That's what happened with all the old "certificate" NPs after the MSN became the standard entry to practice; they could continue to practice in their original state where they were grandfathered in, but couldn't move to another state (would not be able to practice in another state, that is).

If I'm mistaken, I'm happy to be corrected. :) Again, the definitive answer would have to come from the BON of the state to which one is planning to move.

  • Author

no clue, but that is a good thought, and I would not know how to go about that. ask the BON? I am not even sure where I want to end up. some jobs ask for np certification, some just say certification and some do not mention it.

  • Guides

The short answer is that you are still a Psych NP if your state certification as a nurse practitioner is current. The question is will you still be a Psych NP if you move to a different state. I agree with elkpark on this. APN's who move to a different state of jurisdiction are subject to the scope of practice set forth by the BON in the new state where you'll practice. Unfortunately, not every state has the same scope of practice and recognition for CNS as they do for NP's. Also, many states require national certification to be eligible for state designation as an NP (or CNS, for that matter).

We actually have the same issue here in Michigan. There were CNS' who were grandfathered into the NP role back in the 90's here even though those individuals never went through any NP training. It was offered as a one time deal and those who didn't ask to be grandfathered after the period of time it was being offered did not get the NP certification anymore. Furthermore, the CNS role was never added to the state's recognized APN specializations and to date, only NP's, CRNA's, and CNM's receive the state's specialty certificate as APN's. Many of these "old-timers" are working as NP colleagues currently but can not practice in another state in the same capacity as NP's.

As elkpark already suggested, before you make the move, check with the BON in the state you intend to move to and see if a Psych CNS has the same role as a Psych NP. The good news is that in many states, there are exceptions for Psych CNS and they are recognized as APN's there.

  • Experts

I am licensed as an APN (adult health CNS) in IL but I know that other states don't receognize CNS as an APN.

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