What subspecialty will accomplish my goals?

[PICCRN79]

Hello CNS's!!

As per my username, one of my primary functions as a RN is being a PICC nurse. Truthfully, this is all I have ever done or ever really had the desire to do in nursing. This "specialty" does not exist at an APRN level. At this point in my career, I am ready to get out of direct patient care for the most part. Although I would love to work as a central line specialist, placing all types of central lines, I am not sure this would even be an option as a CNS. Aside from line placement I don't really want much direct patient care, so I don't want to be a NP.

I think what I really want to do is work in CAUTI/CLABSI prevention, performance improvement through EBP, nurse education, perhaps develop/lead a vascular access team, overall, help nurses be better nurses through training and education. I am applying soon to a CNS program, all of the requirements to get in are accomplished. I know I will specialize in adult health, but is there a subspecialty that any of you seasoned CNS's can see for me.

Thanks!

[traumaRUs, MSN, APRN]

Hmmm....what about Infection Control? What does your facility hire CNS's to do? In IL, where I work, I practice as an APRN and can work both inpt and outpt, assess, treat, Rx, etc...

[MGMR]

If you're interested in CLABSI/CAUTI prevention and best practice implementation, CNS would be a great choice for your APRN degree. You can get your Adult/Geriatric, Pediatric, or Neonatal CNS degree, but you don't sub-specialize further than that at the academic level. I would say specialty practice beyond your degree is determined by the job you take after graduation and the training they provide you in that specialty, and also any knowledge and expertise you bring from your RN practice previously.

If you're interested in invasive procedures, but little to no patient care, you could also become an NP working in IR. My friend does this. She was a SICU nurse while getting her NP, got a job in IR after. Her day consists of placing CVLs/PICCs, chest tubes, etc. Very little patient contact beyond the line or tube placement as they go back to the unit immediately after.

[PICCRN79]

Thanks you for your responses!!

The facility that I work in uses the CNS in an administrative and educational role. CNS's do not see patients in my current facility. They work in EBP, policy making, performance improvement, infection prevention etc. In the state I live in CNS's have full prescriptive authority if they so desire and can see patients. With all that being said, it is coming time for me to see more of the country and when my kids are all older, about 3-5 years tops, I will be moving to a different part of the country. The few states I am interested in going to, pacific northwest and ultimately some time in Hawaii, all seem to have similar uses for CNS's. I know I have to make the determination, do I want to continue placing lines (patient care=NP) or do I want to get out of direct patient care all together and take on an indirect care role (CNS)..... I guess I could always go the CNS route and work PRN as a PICC RN.......

And now that I am thinking this through, that might be exactly what I want to do.....