Who will do CNS role?

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Specializes in Neurosciences, stepdown, acute rehab, LTC.

Lately I've been thinking about my future as a nurse, and started to consider a CNS role. I think that would be an amazing way to make a true impact as I would have options as a nurse educator, quality improvement, research, bedside care etc.

However, I'm reading that they are phasing out the CNS role?? They still have them at my hospital but I don't know if I would stay there forever. I don't want to be a manager, or in administration, or a clinical instructor, or a provider. I think it would be really cool to get the education to be an adult-gerontology CNS and have more broad and versatile roles. If I got a masters, I would want to put it to use (and also make enough pay to cover the education.) Are there any other similar roles out there?

From what I'm reading, a lot of other nurses are having this dilemma as well. In case you were wondering I've been a bedside nurse for about 8 years and am almost done my RN-BSN program.

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It would help to identify something very specific that you want to do that requires a CNS. So far, the plan is much too vague.

Before becoming an NP, I got my CNS. Nobody knew what it was.

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Specializes in SICU,CTICU,PACU.

I too would like the CNS role ,or something similar, although everything I read seems like it is phasing out. I do not want to leave bedside nursing but would like to be an ICU bedside nurse specialist. The educators at my hospital have zero bedside impact; not the role for me. Management also not for me and I also do not want to be a provider. I wish there was a resource/educator/preceptor/charge/assistant manager masters degree available.

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What's funny (or kind of sad) is that while people talk about it phasing it out, Michigan just officially recognized cns as a nursing specialty this year.

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Specializes in Reproductive & Public Health.

What is the role of a CNS exactly? What makes CNS scope/training unique enough to merit its own, dedicated APRN certification? I am geniunely asking, I can't find a clear answer.

It seems akin to nurse educators/managers/administators- no one is pushing for dedicated licensure for those roles. It is done by NPs or RNs (depending on the exact job description) who have the experience/expertise/desire to do that sort of work.

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Specializes in Nephrology, Cardiology, ER, ICU.

Great discussion.

I'm both an adult CNS and a peds CNS. I practice as an APRN, a provider. In IL my scope of practice = NP.

I've been a CNS since 2006 so long enough to be experienced but not long enough to know "how it used to be." I wanted the role of provider. Today, I would not mke the same decision but at the time I worked for a hospital that had its own college of nursing so my tuition was paid for. CNS was the only option at this college.

As to whether CNS is now a viable option, my own opinion is no, not any longer. I would do my due diligence, shadow some nurses who are in the role you want to be in, look into what degree they have. Another thing to consider, do you ever ever think you will move out of state? Will your role move with you?

Lots to think about BEFORE you pursue further education.

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What is the role of a CNS exactly? What makes CNS scope/training unique enough to merit its own, dedicated APRN certification? I am geniunely asking, I can't find a clear answer.

It seems akin to nurse educators/managers/administators- no one is pushing for dedicated licensure for those roles. It is done by NPs or RNs (depending on the exact job description) who have the experience/expertise/desire to do that sort of work.

What is a CNS? – NACNS :: National Association of Clinical Nurse Specialists

CNSs are advanced clinical experts; while education is one of the core competencies of the CNS role, it is not a management/administrative role. And it was traditionally quite different from what NPs do (that has changed since the two roles have been blurred significantly in recent years and NPs have moved from primary care into acute care settings) and is beyond the scope of practice of generalist nurses.

I agree that, sadly, the healthcare system sees to have stopped valuing the CNS role and there are limited opportunities to fully practice the role any more. Much of nursing wants to redefine advanced practice nursing as necessarily involving prescriptive authority. It's hard to make a case for pursuing education and certification as a CNS these days. However, I predict that the rest of healthcare will miss us when we are finally all gone.

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What is a CNS? - NACNS :: National Association of Clinical Nurse Specialists

CNSs are advanced clinical experts; while education is one of the core competencies of the CNS role, it is not a management/administrative role. And it was traditionally quite different from what NPs do (that has changed since the two roles have been blurred significantly in recent years and NPs have moved from primary care into acute care settings) and is beyond the scope of practice of generalist nurses.

I agree that, sadly, the healthcare system sees to have stopped valuing the CNS role and there are limited opportunities to fully practice the role any more. Much of nursing wants to redefine advanced practice nursing as necessarily involving prescriptive authority. It's hard to make a case for pursuing education and certification as a CNS these days. However, I predict that the rest of healthcare will miss us when we are finally all gone.

The CNSs I've had the privilege of working were experts in and champions of important hospital agendas that were paramount in improving patient outcomes. They lead initiatives that managers were too busy to really focus on and minimized the need to pull nurses from the bedside to work on.

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Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr.

OP: Talk to the CNSs in your current place of work to see if the market is going well or not. At one point where I work and live CNSs were phase out and so schools stopped offering a degree nurse stopped wanting to earn. Now, they are being hired by my organization and our competitors at a time when they are rare! Thus, they are able to call the shots! Good luck!

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Specializes in Nephrology, Cardiology, ER, ICU.

Forgot to add too: with consensus model, since CNSs receive education in chronic, acute and geriatrics, the adult CNS can be credentialed for either in-pt or outpt roles. Same goes for Peds CNS

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Specializes in CVICU, MICU, Burn ICU.

I was headed in the NP direction, even though I had always really wanted to be a CNS. I momentarily caved to the "market". Now I am pursuing my CNS. It is absolutely an APRN role. I will be credentialed and licensed to diagnose and prescribe like other APRNs, although it is very true that is not always a part of the actual role. I'm not really interested as much in being a provider unless it is in more of a mid-level way in an acute care setting, and in my specialty. I want to continue working (and building upon all the hard work, knowledge and experience I have earned at the bedside) with the same population I always have. Because I know we can do things better. I know how to find out HOW we can do things better (POLICY AND PRACTICE). I want to be available to consult on difficult cases (PATIENT CARE) and I want to be a part of the professional development of other nurses (EDUCATION). I do not want to be an independent provider, but rather a contributor to a unit/system. Some would say a cog in the wheel. So be it. May I be an effective cog.

I have researched the market where I live and where I may live regarding the marketability of CNSs. They are used in my state and are independent APRNs per law if they have prescriptive privilege (not all do). I do not fear that I will be unemployable with my degree in the LEAST.... however, I am realistic in understanding my "dream job" may or may not present as an opportunity. There will be opportunities available to me with my CNS credential that do not exist for me now without it. Many of them are a significant pay raise from what I make now -- but probably not all.

I make good money at the bedside and am very content there (I may never leave it completely) -- it is possible I will never work in a true CNS role (though this will probably not be bc there are no CNS jobs available), as I may use the degree to work in education or consulting. I know NPs that have returned to the bedside (and alas, it was not their plan).

So, yes, the role is not well understood -- even among nurses. To me that is sad, as I think they are some of the most efficient influencers and doers around in acute care. Do not become a CNS if what you want to be is a provider. Your role as a CNS may or may not include the role of provider, depending on state and institution.

If you want to go deep in a specialty and be a part of making expert decisions in said specialty, and you have a real passion for NURSING and NURSES, along with that specialty -- well don't discount the CNS. Look into it. Check out your area demand for the role and the programs available to you to pursue it. Figure out how you can use the degree if the true CNS is "phased out", and if those alternatives are also appealing to you at all.

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Specializes in Pediatric Critical Care.
I was headed in the NP direction, even though I had always really wanted to be a CNS. I momentarily caved to the "market". Now I am pursuing my CNS. It is absolutely an APRN role.

I was in this same boat. I ended up completing an NP program and now am in a position that is geared towards quality improvement in my specialty. Never particularly wanted to be a provider, and I am glad that I was able to use my advanced degree in a way that is a little more "CNS-y" :)

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