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anewsns anewsns (Member)

Who will do CNS role?

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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.

That is a good question, but to be perfectly honest, I wrote this post on a whim while daydreaming about my nursing future. I did get a lot of what I was looking for in this thread! I'm loving the discussion. I think I just like to read about the CNS role because you can gain so much knowledge in your realm and really make an impact in the nursing world.

I know I DONT want a normal provider role/ I don't want prescriptive rights.

My passion is primarily in education. I like teaching patients and encouraging new nurses and nursing students. I don't want to be locked in to a classroom and don't want to be a clinical instructor, so I can see myself in some sort of hospital education role.

Sometimes I think I want to leave bedside, but I think I'll always want to work directly with patients in some way.

I'm NOT a leader or a clinical lead, I do not like directive roles or roles dealing with managing large groups of people.

I think I would enjoy research and quality improvement, and influencing nursing change and policy in some way, without being the kind of person who nurses don't want to see walking around the unit pointing out small details to them. "Med out on the counter. SCDs aren't on. Bed alarm is off. Label IV tubing." I want to actually motivate nurses to improve their knowledge and quality of practice.

Lastly, I just like the idea of having a really firm grasp of my field(s). My population passion is pretty general, basically adult/ gerontology / acute and chronically ill people. (As opposed to pure prevention) so I think it would be really cool to have more formal education in this area and the ability to affect change in some way.

I could probably honestly find tons of good roles with my bachelors but would really enjoy all the knowledge that comes with a CNS masters (as opposed to education or nurse practitioner.)

I think I'll likely move into some other roles once I have my bachelors, and then see if I can find a good match for me, and pursue more education based on whatever I'm enjoying the most.

This is not and end to the thread though, I'd like to read more input on this topic!

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There seems to be very few CNS programs. I am in the process of interviewing for a CNS in endocrine. I have a non-clinical MSN and an MA. I will get my CDE, but they want an advance practice nurse. I am lucky that in NC, there is a bridge pathway to get a CNS via portfolio so I don't have to go back to school.

We use a lot of CNS where I work (diabetes education, dietary, pain-these are the ones I can think of right now).

I am very excited about this new position. Mostly insulin pump education, but whatever topic needed/possibly nurse for a single physician.

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I am lucky that in NC, there is a bridge pathway to get a CNS via portfolio so I don't have to go back to school.

That's interesting! I wonder if other states have similar. Do you happen to know?

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That's interesting! I wonder if other states have similar. Do you happen to know?

I don't know which ones -- mine is one -- you have to have formal CNS education followed by national certification.

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I don't know which ones -- mine is one -- you have to have formal CNS education followed by national certification.

How do you get formal CNS education without going to school for CNS? CNS encompasses the 3Ps which would not have been accomplished by your non-clinical MSN and MA.

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I think I was unclear. I don't know how you would get formal education outside of school. I am in a CNS Master's program complete with the 3 Ps and clinicals at a state university.

I am surprised there would be any other path to CNS, as my state is very clear - you must have formal CNS education to be licensed as a CNS.

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From the NC Board of Nursing:

Alternative Recognition Requirements: Submit required Clinical Nurse Specialist Portfolio documents as outlined in the Clinical Nurse Specialist Flowchart --

1) Unrestricted RN License

2) Some kind of graduate degree in nursing or related field

3) Have national CNS certification from prior to 2007 and are an actively practicing CNS (or contact them if no certification available.)

Sounds like its meant to grandfather in older (more experienced) CNS's.

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I became a CNS back in 1981 ... but as support for the dwindled over the years, I transitioned into being a Nursing Professional Development Specialist. The hospital I work for now has combined the NPD role with what most would consider to be CNS job responsibilities. Some people in my department focus more on the clinical practice and quality improvement aspects of our role: others focus more on the educational aspects. But we all have the same job title that we made up that combines both educational and clinical practice functions.

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My comment may be a bit naive, so please forgive and correct me if I post something radically wrong. Personally, I've never wanted to pursue a job that has a very vague role, or a role that not many understood, such as the CNS. I'm a newly graduated nurse practitioner, and I'm still not exactly clear as to what a CNS really CAN do that ISN'T still vague at this point in our career field.

Most professional development facilitators or clinical unit educators really all take the role of ensuring a smooth process of on-boarding and training new staff, but also ensuring that floor staff (and some providors) follow facility policy and audit the medical chart for restraints, pain management, etc, and TYPICALLY only require a BSN, sometimes an MSN, but should or would the CNS take this role and do this any better or different?

Another example, diabetes educator. I've primarily seen nurses with BSN and a certification for diabetes as an educator/instructor for patients with new or uncontrolled diabetes and to help them with resources for their own management as well. From that standpoint would the CNS take this role? And if so, would that justify more pay or a new role altogether?

I guess my question is, since most roles like those and more, are filled already with BSN/expert certification nurses, how does a CNS elevate that role (or would they?) or how would a hospital or facility justify bringing on a CNS ontop of the other roles already in place. I'm so naive, no insult meant, I'm just trying to clarify the role to learn.

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My comment may be a bit naive, so please forgive and correct me if I post something radically wrong. Personally, I've never wanted to pursue a job that has a very vague role, or a role that not many understood, such as the CNS. I'm a newly graduated nurse practitioner, and I'm still not exactly clear as to what a CNS really CAN do that ISN'T still vague at this point in our career field.

Most professional development facilitators or clinical unit educators really all take the role of ensuring a smooth process of on-boarding and training new staff, but also ensuring that floor staff (and some providors) follow facility policy and audit the medical chart for restraints, pain management, etc, and TYPICALLY only require a BSN, sometimes an MSN, but should or would the CNS take this role and do this any better or different?

Another example, diabetes educator. I've primarily seen nurses with BSN and a certification for diabetes as an educator/instructor for patients with new or uncontrolled diabetes and to help them with resources for their own management as well. From that standpoint would the CNS take this role? And if so, would that justify more pay or a new role altogether?

I guess my question is, since most roles like those and more, are filled already with BSN/expert certification nurses, how does a CNS elevate that role (or would they?) or how would a hospital or facility justify bringing on a CNS ontop of the other roles already in place. I'm so naive, no insult meant, I'm just trying to clarify the role to learn.

These are great questions! The CNS, as an APRN, is responsible for more than just staff education and auditing practice improvement measures. The CNS is an expert in a specialty -- as an APRN, they are able to interpret and conduct research and are expected to not only evaluate change but innovate it. They are (often, but not always) providers able to give direct patient care including diagnosis and prescribing treatment -- and are often used to consult on difficult cases within their field of expertise. They are responsible for bring evidence based practice to the bedside. They are decision makers and change agents.

The above represents the scope of the CNS. The VA utilizes CNSs in the ways I have described above. Sadly, many institutions do not employ CNSs for the full scope of what they can do. Many CNSs, as evidenced in this thread, are not employed in CNS positions but rather staff support/education positions. This is really too bad. And it is understandable why nurses interested in the CNS role would shy away from it.

That said, I hope to someday be employed as an actual CNS -- with full scope of practice. But a HUGE reason I chose CNS is because I want to be a change agent at the bedside -- both in preparation of nurses and in bringing best practices to the bedside. A CNS degree will give me opportunity to do just that. Even if I end up as an educator of sorts -- I will consider it a win. This degree is costing me only slightly more than an MSN in Education would, and at the end of the day I will have many more options than with just an MSN in Education.

I hope that helps clarify, as I am passionate about seeing this role make a full revival!

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My comment may be a bit naive, so please forgive and correct me if I post something radically wrong. Personally, I've never wanted to pursue a job that has a very vague role, or a role that not many understood, such as the CNS. I'm a newly graduated nurse practitioner, and I'm still not exactly clear as to what a CNS really CAN do that ISN'T still vague at this point in our career field.

Most professional development facilitators or clinical unit educators really all take the role of ensuring a smooth process of on-boarding and training new staff, but also ensuring that floor staff (and some providors) follow facility policy and audit the medical chart for restraints, pain management, etc, and TYPICALLY only require a BSN, sometimes an MSN, but should or would the CNS take this role and do this any better or different?

Even when a cns role is confusing to some, the role/rationale confusion of a CNL makes my brain hurt.

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In my area, we have a large number of CNS's because a local college of nursing affiliated with the big hospital system had CNS as the only option for MSN.

We all work as APRNs with CNS=NP as to scope of practice. Although I was taught the "CNS scope of practice" in school, in practicality I've never used it.

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