Clinical Degree Nursing Without

Q: I'm considering a change in career and I've been looking at some MSN programs. They usually require you to specialize in something and looking at the list, I see Clinical Nurse Specialist. What exactly is this profession?

A:I'm getting the impression that this "clinical nurse" is not very welcomed around here. C'mon guys, give them a break. Not everyone likes bedpans or emesis basins, that doesn't make them less of a nurse. There are so many opportunities out there for all of us. Don't put someone down just because they want more knowledge. I'm not a clinical nurse specialist but have thought about it recently. I'm a PACU nurse who wants to keep working in the PACU but I want more knowledge. I am a clinical nurse specialist who can still scrub for a C/S as well as teach others to scrub (new grads who've never had the opportunity to even see surgery. I can also do bedside care and, yes, I do make less than the staff nurses. However, I'm the one who orients & teaches the new grads who've only had 4-6 weeks in school so that their preceptors can work with them on a one-to-one basis to turn them into competent nursing staff. Try the www.nacns.org website to see what else we do. (And BTW, I was a bedside nurse for over 15 years while getting my BSN and my MSN). You DON'T need a degree to have more knowledge. You PAY for the degree, you get knowledge by working and learning as you work. You also learn from your coworkers and by looking up things and asking questions along the way. A clinical nurse specialist has a masters degree in a clinical area of nursing. What they do can differ greatly depending on where they are doing it and what clinical area they are in. Many work as clinical educators or clinical resources in hospital settings. Some (primarily in psych and, to some extent, gerontology) work independently. Medicare law allows CNSs to bill Medicare independently for their services, but that means (primarily) for clinical services provided direclty to a patient, not for consultation or staff education in inpatient settings. I am not sure what the attraction

would be for someone to go directly into a CNS program without prior nursing experience. I'm not saying it can't be done--I am just not sure how someone would choose to train for a role as a clinical expert in a specialty area without having some experience first. I can better understand going directly into a program to become an NP, since that's a role that is more defined and probably more familiar to non-nurses. ( I think the exception would be for more independent roles, like psych CNSs). For a while, most nursing schools were getting rid of the CNS programs in favor of establishing and expanding NP programs. That trend seems to have reversed somewhat.