Nurse Practitioner vs. Clinical Nurse Specialist

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Earning an advanced nursing degree can be rewarding in many different ways. However, aspiring nurses may be easily confounded by the variety of roles that are available to them. For instance, both nurse practitioners and clinical nurse specialists work closely with patients, are highly educated, and can earn enticing salaries. How is a young nurse to know which path is right? Read on to learn about the specifics of NP and CNS professions, including the type of education and clinical work that is required to be successful.

The Differences Between a Nurse Practitioner and Clinical Nurse Specialist

While both nurse practitioners (NPs) and clinical nurse specialists (CNSs) are highly educated and experienced in a variety of nursing procedures and practices, the roles remain distinct from one another. Being able to grasp the core differences between the two positions can help aspiring advanced practice nurses to decide which role will best suit their skills and personality.

Both NPs and CNSs must obtain at least a master of science degree in nursing (MSN) to be able to practice. After obtaining an MSN or doctor of nursing practice (DNP) degree, the different responsibilities that are expected of the two types of nurses is still different. For instance, NPs are able to prescribe medications in most states, while clinical nurse specialists are generally not allowed this opportunity.

In the textbook DNP Role Development for Doctoral Advanced Nursing Practice, the authors state that a CNS is “an advanced nursing clinician focused on expert practice, improvement of care at the bedside, and intertwining roles as clinician, consultant, researcher, educator, and manager….In its evolution, the CNS scope of practice would include direct patient care services, as well as staff education and macrosystem management of a specialized population, embedded within a nursing or a system model, rather than the medical model of care.” Furthermore, the authors summarize the differences between an NP and CNS, contending that, “While the focus of NP practice was conceived as the individual at the direct care level, the focus of CNS practice was to be both individual and macrolevel, incorporating nursing diagnosis and management as well as systems assessment and synthesis of improved approaches to nursing care.”

Overall, both NPs and CNSs work hard to provide exceptional patient care, but the right role for any individual nurse will depend largely on what type of work and work environment most interests them and best provides an outlet for their skills.

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Nurse Practitioner vs. Clinical Nurse Specialist

Many times, when comparing two opportunities, it helps to look at them side-by-side. Look over the following chart for a useful summary of the differences between a Nurse Practitioner and Clinical Nurse Specialist in terms of education, personality traits, and many other factors.

Nurse Practitioner Clinical Nurse Specialist
Education Master of science in nursing (MSN), at minimum. A doctor of nursing practice (DNP) may be required in the future. MSN, at minimum
Typical Duties
  • Take health histories
  • Assess, diagnose, and treat acute and chronic illnesses, often acting as primary care medical provider
  • Prescribe medications
  • Offer referrals for specialized care
  • Direct patient care
  • Collaborate with other nursing personnel
  • Educate as faculty or consultant
  • Perform nursing practices research
Common Practice Settings
  • Private practice
  • Ambulatory clinics
  • Long-term care facility
  • Hospital
  • Community health clinic
  • Mental health setting
  • Educational institutions
Licensing & Certification Certification is available through both the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners. Certification in a variety of specialties is available through the American Nurses Credentialing Center. Not all specialties have their own certification exam.
Continuing Education Requirements Must recertify with AANP every five years. Recertification requires at least 1000 hours of clinical practice and 75 contact hours of continuing education, relevant to the NPs role and focus. ANCC recertification is also required every five years. As of 2018, ANCC requires 150 continuing education hours, including at least 51 percent directly related to the NPs focus at 25 in pharmacotherapeutics. As of 2018, CNSs must recertify through the ANCC every five years. To be eligible for recertification, the CNS must complete at least 150 hours of continuing education, 51 percent of which must be in the CNSs chosen specialty and 25 hours of which must be in pharmacotherapeutics.
Specialties
  • Acute Care
  • Adult
  • Adult-Gerontology Acute Care
  • Adult Gerontology Primary Care
  • Adult Psychiatric-Mental Health
  • Family
  • Pediatric Primary Care
  • School
  • Adult Health
  • Adult-Gerontology
  • Adult Psychiatric-Mental Health
  • Child/Adolescent Psychiatric-Mental Health
  • Home Health
  • Pediatric
  • Public/Community Health
Successful Personalities Because NPs often work in private practice with little or no supervision from physicians, the most successful tend to be independent and organized. NPs may also work closely with patients directly for many years, meaning empathy and communication are also of utmost importance. CNSs often work in busy, collaborative environments. A successful CNS should be able to handle stress efficiently and keep track of care and progress for many different patients. Because CNSs may also choose to specialize in a certain type of care, it is important that they are able to stay focused and delve into expertise on one subject for long spans of time.
Common Clinical Collaborators Some NPs must have collaboration agreements with physicians in order to practice, meaning ultimately an MD supervises their work. Whether this is required for NPs depends on the state in which they practice. CNSs work in collaborative setting where they can act as both supervisor of other nurses and supervisees of doctors and other specialists.
Salary Expectations According to the Bureau of Labor Statistics (BLS May 2017), NPs earn a median annual wage of $103,880, although this amount can vary greatly depending on specialty, geographic location, and years of experience. According to Salary.com (2018), clinical nurse specialists earn an average annual salary of $101,276, with the highest paid CNSs earning more than $120,000. Overall, the more experience a CNS has, the higher salary he or she can expect to earn.

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