Nurse practitioners (NPs) and clinical nurse specialists (CNSs) are both considered advanced practice nurses, yet their roles differ significantly. An NP focuses on providing primary care to an identified group of patients in a role similar to that of a physician, but with a more limited scope of practice. A CNS may have any of a number of roles as a direct care nurse, educator, researcher and/or consultant to improve quality and costs within an organization.
Education
In order to become either an NP or a CNS, a registered nurse needs to complete a master's degree in nursing. Typically, a nurse will complete a bachelor's degree in nursing, pass a national exam known as the NCLEX to earn her RN license, and then practice for awhile before enrolling in a graduate program. There are, however, some combination bachelor's degree-master's degree programs that streamline the process.
Patient Populations
An NP specializes in providing primary care to a group of patients within a field such as family practice, geriatrics, psychiatry, acute care, pediatrics, women's health or neonatal care. A CNS provides specialized nursing care to a group of patients within a particular population, setting, disease or medical specialty, type of care or type of problem, such as working with geriatric cancer patients in a hospital.
Practice Settings
A CNS has a lot of options for his practice setting, including hospitals, long-term care facilities, private practice, mental health facilities and private homes. An NP, on the other hand, is usually employed to work collaboratively with a physician in an office practice, clinic, hospital or ambulatory care center.
Scope of Practice
A CNS provides to her patients, and also works closely with other nurses to share her knowledge as a consultant, clinical expert, researcher and/or educator. An NP practices much like a physician, but with a more limited scope of practice. She can perform health screenings, diagnose and treat acute and chronic diseases, prescribe medications and treatments, educate and counsel her patients about healthy lifestyles, and refer them to other providers for more complex or specialized care when appropriate.
Certification
The American Nurses Credentialing Center (ANCC) and other specialty organizations certify nurses as CNSs based on a combination of experience and a passing score on a written exam. NPs are certified through ANCC, as well as the American Academy of Nurse Practitioners. Once he is certified, an NP can take the appropriate licensing exam through the board of nursing in his home state.
Prescriptive Authority
Most NPs do prescribe medications and treatments as part of their primary care role. A CNS is eligible to apply for prescriptive authority if she meets state-specific criteria, which are generally met during her graduate school experience. Both NPs and CNSs are eligible for reimbursement by insurance companies and Medicare according to federal law, but legislation in individual states may limit or preclude that reimbursement.
Tags: , primary care, care group, care , , direct care