NP vs. CNS: What's the Difference?

The demand for advanced practice registered nurses (APRNs) has never been greater. As APRNs, nurse practitioners (NPs) and clinical nurse specialists (CNSs) rank among the most highly trained and highly paid registered nurses.

While both types of nurses require a master's or doctoral degree and specialty training for certification, their roles and responsibilities differ.

Learn more about each of these nursing roles, including education and certification requirements, salary prospects, and work environments.

NP and CNS Key Similarities and Differences

Like most APRNs, NPs and CNSs must hold graduate degrees, state licenses, and certification to practice. Both careers offer expanding employment opportunities and higher-than-average nursing salaries.

NPs provide direct patient care, practicing autonomously in place of primary care physicians, or under the supervision of other healthcare providers.

They may diagnose and treat medical conditions, order laboratory tests, make referrals, prescribe medications, and perform other procedures, depending on state authorization.

Clinical nurse specialists manage patient care. They collaborate with other nurses and medical professionals on health promotion and disease prevention. CNSs focus on complex cases and vulnerable populations.

Both types of nurses aim to improve healthcare delivery. NPs work with patients directly to assess and treat chronic and acute conditions, either supervised or independently.

While CNSs have less autonomy, they collaborate with teams of healthcare professionals, focusing their efforts on education and support using evidence-based research.

Duties and Responsibilities

While both NP and CNS roles require at least a master's degree and APRN licensure, aspiring nurses should understand the differences before choosing a career path.

NPs deliver direct primary care. They often practice autonomously or with healthcare providers. CNSs tend to hold less practice autonomy, but have considerable input in managing patient care. CNSs provide leadership to nurses and other staff members.

CNSs work closely with medical personnel, consulting, educating, and supporting with the intention of improving nursing care.

Education and Certification

When comparing NP vs. CNS, the educational path for both nursing roles takes between 6-8 years. Both need a bachelor of science in nursing (BSN) degree and at least one year of clinical experience before applying to an MSN or DNP program.

While NP graduate classes focus on primary care, and CNS classes emphasize management and research, most graduate programs share content.

State nursing boards generally require these advanced practice nurses to hold certifications. Certifications require passing exams in specialty areas after graduate training.

NPs and CNSs must fulfill continuing education requirements to maintain their certifications.

Salary and Career Outlook

APRNs, including NPs and CNS, can expect a promising job outlook and high salaries throughout the next decade. The U.S. Bureau of Labor Statistics (BLS) projects that jobs for all APRNs will grow by 45% from 2020 to 2030, much faster than average for all other occupations.

While nurses in CNS roles earn slightly less than NPs, both kinds of nursing careers can offer six figure salaries. Compensation varies by type of employer, years of experience, and geographic location.

NP vs. CNS: Which Career is Right For Me?

Successful NP and CNSs both must possess the "hard" skills acquired through their training, and "soft" skills like good communication and problem-solving. While they share a mission to improve patient care, each of these nursing roles requires specific kinds of skills to deliver the best possible healthcare outcomes.

NPs, especially those with full practice authority, often work autonomously, diagnosing and treating acute and chronic diseases. They may work directly with the same patients for many years and manage large caseloads.

These NPs need good communication, organizational, decision-making, and problem-solving skills. They also need to develop empathy to build a trust-based rapport with their patients and their families.

CNSs are more likely to work with groups and communities, focusing on illness prevention. They spend much of their time collaborating with teams of healthcare professionals, improving outcomes for vulnerable patient populations or in complicated cases. A CNS may also engage in research, teaching, and supervisory roles.

In these busy and stressful workplace settings, the successful CNS must develop an aptitude and appreciation for teamwork, the ability to work well with diverse groups, the organizational skills to keep track of several ongoing cases and projects, and the analytical and leadership skills to achieve results.

While both roles emphasize health promotion and positive patient outcomes, prospective nurses should consider how their own preferences, training, and talents fit within the work environments and responsibilities associated with each of these nursing careers.

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Page Last Reviewed May 1, 2022