Initially evolving out of similar, but somewhat separate roles in both patient and clinical reporting hierarchies, the distinctive roles of each have now matured into an identification based on each of their functions and the demands that each role requires in advanced nursing. Thus we have the discussion of the nurse specialist vs nurse practitioner roles and how they compare.
Nursing has become a very interesting career, because the health care market is now forcing the downsizing of some hospitals, which systematically eliminates registered nursing jobs, while these institutions hire more unlicensed assisting personnel such as Certified Nursing Assistants. However, the pressures are requiring more sophisticated judgment by nurses with a very high threshold. Patients are being discharged at much earlier rates, given that new mothers are discharged 24 hours after delivering their babies, for example.
This often requires additional medical attention outside of the hospital setting for these early discharged patients, as things don’t always go so well, and they show up at clinics and emergency rooms. The primary care Nurse Practitioner is and is going to be more in demand as more and more patients are moved out of the hospitals in the early stages of their recoveries.
When we talk about the nurse specialist vs nurse practitioner we have to address the roles that each plays in the workplace.
The role of the CNS, or clinical nurse specialist as a hospital nurse in advanced hospital situations is now in a variable demand situation. In many cases they are being downsized, in others they are filling new niches, but the reasoning is that the CNS’s specialized expertise is “no longer needed.” Yet can unlicensed personnel really fit into those niches? If you have ever been a patient, who is alone in bed at 3:30am in the hospital and the only caregiver you have to communicate with seems to be someone with very little training, you might get a clearer picture of this dilemma.
There is a high degree of pressure on hospitals to discharge patients more quickly, as reimbursements end, and the patient’s stay is not long enough now for the CNS’s expertise to come into play. This is also evidenced by the fact that there is a decline in the training of new CNS’s and some graduate programs only offer NP training.
Given the nature of the post acute care role of NP’s the nurse specialist vs nurse practitioner debate seems to be morphing into a practical role of both merging where more and more CNS’s move into NP training, as the need will definitely be there.
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