CNS vs. NP: What's the Difference?

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. What NP specialization are you most interested in?
What NP specialization are you most interested in?

As the nursing field continues to advance, its versatility as a career path evolves as well, creating room for clinical nurse specialists and nurse practitioners to thrive. A vast number of opportunities and branches of specialization lie in modern nursing, allowing aspiring professionals to find a career that fits their skills and interests. Those interested in administrative and clinical aspects of nursing may want to understand the differences between the CNS vs. NP, and which best suits their goals.

A nursing role exists to match any student’s health care ambitions — it’s simply a matter of finding the appropriate education to equip them for success in this thriving career field. Bridge programs, such as online BSN to DNP programs, can set up future nursing professionals to advance into leadership roles.

What Is a Clinical Nurse Specialist?

Consultation and advanced patient care are in the hands of the clinical nurse specialist (CNS). The CNS role features diverse responsibilities that touch on many aspects of clinically holistic treatment, including research, well-informed practices, and management and training of new staff. Their job may involve hands-on activity by analyzing patient conditions, administering medicine, and providing consultation, or the brunt of their work may be more administrative, such as recording medical histories, corresponding with doctors, or allocating staff resources. Regardless of the focus of their responsibilities, the CNS must constantly seek to optimize patient care, whether through direct interaction or by educating staff on the floor.

A CNS works primarily in hospitals, as well as in less common ambulatory health care service locations such as physician’s offices.

Some of the key skills for CNSs are:

  • Critical thinking. Every day, CNSs will encounter new problems, many of which they must solve quickly and independently.
  • Resourcefulness. CNSs acknowledge when they don’t know the next best course of action, and determine where they can turn for an accurate answer or solution.
  • Medical analysis. Having years of education and experience, CNSs should be proficient in medical terms and data, and what they mean for patients and their treatment.

CNSs can specialize in a variety of paths. Examples of CNS specializations are gerontology, neonatal care, and pediatric care.

What Is a Nurse Practitioner?

Compared with a CNS, an NP may operate in either a general purpose capacity or a highly specialized capacity, depending on the worker’s skills and preferences. NPs may create and maintain patient treatment plans, assess health concerns, and encourage lifestyle changes to improve patient health. Their responsibilities include performing medical examinations, assessing patient reactions to treatments and medications, diagnosing health problems, and developing patient care plans. They may also prescribe medication without physician supervision in states that allow full practice authority for NPs.

Most NPs work in physician’s offices and hospitals, although they may also work in outpatient care facilities and educational facilities.

Some of the key skills of effective NPs are:

  • Composure. NPs may find themselves involved in stressful or fast-paced situations. When this happens, they must stay calm and think clearly, so they can best help their patients.
  • Teamwork. NPs often work collaboratively with physicians, peers, and other key parties involved in patient treatment.
  • Medical treatment. Skilled NPs will know how to administer various tests, perform symptom analysis, and provide high-level medical treatment for various patient concerns.

NPs aspiring to have a specialization may choose from a diverse selection of options, including psychiatric mental health, family care, and adult-gerontology acute care.

Nurse wearing scrubs on the phone at a nursing station.

CNS vs. NP Differences

Though overlap between the CNS and NP roles certainly exists, several differences between them also exist. Education requirements, expected certifications, future job outlook — the inquiring professional must know the distinctions so they can make the best possible decision for their career path.

Education, Certification, and Licensure

Both CNS and NP career paths require licensure to practice as registered nurses (RNs). This means earning an undergraduate degree in nursing, such as a BSN, gaining the required work experience, and taking the National Council Licensure Examination for Registered Nurses (NCLEX-RN).

This is normally followed by a graduate nursing degree, such as an MSN or a DNP, which can hone technical nursing skills and open up more leadership opportunities. Those who wish to skip the MSN can also go straight to a doctoral degree through a BSN-DNP.

While the educational paths are virtually the same, they differ in specializations and further certification or licensure. After the completion of a graduate degree, a CNS should obtain additional certification as a CNS through the American Nurses Credentialing Center (ANCC) and state approval to operate as an active nurse. A CNS may also seek additional certification in CPR, advanced cardiac life support (ACLS), or other work-related training.

An NP, however, must obtain NP licensure through a state board to be able to practice. Many certifications are available through the American Academy of Nurse Practitioners Certification Board (AANPCB), ANCC, or the Pediatric Nursing Certification Board (PNCB).

Responsibility Differences

Though both positions may involve working directly with patients and providing patient care, CNSs often fulfill a more administrative role, diversifying their skills. NPs, however, are likely to specialize in a specific field of health care and fulfill a more clinical role. CNSs might have responsibilities such as allocating hospital resources to keep the facility operational, while NPs might have a stronger knowledge of treatment protocols and preventive techniques.

CNS vs. NP Income and Job Growth

The U.S. Bureau of Labor Statistics (BLS) reports that a substantial difference in projected income and job growth exists between the CNS vs. NP. Note that the BLS classifies the CNS role as an RN.

The BLS reports that the median annual income for a CNS is $75,330 as of May 2020, with a projected job growth of 9% from 2020 to 2030.

An NP, however, has a median annual income of $111,680 as of May 2020, with a projected job growth of 52% between 2020 and 2030, according to the BLS. This higher than average percentage is largely attributed to the coming need for replacements in the labor force, as existing professionals are expected to change careers or retire.

A Comprehensive Nursing Education

In a career field full of new opportunities and advancement, you want a well-designed, respectable nursing education to give you a competitive edge. Find confidence in Hawai‘i Pacific University’s online BSN to DNP program, which spans multiple stages of the traditional education path, bringing you from your bachelor of science into the academic heights of a Ph.D..

Three different specializations exist in Hawai‘i Pacific University’s education path, including family nurse practitioner (FNP), psychiatric mental health nurse practitioner (PMHNP), and adult gerontology acute care nurse practitioner (AGACNP), so you can choose the option that aligns with your career goals. Some courses featured in our curriculum include Advanced Pathophysiology and Advanced Physical Assessment. Explore the curriculum, find your specialization, and start your path toward an advanced nursing career.

Recommended Reading:

10 Effective Nursing Communication Techniques for Nurse Leaders

Overcoming Cross-Cultural Communication Barriers in Nursing

What Is Evidence-Based Practice in Nursing?


American Academy of Nurse Practitioners Certification Board, Certifications

American Association of Nurse Practitioners, All About NPs

American Association of Nurse Practitioners, State Practice Environment

American Association of Nurse Practitioners, The Path to Becoming a Nurse Practitioner (NP)

ANA Enterprise, Our Certifications

Betterteam, Clinical Nurse Specialist Job Description

Betterteam, Nurse Practitioner Job Description

Indeed, What Is a Clinical Nurse Specialist? (5 Steps to Become a CNS)

National Association of Clinical Nurse Specialists, What Is a CNS?

Pediatric Nursing Certification Board, Certifications

U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners

U.S. Bureau of Labor Statistics, Registered Nurses