In this career, your responsibilities may include:
- Specializing in a specific field of medicine that may focus on:
- A certain population (like pediatrics or geriatrics);
- A certain type of medical problem (like wound care or chronic pain management);
- A certain medical specialty (like infectious disease or diabetes);
- A certain healthcare setting (like surgical or intensive care units);
- Or a certain type of care (like rehabilitation or public health).
- Prescribing medications and medical treatments, and ordering and interpreting diagnostic tests. CNSs may practice and prescribe independently or in collaboration with a supervising physician, depending on the state.
In your job search, you may find job listings for this career under different titles. You can find some examples of these, as well as more information about this career, at Career One Stop.
To practice as a CNS, you must have either a master’s degree, a post-graduate certificate, or a doctorate from an accredited program. Obtaining a doctorate can make you eligible for careers with greater responsibility and higher salaries in this pathway.
Population-based certification is required in adult/gerontology, pediatrics, or neonatal care, and you may also obtain additional specialty certifications. These include the following:
- ACCNS-N (Neonatal), ACCNS-P (Pediatric), and ACCNS-AG (Adult-Gerontology), all offered by the American Association of Critical-Care Nurses
- Adult-Gerontology Clinical Nurse Specialist Certification (AGCNS-BC), offered by the American Nurses Credentialing Center
- Certified Perioperative CNS (CNS-CP), offered by the Competency & Credentialing Institute
- Certified Wound Care Nurse (CWCN-AP), Certified Ostomy Care Nurse (COCN-AP), Certified Continence Care Nurse (CCCN-AP), or Certified Wound, Ostomy, and Continence Nurse (CWOCN-AP) for the tri-specialty certification, all offered by the Wound Ostomy Continence Nursing Certification Board
- Advanced Certified Hospice and Palliative Nurse (ACHPN), offered by the Hospice and Palliative Credentialing Center
Many state boards of nursing require that internationally trained RN candidates complete the CGFNS Certification Program in order to take the NCLEX-RN exam, which is required for licensure as an RN (and is also a requirement for the higher designation of APRN). This three-part program includes a credential evaluation, a nursing exam, and verification that you have passed one of the accepted English language exams.
- NOTE: The exam component of the program also fulfills the examination requirement for the federal VisaScreen: Visa Credentials Assessment for immigration.
Registered Nurse (RN) licensure is required for RNs and Advanced Practice Registered Nurses (APRNs). Each state has a board of nursing that regulates licenses, and requirements vary by state. To be eligible for licensure, most states require that you pass the NCLEX-RN exam.
- Some states allow recent graduates of RN programs to practice nursing under supervision for a limited period of time while they await their NCLEX exam date, under a temporary or limited permit or license. Check with your state board of nursing to find out if this can be an option for you.
You must obtain a credential evaluation of your international education in order to take the NCLEX-RN exam. Many states require that you obtain your credential evaluation from CGFNS International (formerly the Commission on Graduates of Foreign Nursing Schools). Some states may also accept evaluations for RN or LPN/LVN licensure from Educational Records Evaluation Service (ERES), Josef Silny & Associates, or the International Education Research Foundation (IERF). Currently, IERF only performs evaluations for applicants educated in Canada, India, Mexico, Philippines, and Puerto Rico.
- Puerto Rico is the only U.S. territory that is NOT a member of the National Council of State Boards of Nursing (NCSBN). Therefore, any nursing education completed in Puerto Rico must be evaluated for licensure purposes the same as it would have to be for any education completed in a foreign country. Exceptions to this rule may exist on a state-by-state basis, such as in New York, which does recognize nursing education completed in Puerto Rico as being a U.S. education.
In most states you will need to pass an English language exam if your degree program was not taught entirely in English and in a country where English is the primary language. Accepted exams and scores vary by state, but may include the IELTS Academic, the PTE Academic, the TOEFL iBT, or the TOEIC.