Acute Care Salaries and Roles for PNP and CNS

Acute Care Salaries and Roles for PNP and CNS

I am wondering if you could answer a question for me. I see that most of the jobs in the CVICU or PICU are CNS positions. I have heard of Clinical Nurse Specialists. I am pretty sure that as a PNP we can fill that role. Just wondered what you thought the difference is? Salary? role? or scope of practice? I am very interested in working in an acute care setting (even though I don’t have an acute care PNP degree). It seems most are filled by those who have a Primary care Peds NP and have experience as an R.N. in acute care peds. Let me know what you think. Thanks

Hi,the CNS role varies by hospital and state. Some states require a certification, some require education as a CNS and some require a MSN. In some states CNS have prescriptive authority and some do not. The true role of a CNS is as a facilitator of best practices. The way that is communicated is at the bedside training unit nurses, research, education and working with management to understand and communicate the hospital wide goals.
A PICU or CVICU PNP job usually requires 2-3 years as a RN in the PICU. Some states require the Acute Care certification and training many hospitals prefer it. Post Masters Acute Care programs are available and have a distance education option. A PICU CNS job similarly requires 2-3 years RN experience in the PICU. That makes sense because it is difficult to teach best practices to nurses if you have not been in the role yourself.

Regarding all other acute care units, there is a very similar story. If you want to work in inpatient cardiology you need to have cardiology experience, if you want to work in hematology oncology the same is true. If you have RN experience in med surg, it is easier to work in hem onc, cardiology and surgery as a PNP. As a CNS there are training programs for specific units and it generally require RN experience in that unit for the reasons stated above.
Salaries for acute care positions depend on location and experience. A new grad in California can make anywhere from 75,000-90,0000 as a PNP in acute care. The same PNP job with experience would jump to 90,000-$120,000.A new grad CNS was offered $120,000 in California to work as a NICU level III with ecmo. She had four years RN experience and was trained in a program as a NICU CNS.

In Oregon and Washington a new grad acute care PNP can make 73,000-80,000 and an experienced PNP can make 80,000-90,000. As an acute care CNS the salary range is 80,000-85,000 for new grad to experienced CNS.

In Texas a new grad PICU PNP can make 90,000-100,000 and other acute care PNP's can make 76,000-100,000. All PICU, CICU and cardiology PNP's are required to have an acute care certification and training. Other inpatient units either require or expect a PNP to acquire training and certification within 2 years of employment start date.

In the mid west, a new grad acute care PNP can make 65,000-75000 and an experienced PNP can make 80,000-100,000. It is important to take the cost of living into consideration. In Kansas City, if you make 75,000 you need to make 92,000 in Dallas, 171,000 in California, 131,000 in Seattle and 164,000 in Washington DC given a cost of living comparison.

In New York acute care PNP and CNS salaries are high. They range from 80,000-100,000 as a new grad and 95,000-140,000 with experience. Boston is similar although the starting salaries for new grads can be 75,000. Starting salaries for new grads in acute care PNP in Atlanta is 75,000.

Experience can be defined as years of RN or PNP experience depending the hospital policies. A CNS starting salary can be the same for experienced CNS as new grads because there is a high demand. Starting salaries do not correlate to salaries with longevity at a hospital. Many hospitals give annual increases of 2-5%. There are a number of PNP's nationwide making $120,000-140,000 because of annual increases in their wages.

I hope this helps.

Warm Regards,
Jill Gilliland
Melnic Consulting Group
800 886-7906

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