Clinical Nurse Specialist
What is a Clinical Nurse Specialist?
A Clinical Nurse Specialist (CNS) is one of the roles of a broader group of nurses called Advanced Practice Registered Nurses (APRNs). Other APRN roles include: Nurse Anesthetist, Nurse Practitioner, and Nurse Midwife. Although the scope of practice for a CNS varies by state as defined by the State Board of Nursing, a Clinical Nurse Specialist most commonly provides evidence based nursing care to deliver advanced care to a specific group of people based on the nurse’s specialty.
The CNS differs from a hospital, AD or BSN prepared Registered Nurse in that the scope of practice is typically much broader. The CNS may work in an independent practice but most often works in a collaborative practice with other clinicians.
The CNS elects to focus on a particular specialty based on one of the following categories:
- Problem, for example, pain, wound or palliative care;
- Type, for example, rehabilitation or psychiatric;
- Population, for example, women, pediatrics, geriatrics;
- Disease, for example, oncology, cardiac, diabetes;
- Setting, for example, hospice, long-term care, Emergency department, critical care.
Quick Facts about Clinical Nurse Specialists (as an APRN):
The Bureau of Labor Statistics does not track the CNS, so the data below is based on the closely related Nurse Practitioner role:
- 2015 Median Pay (according to PayScale.com)
- Number of Jobs in 2014
- Job Prospects from 2014-2024
- Much faster than average
- Projected Employment in 2024
- Areas of Growth
- Rural, inner cities, medically underserved areas
Figure 1: Accessed online from Bureau of Labor Statistics July 2016
What does a Clinical Nurse Specialist do?
The CNS role is designed to provide nursing care that improves patient outcomes. The CNS has the diagnostic and treatment capabilities of the physician while maintaining a nursing focus on patient and family centered care. Depending on state-specific scope of practice, a Clinical Nurse Specialist will do some or all of the following:
- Take medical and nursing histories from patients and families;
- Perform in-depth physical exams;
- Order tests based on the physical exam;
- Analyze results of tests;
- Diagnose nursing and medical problems based on the history, exam and testing;
- Create plans of care for patients and families based on the diagnoses;
- Prescribe medication and treatments based on the plan of care;
- Evaluate the individual’s response to prescribed medications and treatments;
- Teach and collaborate with patients and families about the findings and plan of care;
- Consult with and educate other members of the healthcare team;
- Optimize patient care by conducting or participating in research studies.
Where do Clinical Nurse Specialists work?
Clinical Nurse Specialists can work in a wide variety of environments including acute care hospitals, physician offices, long term care facilities, hospice and palliative care, public health departments, surgery centers, outpatient clinics, and rehabilitation. The area of specialization will help to determine where you will work as a CNS.Again, it is important that you understand that CNS practice is governed by each state’s Board of Nursing and the hiring facility so it is critical to understand the rules and regulations in your state and the policies of your workplace.
What qualities should a Clinical Nurse Specialist have to be successful?
In order to be most successful as a Clinical Nurse Specialist, the nurse should:
- Have exceptional basic nursing skills.
- The successful Clinical Nurse Specialist will be a life-long learner with exceptional problem solving and critical thinking skills.
- As the nurse who is often in charge of teams and consultation with other practitioners, the CNS must have leadership skills and must be able to communicate with all members of the healthcare team.
- Since the CNS deals directly with the patient and family, the Clinical Nurse Specialist must have compassion and a caring attitude.
- The CNS is often in charge of helping to orient new team members so must have great listening and mentoring skills.
How much can I expect to earn as a Clinical Nurse Specialist?
The great news is that the Clinical Nurse Specialist can expect to earn a very good living. Salaries will vary depending on specialization, location, experience and other factors. As of May 2015, the median annual wage was $81,952 with a range from $61,277 to $112,051. Of course, wages vary widely by state, cost of living, and need. Experience of the Clinical Nurse Specialist does not have a strong influence on pay:
Figure 2: Accessed online at www.payscale.com July 2016
What are the job prospects for a Clinical Nurse Specialist?
The need for Clinical Nurse Specialists will grow much faster than other professions through 2024. Job prospects for Clinical Nurse Specialists are excellent over the next 10 years as baby boomers age, begin to leave the work force and begin to develop health issues.
In July 2016, the My Next Move website showed the following as employment opportunities for the CNS by state:
Figure 3: Accessed online from My Next Move July 2016
How can I become a Clinical Nurse Specialist?
A Clinical Nurse Specialist must be a Registered Nurse before being eligible for this advanced practice. In order to earn a CNS, you must earn a master’s degree (or higher) from an accredited program. Typically, this means that you must have a Bachelor’s degree in nursing first; however, if you have a bachelor’s degree in another health science, there are programs that will allow you to prepare for RN licensure at the same time you are studying for a Master’s degree in nursing. If you are a full time student in a Master’s program, you can expect to spend two to three years earning the Master’s degree that will prepare you to take the national certification exam for your chosen CNS specialty.
Although state requirements are different for recognition of Clinical Nurse Specialists, most states require certification by exam to use the CNS title. Clinical Nurse Specialists can work with diverse patient populations, so there are many different certifications available. Most CNSs take a certification examination from the American Nurses Credentialing Center (ANCC) or the specific professional organization for the specialty.