The nursing profession offers many career specialization opportunities and a job market that continues to grow at a higher rate than the average for all other occupations. Clinical nurses typically work in hospitals, health centers, and private practices. This guide provides detailed information on education and job training, licensure requirements, and clinical nurse salaries.
What is a Clinical Nurse?
All clinical nurses begin their careers as registered nurses (RNs) who obtain licensure by completing a nursing degree or diploma and passing the national council licensure examination (NCLEX). According to the National Association of Clinical Nurse Specialists, a clinical nurse has been prepared by a master's, doctoral, or post-graduate certificate level CNS program, along with advanced clinical skills in a specialty. Some clinical nurses work in facilities that accept advanced training and certification in lieu of a master's degree.
Often designated as clinical nurse specialists (CNS) because of their training and experience, these RNs fall into the category of advanced practice registered nurses (APRNs), a title they share with nurse practitioners, certified nurse-midwives, and certified registered nurse anesthetists. They serve as leaders in healthcare because of their advanced specialized knowledge and ability to train and mentor other nurses.
How to Become a Clinical Nurse
A clinical nurse can begin their career with a diploma, associate degree in nursing (ADN), or bachelor of science in nursing (BSN). They must successfully pass the NCLEX-RN exam to obtain licensure for practice in any state. Clinical nurses must possess advanced education and training, so each aspiring professional should expect to earn an MSN and complete training in a specialization.
Clinical nurses who want to assume leadership roles as mentors and educators should develop non-clinical skills, such as effective communication, teamwork, problem-solving, and organizational leadership. This rewarding career allows learners to treat specific populations through their specialized training in areas like adult-gerontology, acute care, pediatrics, and psychiatric/mental health.
Education
A career as a clinical nurse requires an MSN or DNP. Each degree-seeker can start by earning a nursing diploma, ADN, or BSN from an institution accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN).
The RN-to-BSN serves as a popular pathway for RNs with ADNs to earn BSNs. Many schools offer online RN-to-BSN programs for RNs to advance their education without sacrificing their careers.
The RN-to-BSN usually takes 12-24 months to complete. Nurses typically satisfy clinical requirements in their communities, often at their current places of employment. Some schools offer online RN-to-MSN programs that allow each learner to choose a specialization, such as clinical nurse specialist, nursing education, or nurse practitioner. The length of nursing programs depends on the chosen specialization and whether students choose full- or part-time enrollment.
Training and Certification
Aspiring nurses must pass the NCLEX-RN examination to practice in all 50 states.
Once students enroll in a CCNE- or ACEN-accredited program, they complete a curriculum that covers topics in human development, anatomy and physiology, health assessment, pharmacology, and pathophysiology. Upper-level practice courses cover health promotion and maintenance, advanced pathophysiology, and advanced health assessment.
Nursing schools may offer CNS tracks, such as pediatrics, acute care, adult-gerontology, and women's health. The curriculum may include a practicum or internship in a medical setting. Internships provide more in-depth experience than practicums and require students to administer medication and assist with procedures on real patients. Clinical experiences also allow nursing students to explore different specialties. The number of clinical hours varies by program and degree level, with bachelor of science in nursing students completing between 800 and 1,000 hours.
A nursing graduate or student about to graduate must meet state requirements to take the computerized NCLEX-RN license examination. Once they meet state eligibility requirements, they register with the state board of nursing to take the exam. The basic NCLEX-RN exam registration fee costs $200.
Once nurses pass the exam and begin to build their nursing experience, they may want to consider pursuing specialization for career advancement and higher salaries. The American Nurses Credentialing Center (ANCC) offers certifications for RNs with a minimum of 500 clinical hours in the CNS role. ANCC offers certifications in adult-gerontology, pediatrics, and and neonatal.
Clinical Nurse Salaries and Job Growth
The U.S. Bureau of Labor Statistics projects a 6% job growth in 2025-35 for RNs, which is faster than the average growth rate forecasted for all occupations. The BLS also indicates that the 2025 median pay for RNs with a bachelor's degree stood at $97,550. A clinical nurse typically holds a master's degree and advanced training in a specialty, which can enhance career prospects and clinical nurse salaries.
The average clinical nurse specialist earns $104,400, according to February 2025 data from Payscale, and the most popular clinical specialties include clinical education, acute care, intensive care unit, medicine/surgery, and oncology. Clinical education offers an average salary of $90,135 in compensation, alongside training program development ($90,129) and critical care ($91,355). The highest salary locations for clinical nurses include Chicago, Los Angeles, Baltimore, and Seattle. Those interested in this profession should factor in the cost of living in these areas.
Clinical Nurse Resources
National Association of Clinical Nurse Specialists: NACNS represents clinical nurses across the country. The organization boasts a membership of 2,000 and represents more than 89,000 clinical nurses. Member benefits include access to continuing education, publications, toolkits and reports, webinars, and a career center.
Journal of Clinical Nursing: JCN is an international, peer-reviewed periodical that focuses on scholarship to advance nursing practice. This monthly publication covers topics in clinical research, evidence-based practice, nursing research, clinical decision-making, and evaluations of nursing practice across health sectors.
American Nurses Credentialing Center Certifications: ANCC is a nationally recognized authority in nursing credentialing for individuals and organizations. In addition to adult-gerontology clinical nurse specialist board certification, ANCC offers other specialty certifications, such as informatics, nursing case management, and psychiatric-mental health nursing.
American Nurses Association: Founded in 1896, ANA is the premier professional organization representing the interests of the nation's 4 million RNs. ANA offers a robust suite of membership benefits, including access to ANA meetings and conferences, ANA journals, a mentorship program, career center, and hundreds of discounted study modules. Members also receive ANCC certification discounts.
