Clinical Nurse Specialist Career Overview
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What Does a Clinical Nurse Specialist Do?
CNSs provide patient care in a specialty area, including adult-gerontology, family practice, neonatal, pediatrics, psychiatric mental health, and women’s health. They collaborate with other nurses and medical staff, serving largely in leadership roles such as nurse educators, researchers, advisors, and policy advocates.
CNSs often perform the following responsibilities:
Primary Responsibilities
- Providing or assisting with direct patient care
- Teaching nurses and staff
- Leading evidence-based practice projects
- Educating patients and their families and community members
- Precepting nursing students
- Conducting or assisting with research
Key Skills
- Attention to detail
- Communication and critical thinking skills
- Compassion
- Leadership
- Resourcefulness
Where Do Clinical Nurse Specialists Work?
More than a third of CNSs work in hospitals with acute care patients, nearly 30% find employment in academic health centers, and 10% choose nursing education in academia. The list below highlights typical roles and responsibilities.
Hospital – Acute CareCNSs direct patient care, manage acute care and improvement, and supervise and educate nursing staff.
- Academic Health Center – Acute Care
CNSs provide acute care consultation, implement evidence-based practice, and evaluate nursing students.
- Nursing Education – Academia
CNSs lecture and instruct courses, design curriculum, and conduct research on best practices.
What Is the Difference Between a Clinical Nurse Specialist and a Nurse Practitioner?
While their duties may overlap, the differences between CNSs and nurse practitioners (NPs) lie in their practice focuses. Generally, NPs work on teams of healthcare providers to perform advanced nursing care. CNSs manage, educate, and facilitate safe and optimal practices within healthcare systems. In some states, CNSs can practice and prescribe independently.
Clinical Nurse Specialist
Practice defined by care or problem type, medical specialty, and patient population- Requires a master’s or doctor of nursing practice DNP
- Earns an average annual salary of $100,392
- Duties include expert consultation, evidence-based practice application, healthcare administration, system and patient outcome improvement, and teaching
Nurse Practitioner
- Practice defined by patient population
- Requires a master’s or DNP
- Earns an average annual salary of $121,610
- Duties include direct patient care, primary care diagnoses, health assessments, and treatment, prescribing medications (if state law permits), promoting disease prevention and education, and diagnostic testing
How to Become a Clinical Nurse Specialist
The steps listed below outline the process to become a CNS. Although a master of science in nursing (MSN) is the current minimum degree, the National Association of Clinical Nurse Specialists (NACNS) endorses a shift to the DNP by 2030.
- 1
Graduate with a bachelor of science in nursing (BSN)
A BSN qualifies nurses to sit for the National Council Licensure Examination for RNs (NCLEX-RN) and earn their RN license. Most programs take four years to complete, but some students may qualify for accelerated options.
- 2
Pass the NCLEX-RN Exam to receive RN licensure
Nursing school graduates typically take the NCLEX-RN about a month after completing their program. RN licensure allows nurses to obtain entry-level clinical work experience.
- 3
Apply to an accredited CNS program
Graduate school is the time to select a clinical specialty area. Admission generally requires an RN license with a year of clinical experience, a BSN, and program-specific prerequisite coursework.
- 4
Graduate with an MSN or a DNP
Students can complete their MSN in two years. MSN-holders in a DNP program would take an additional 1-2 years, while BSN-holders would take closer to six years. RN-to-DNP bridge programs offer streamlined options for qualified learners. Graduates apply with their state nursing boards for licensure as APRNs.
- 5
Apply for certification from the American Association of Critical-Care Nurses or the American Nurses Credentialing Center
Many state nursing boards and employers require CNSs to hold certification in their specialty area. Certification areas align with patient populations, such as adult-gerontology, pediatrics, and neonatal.
How Much Do Clinical Nurse Specialists Make?
PayScale lists the average base salary for CNSs as $105,993 per year. Bonuses and other benefits, if offered, bring the total pay amount to $71,000-$143,000. The U.S. Bureau of Labor Statistics reports a median annual salary of $223,210 for APRNs and references CNSs as being equivalent to APRNs.
Location impacts salaries. According to PayScale, CNSs in San Francisco earn 37% more than the U.S. average, followed by Los Angeles (15% more) and Seattle (14% more). However, Milwaukee CNSs make 21% less than the national average.
Resources for Clinical Nurse Specialists
National Association of Clinical Nurse Specialists
NACNS hosts a national conference, posts news briefs and job listings, provides insurance discounts, and publishes an online journal and newsletter for its CNS membership. Nursing students can join at a discounted rate. Other membership levels include practicing CNS, retiree, and associate.NACNS Cost Analysis Toolkit
NACNS toolkit serves as a business guide for CNSs, offering strategies for implementing cost-analysis tools to quantify and describe the contributions CNSs make to healthcare improvement. The guide includes a cost-analysis process checklist, a comprehensive literature review, resources, and frequently asked questions.American Association of Critical-Care Nurses Certifications
AACN offers certification in several areas for the adult, adult-gerontology, pediatric, and neonatal patient populations, including acute/critical care nursing, acute/critical care knowledge professional, progressive care nursing, and CNS wellness through acute care. It also offers credentials in TeleICU acute/critical care nursing and adult cardiac medicine and cardiac surgery.American Nurses Credentialing Center Certification
ANCCs certification options for all nurses include an adult-gerontology clinical nurse specialist credential. Candidates with an RN license, a graduate nursing degree from an accredited adult-gerontology CNS program with 500 supervised clinical hours, and listed prerequisite coursework can apply to take the 3.5-hour exam.
Frequently Asked Questions About Clinical Nurse Specialists
The NACNS position statement endorses the DNP as the minimum degree needed to become a CNS. The NACNS cites the future direction of nursing practice and increasingly complex patient needs as its reasons to advocate for doctoral-level advanced practice nurse training.
Reviewed by:
Dr. Deborah Weatherspoon, Ph.D., RN, CRNA is an advanced practice nurse. She graduated with a Ph.D. from the University of Tennessee in Knoxville. She is currently a university nursing educator and has authored multiple publications. She has also presented at national and international levels about medical and leadership issues. She enjoys walking, reading, traveling to new places, and spending time with her family.
Weatherspoon is a paid member of our Healthcare Review Partner Network. Learn more about our review partners.
