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Clinical nurse specialist (CNS) jobs provide the most flexibility of the four advanced practice registered nurse roles. They connect healthcare practitioners, using their relationships and evidence-based information to impact patient outcomes and healthcare system decisions.
A CNS collaborates with a range of professionals. They seek to improve resources to financially benefit an organization. They also carry out research-based initiatives to improve the organization's bottom line.
The COVID-19 pandemic has highlighted the impact of the position. A CNS influences costs, resource allocation, and cross-training to support team-based staffing. These professionals have the opportunity to specialize in many different fields, such as:
Patient population: Geriatrics, pediatrics, adult care, or women's health
Setting: Critical care and emergency room
Disease: Diabetes, oncology, or gastroenterology
Type of care: Psychiatric, cardiac rehabilitation, or physical rehabilitation
Type of problem: Pain, wound care, stress management, or smoking cessation
Salaries vary by role, nursing specialty area, geographical setting, and additional certification. According to Payscale data from Match 2022, the average CNS salary in the U.S. is $93,810. This is well above the average registered nurse (RN) salary of $80,810 and slightly below the average nurse practitioner salary of $114,510, according to data from the U.S. Bureau of Labor Statistics.
Below, you can find some of the best-paying jobs for a CNS, where a CNS works, the practice environment, and common CNS responsibilities.
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1. Intensive Care Unit CNS
One of the top CNS jobs is in the intensive care unit (ICU). A CNS takes an interpersonal approach to quality control in the ICU. A CNS can effectively meet the needs of the organization, healthcare colleagues, and patients while lowering the economic demand on the system.
In the ICU, a CNS is used to support patient care, provide staff education, and ensure practice protocols are met. They promote safety and evidence-based practice in the ICU setting.
The National Library of Medicine shared data from a study that evaluated clinical outcomes in the ICU when the head nurse was a CNS. The study found the position helped leverage practical skills in nursing management. A CNS in the head nurse position may have helped improve patient outcomes.
The CNS in the ICU must have critical care experience. Some hospitals use one CNS across more than one ICU setting, such as pediatric and neonatal units. The nurse might work with a variety of specialty-based populations and develop treatment plans in collaboration with a multidisciplinary team.
This CNS is an ideal position to innovate, lead, and evaluate change.
Average Salary: $98,240 (according to Payscale in March 2022 for a CNS with skills in intensive care units)
2. Acute Care CNS
Acute care is the next step after primary care when a patient is first in contact with healthcare professionals. According to the American Association of Critical-Care Nurses, the scope of practice encompasses a neonatal, pediatric, or adult-gerontology patient population.
An acute care CNS functions as an expert clinician and patient advocate, leading the advancement of nursing practice in the organization and the profession. A CNS identifies opportunities for leadership and change in the system.
The acute care CNS oversees and can provide culturally sensitive nursing care. This includes prescriptions, health promotion, risk assessment, and preventive care. In the acute care setting, a CNS is expected to conduct comprehensive and holistic assessments. They use evidence-based techniques and tools to evaluate acute and chronic health concerns in the patient.
The CNS also formulates and carries out a plan that encompasses the patient and family, nursing, and the organization.
Finally, the CNS is also involved in the evaluation and communication of healthcare outcomes.
Average Salary: $97,090 (according to Payscale in March 2022 for a CNS with skills in acute care)
3. Medical-Surgical CNS
Another of the best-paying jobs for a CNS is in a medical-surgical unit. In 2019, the Academy of Medical-Surgical Nurses revised the definition of medical-surgical nursing to reflect the changing healthcare landscape to include the following:
- Medical-surgical nurses provide care to adults with a variety of medical or surgical issues.
- They have a broad knowledge base.
- They have advanced skills in organization, prioritization, assessment, and communication.
- Medical-surgical nursing can be practiced in several settings, including homes, hospitals, and telenursing.
A medical-surgical CNS conducts programs within the organization. They promote health and wellness and analyze financial factors. They also implement and evaluate clinical programming and provide staff development opportunities.
These professionals help lower length-of-stay and readmission rates through a reduction in healthcare inefficiency to help improve patient outcomes.
Average Salary: $96,860 (according to Payscale in March 2022 for a CNS with skills in medicine and surgery)
4. Clinical Nurse Educator
Clinical nurse educators play a key role in promoting innovation in healthcare by preparing the next generation of nurses in CNS programs. Some clinical nurse educators choose to work part time. This helps maintain their skills by providing direct patient care.
Clinical nurse educators can work in a community college, nursing program, or technical school. They facilitate learning and teaching by providing different educational options to healthcare professionals.
In a hospital setting, a clinical nurse educator suggests and incorporates clinical programs to improve practice. These professionals may perform research, speak at healthcare engagements, author grant proposals, review educational materials, and serve on peer review committees.
The Professional Nurse Educators Group provides a learning community for professionals who serve through education. There is no cost to join.
Average Salary: $93,460 (according to Payscale in March 2022 for a CNS with skills in clinical education)
5. Oncology CNS
A CNS can play a crucial role in cancer care, including assessment, treatment, and management of outcomes. Research into the underlying biological and physiological changes in cancer is rapidly expanding. This influences treatment options and supportive care interventions.
Studies show improved patient outcomes when an oncology CNS participates in cancer care, including better symptom management, patient satisfaction, service coordination, and psychological support.
The journey a cancer patient takes through the healthcare system is often lengthy, disjointed, and complex. It can involve a variety of providers in different settings, suggesting gaps in care or patient needs going unmet. An oncology CNS can help tailor an approach to meet the needs of the individual and empower them through a person-centered approach.
By reducing costs and improving the efficiency of care delivery, an oncology CNS can facilitate innovative practice, lower emergency room admissions, reduce the length of hospital stays, and support people in their choice of care.
Average Salary: $91,300 (according to Payscale in March 2022 for a CNS with skills in oncology)
6. Clinical Nurse Manager
The term clinical nurse manager is sometimes used interchangeably with a nurse administrator. However, there is a difference in the responsibilities and job duties. An administrator oversees several departments within an organization, while a clinical nurse manager supervises one or two units.
A clinical nurse manager provides clinical support and a safe, healthy environment for the nursing staff. The role of a CNS in a clinical nurse manager position includes making decisions that assist in the provision of patient care. This can include decisions regarding:
- Case management
- Educational planning
- Discharge planning
- Records management
A clinical nurse manager needs strong communication and leadership skills to coordinate resources and meet organizational goals. Clinical nurse managers are often employed by hospitals, but they can also work in doctor's offices, psychiatric institutions, rehabilitation hospitals, and schools.
A successful clinical nurse manager advocates for the nursing staff. They act as a nursing mentor to the staff instead of micromanaging decision-making.
Average Salary: $84,690 (according to Payscale in March 2022)
Discover New Opportunities as a CNS
Becoming a clinical nurse specialist means having many career opportunities. This role is perfect if you are looking for a position of leadership and career advancement with the opportunity to work in patient care.
The role requires completing a master of science in nursing program or doctor of nursing practice program. Getting a specialty nursing certification demonstrates an advanced level of commitment and knowledge. A CNS must also hold a registered nursing license after passing the National Council Licensure Examination for RNs.
CNS programs focus on a specialty area, such as pediatrics, adult health, acute care, and adult-gerontology. The programs cover advanced pathophysiology, assessment, pharmacology, and health promotion and maintenance.
The American Nurses Credentialing Center offers certifications in several specialty areas, including adult-gerontology, informatics, ambulatory care, cardiovascular nursing, and medical-surgical nursing.
While it is enticing to choose from some of the best-paying jobs for a CNS, there are other positions you may find as satisfying. Consider evaluating different options to meet your financial needs and professional goals.
Related CNS Resources
Page last reviewed February 18, 2022
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