How to Become a Clinical Nurse Specialist

Clinical nurse specialists are advanced practice nurses (APRNs) who specialize in a particular field of practice or patient population, such as cardiology or pediatrics.

Clinical nurses are in high demand, like all APRN nurses; earn an above-average annual salary; and can choose from a wide variety of specializations. If this sounds interesting to you, find out how to become a clinical nurse.

Clinical nursing specialties can include cardiology, diabetes, pediatrics, mental health, wound care or emergency department care, to name a few. They work in a variety of settings, depending on their specialties, but most often in hospitals. Like all APRNs, they have greater professional autonomy than RNs and can diagnose conditions and prescribe treatments. However, unlike other APRN specialities, they focus on consolation, education, leadership, rather than direct patient care.

To become a clinical nurse specialist, you must become an APRN by earning an MSN from an accredited program and pass a certification examination in a general area, either adult/gerontology, pediatrics, or neonatal. After this, most employers will require additional certifications, based on your department.

When reviewing programs to find the right one for you, consider factors such as cost and financial aid, location or online options, admissions requirements, board examination pass rates, and reviews and recommendations.

To become a CNS, you will choose a primary population specialization of either adult/gerontology, pediatric, or neonatal nursing and must pass the certification examination for your chosen area. However, many hospitals or health systems, especially the larger ones, may require or strongly prefer additional specialty certifications, such as cardiology nursing.

Which population specialization you choose will depend on your interests and goals. While adult/gerontology serves the widest variety of patients, demand is high for all three specialties.

To become a CNS, you must first earn your RN license, pass your certification examination, and gain RN experience. Then, you can earn an MSN and pass your board certification exam to earn CNS licensure. You apply for your licenses with your state board of nursing, while examinations are administered by private organizations.

Once you’ve received your license, you can start work as a clinical nurse specialist. Use your professional and alumni networks and take advantage of professional association job boards to post your resume and find openings.

Clinical nurses work in a variety of settings, including hospitals and health systems, private practices, clinics, and government facilities. Their work involves precepting (teaching and mentoring) students, consulting with nurses, working on evidence-based projects to improve nursing, helping facilitate interprofessional collaboration, and leading the implementation of changes in nursing best practices. The BLS projects 45% growth for all APRNs, and CNS nurse jobs are likely to grow at approximately the same rate. Also like all APRNs, you can expect to earn an above-average salary, though the specifics will vary by location and experience.

It typically takes at least six years, four years for a BSN and two for an MSN. If you already have an ADN, you may be able to enroll in an RN to MSN program, which will take three years. If you study part-time or want to earn a DNP, you will need longer.

To become a clinical nurse specialist, you will need an MSN or DNP from an accredited program and must pass the specialty board certification examination and earn your state license. Most MSN programs require at least a 3.0 GPA. Some employers may require or strongly prefer additional specialty certifications.

The specific rules vary state by state, but most states do not allow CNSs to prescribe medication without physician involvement. In 19 states, CNSs can prescribe medication, though some states may require additional education. In 23 states CNSs have full-practice authority. In reduced or restricted practice authority states, you may need a physician’s supervision to prescribe medications or may not be able to.

The difference between a CNS and a nurse practitioner is where each role fits into the care team and their typical responsibilities. Both are APRNs, but NPs usually engage in more direct nursing than clinical nurse specialists and often serve as primary care providers. Clinical nurse specialists spend more time on precepting students, consulting with nurses, and improving evidence-based practices.