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Clinical Nurse Careers and Salary Outlook 2020

June 3, 2020 | Staff Writers

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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.

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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 obtained a master of science in nursing (MSN) or a doctor of nursing (DNP), 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.


  • What Do Clinical Nurses Do?

    Clinical nurses hold advanced education, training, and certification in specializations like obstetrics, emergency, and intensive care. They find work in hospitals, health centers, private clinics, and other settings, administering medicine, educating patients about their conditions, and serving as liaisons between patients and doctors. Clinical nurses do not always prescribe medicine or have the authority to do so.

    With enough experience, these nurses can assume roles as leaders. As clinical nurse managers, they oversee teams of nurses who provide direct care in a medical facility, and as clinical nurse leaders, they work with clinical nurse specialists, nurse practitioners, physicians, and other professionals to evaluate patient outcomes and ensure the implementation of evidence-based practices.

    In addition to educating nurses at community college and other institutions, clinical nurses instruct RNs at medical facilities to help improve patient outcomes. They earn clinical nurse salaries commensurate with their level of training and experience.

  • Where Do Clinical Nurses Work?

    Clinical nurses work in diverse settings based on their area of specialization. In the emergency room or critical care units, they serve as acute care specialists to treat pediatric, neonatal, trauma, or other patients in need of specialized critical care. In nursing homes, clinical nurses who specialize in gerontology can develop treatment plans and care protocols designed specifically for older adults.

    Clinical nurses work with multidisciplinary teams that include other nurses, physicians, pharmacists, and social workers. The work setting determines the scope of responsibilities. While still working in a clinical setting, some clinical nurses may assume teaching roles at two- or four-year colleges to develop and mentor the next generation of RNs. In this capacity, they plan academic programs that can equip nursing students with the education and training necessary to meet state licensure standards.

  • Skills That Could Affect Clinical Nurse Salaries

    Clinical nurses with skills in in-demand specializations enjoy robust employment and pay prospects. Some of the best-paying nursing specialties include clinical nurse educator, clinical nurse consultant, clinical nurse manager, and intensive care unit clinical nurses. The best-paying clinical nurses work in the neonatal intensive care unit, where they provide care to premature newborns and help develop and implement evidence-based care.

    As the nursing profession and healthcare field continue to evolve, clinical nurses with managerial skills play an integral role in improving patient care and outcomes. These leaders, such as clinical nurse managers and clinical nurse leaders, must demonstrate an ability to effectively manage others. They cultivate non-clinical skills like managing budgets, coordinating schedules, and handling personnel issues.


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 two years 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.

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 health, pediatrics, adult-gerontology, adult psychiatric-mental health, and child/adolescent psychiatric mental health.

Clinical Nurse Salaries and Job Growth

The U.S. Bureau of Labor Statistics projects a 12% job growth in 2018-28 for RNs, which is more than double the average growth rate forecasted for all occupations. The BLS also indicates that the 2018 median pay for RNs with a bachelor’s degree stood at $71,730. 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 $89,096, according to PayScale, and the most popular clinical specialties include acute care, intensive care unit, medicine/surgery, oncology, and geriatrics. Medicine/surgery tops the list of the three highest-paid of the five with $90,280 in compensation, followed by geriatrics ($89,336) and oncology ($88,6860). The highest salary locations for clinical nurses include New York City, Seattle, Los Angeles, and San Diego, according to PayScale. Those interested in this profession should factor in the cost of living in these areas.

Median Salary for Clinical Nurses by Career Experience

  • Entry Level: $81,000 yearly
  • Early Career: $86,000 yearly
  • Mid Career: $90,000 yearly
  • Experienced: $90,000 yearly
  • Late Career: $95,000 yearly
  • Source: PayScale

    Related Job Salaries
    Registered Nurse Registered Nurse, Operating Room Licensed Practical Nurse Registered Nurse, Emergency Room Registered Nurse, Critical Care
    $63,393 yearly $70,559 yearly $43,528 yearly $66,391 yearly $72,656 yearly

    Source: PayScale

    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 70,000 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 care management, and psychiatric-mental health nursing.
    • Nurse.com Job Search This website provides a specialized repository of job listings just for RNs. Nurses can sign up for a Nurse.com account for free and receive access to a simplified application process, job postings, job email alerts, and other resources.
    • 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.
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