Clinical Nurse Specialist (CNS) Overview

Clinical Nurse Specialist Career and Degree Guide


A clinical nurse specialist position requires a combination of leadership and high-level patient care skills in an area of specialty.

If you’re looking for an advanced nursing role and have both clinical and leadership skills, working as a clinical nurse specialist (CNS) could be a great fit. CNSs are a type of advanced practice registered nurse (APRN).

They have advanced training that allows them to take on increased clinical tasks like diagnosing patients and prescribing medicine, but that’s not all. CNSs are leaders. They take on complex projects and help to improve hospitals and healthcare facilities.

A good CNS can have a significant impact on the culture and cohesiveness of a healthcare facility’s nursing team, says Manjulata Evatt, DNP, RN, CMSRN, an assistant professor and program coordinator at Duquesne School of Nursing in Pittsburgh, Pennsylvania. For example, the CNS is often the team member called upon to foster a positive work environment, encourage hard work, and keep morale high. 

“CNSs are prepared to use frameworks, models, and concepts to make the novice nurses more knowledgeable, more competent,” says Evatt, resulting in a team that’s empowered, skilled, and able to work well together.  

That’s just one example of the kind of impact you could have as a CNS. Intrigued? Learn more about this exciting and growing role.

What Is a Clinical Nurse Specialist?

According to the National Association of Clinical Nurse Specialists, a CNS is an APRN who has at least a graduate-level degree, such as a Master of Science in Nursing (MSN), which allows you to assess, diagnose, and manage patient problems, in addition to ordering tests and referring patients to treatment facilities. 

CNS: Part of the APRN Family


Clinical nurse specialists aren’t the only type of advanced practice nurses. Other APRN roles include:

  • Nurse practitioners (NPs)
  • Certified nurse midwives (CNMs)
  • Certified registered nurse anesthetists (CRNAs)

Like other advanced nurses and as their name implies, CNSs have a specialty. This specialty can be defined in a few ways:

  • Patient population
  • Medical setting
  • Type of disease
  • Type of patient care needed
  • Type of patient problem

CNSs also are leaders. As a CNS you’ll take on tasks like mentoring other nurses, training new nurses, implementing policies, and more. You’ll work within your hospital or healthcare system to promote positive changes in nursing and patient care. However, you’ll still see patients and do your own patient care. In fact, some CNSs are able to have their own practice where they see patients completely independently.

Choosing an Area of Specialization

As a CNS student, you’ll declare your specialization during your graduate degree program, and some of your courses will offer deep dives into your future specialty.

So, how do you choose a specialty? The environment you’ll work in and the type of patients you’ll interact with are important factors to consider when choosing a specialization. For example, if you’re interested in improving the mental health care system, you might choose to specialize in psychiatric nursing.

CNSs always work in an area of specialty.

Your specialization should also be in line with your career goals and your personality traits. For example, if you want to work in private practice, you might consider specializing in adult health or adult-gerontology. Conversely, if you’re interested in large-scale policy changes, you should consider a community health specialty.

Once you’ve chosen and studied a specialty, you’ll need to get certified. The American Nurses Credentialing Center (ANCC) as well as the American Association of Critical Care Nurses Certification Corporation (AACN) offer certifications for CNSs.

What Do CNSs Do?

The clinical nurse specialist job description is an extensive one. As an expert in the general practice of nursing as well as their specialty area, a CNS is dedicated to all parts of healthcare and patient outcomes. The role gives you the additional opportunity to focus on nurse management and nurse administration, which means getting the full picture of the nursing field. You can go well beyond the scope of a registered nurse: Instead of working with one patient at a time, you can implement policies that will improve patient care as a whole.

The desire to make these kinds of big-picture changes motivates many nurses to take on a CNS role, says Evatt. Many want to be able to take healthcare research findings and create programs that can positively affect their facilities and their patients. For example, they may consult studies that address lowering infection rates in hospitals, Evatt says, and work to create standardized practices that their care team can adopt in an attempt to create a safer facility.

Job Duties

Your duties will depend on your specialty and where you work, but you can expect to be responsible for a variety of tasks, including:


Advanced Patient Care

  • Diagnose patient health problems
  • Treat patients
  • Develop treatment plans
  • Implement treatment plans
  • Change treatment plans as needed
  • Order tests and evaluate them

Nursing Leadership

  • Advise other nurses
  • Serve as a subject matter expert
  • Collaborate with other professionals to improve patient care

Administration

  • Research, develop, and implement new policies and procedures
  • Conduct research and share it with a leadership team
  • Promote disease and wellness plans
  • Identify areas of need and create policies to address them

Do Clinical Nurse Specialists Treat Patients?

Clinical nurse specialists usually continue to both diagnose and treat patients. With their graduate-level nursing education, they’re experts in both nursing practice and their area of specialty.

An important part of being a CNS is the ongoing treatment of patients, as well as keeping their families informed of their progress. This also means educating patients and their loved ones about the patient’s health issues, especially since you’ll be treating patients within your nursing specialization.

In fact, the ability to continue that interaction with patients is part of the popularity of the CNS role.

“Many nurses prefer the job of a CNS so that they continue the practice with patients and the community,” says Evatt.

CNS vs CNL:
What’s the Difference?

Clinical nurse specialist and certified nurse leader (CNL) careers can seem very similar on the surface. They’re both advanced roles that provide leadership to nursing units and require at least a master’s degree. However, there are some key differences.

Clinical nurse specialists:

Certified nurse leaders:

  • Spend a lot more time seeing patients. They can prescribe medicine in 19 states and are able to provide advanced clinical care in all states.
  • Focus on policy and leadership. They might develop training or programs rather than seeing patients.
  • Often research and create policies that affect patient care outcomes or nursing standards.
  • Often create policies that help hospitals provide safe and cost-effect care.
  • Always have a specialty.

  • Don’t specialize. Rather, they work broadly, often serving entire hospitals or multiple units at once.

Can a CNS Prescribe Medication?

A CNS can sometimes prescribe medication, but it depends on the state in which they practice. According to NACNS, clinical nurse specialists can now prescribe medication in 19 states. In many cases, a CNS must be authorized to do so.

To see your state’s clinical nurse prescriptive authority, take a look at the NACNS scope of practice map.

CNS Educational Requirements

The requirements for pursuing a CNS career are demanding, but this is understandable considering the impact the profession has. Since a CNS is an APRN role, becoming an RN is your first step. After that, you’ll need at least an MSN degree to begin working as a CNS, and a doctorate degree can really help you advance your career. In fact, the NACNS has issued a statement recommending the DNP as an entry-level degree in the field by 2030. So you should keep the possibility of a DNP degree in mind when you plan your CNS career path.

Your degree will prepare you to take on the challenges of a CNS role. You’ll learn advanced clinical skills and you’ll study the theory behind the policies that shape healthcare.

How Long Does It Take?

The amount of time it takes to become a CNS varies by individual. You can take a few different routes, and some people choose to work in the field as an RN for a while before starting an MSN or DNP program. Once you decide to start, factors like your specific program or whether you attend full or part time will impact how long it takes. In general, MSN programs take about two years to complete, while DNP programs can take around four to six years.

A master’s degree usually takes around two years to complete.

What You Can Earn as a CNS

$82,380
Average Annual Salary for Registered Nurses like CNSs

Given the breadth of clinical nurse specialties, salaries for this position may vary. The U.S. Bureau of Labor Statistics (BLS) does not track salary data for CNSs specifically, although they do classify CNSs alongside registered nurses, who earn an annual salary of $77,460. RNs who are healthcare diagnosing or treating practitioners—such as CNSs—earn an average of $82,380, according to the BLS.


Written and reported by:

Stephanie Behring

Contributing Writer

With professional insight from:

Dr. Manjulata Evatt, DNP, RN, CMSRN

Assistant Professor/RN-BSN Program Coordinator, Duquesne School of Nursing