Clinical Nurse Specialist: Education Requirements, Career Paths & Job Outlook
If you’re looking to advance your clinical skills and increase your influence in patient care, consider a career as clinical nurse specialist. With the extended education needed for this role, these certified nurse specialists are highly involved in patient treatment and diagnosing.
What Is a Clinical Nurse Specialist (CNS)?
A clinical nurse specialist is an advanced practice registered nurse (APRN) because of the graduate-level education they’re required to have. As an APRN, you must have a master’s or doctoral degree in nursing, which allows you to assess, diagnose, and manage patient problems, in addition to ordering tests and referring patients to treatment facilities.
Clinical nurse specialists aren’t the only type of advanced practice nurse. Other APRN careers include certified nurse practitioners (NPs), certified nurse midwives (CNMs), and certified registered nurse anesthetists (CRNAs).
Like other advanced nurses, clinical nurse specialists are able to focus on an area of 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
No matter what area you choose to pursue—and you can learn how to go about choosing your specialty below—you’ll be able to collaborate with all kinds of healthcare professionals, from entry-level nurses to physicians.
How do I choose an area of specialization?
The environment you’ll work in and the type of patients you’ll interact with are important factors when considering a specialization. For example, if you’re interested in improving the mental health care system, you might choose to specialize in psychiatric nursing. Your specialization should also be in line with your career goals and your personality traits. The American Nurses Credentialing Center (ANCC) offers 10 CNS specialization certifications including home health, pediatrics and adult health.
What Clinical Nurse Specialists 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 fully 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.
According to O*NET, you can expect to be responsible for myriad tasks on a daily basis:
- Collaborate with other healthcare professionals to optimize patient care, including consultations regarding patient discharge and clinical procedures
- Diagnose patient health problems
- Treat patients
- Order tests and evaluate them
- Advise other nurses
- Be a subject matter expert
- Research, develop, maintain, and train others in departmental policies, procedures, and patient care standards
- Promote disease prevention and wellness plans
- Develop and implement treatment plans
- Maintain patient records
- Change treatment plans as needed
- Keep abreast of advances in nursing and science
- Conduct research and share findings
Because of the wide scope of responsibility, the medical field benefits from these high-level nurses identifying gaps in the design and implementation of healthcare delivery.
Do clinical nurse specialists treat patients?
Yes, 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.
Can a CNS prescribe medication?
A CNS can sometimes prescribe medication, but it depends on the state in which you practice. According to the National Association of Clinical Nurse Specialists (NACNS), clinical nurse specialists can now prescribe medication in 19 states. In many cases, a CNS must get authorized to do so.
To see your state’s clinical nurse prescriptive authority, take a look at the NACNS scope of practice map.
Clinical nurse specialist vs. nurse practitioner
Both CNSs and NPs are advanced practice nurses with similar goals, though they do differ in subtle but important ways.
|Clinical Nurse Specialist||Nurse Practitioner|
|Practice Area||A CNS can be defined by specialty, population, type of health problem, or type of care||An NP is usually defined by population|
|Duties||A CNS is more likely to train nurses and serve as an expert consultants||It’s more common for NPs to write prescriptions|
|Licensing & Certification||Not all specialties have their own certification exam, but many can be certified through the American Nurses Credentialing Center (ANCC)||Certification is available through the American Nurses Credentialing Center and the American Academy of Nurse Practitioners (AANP)|
It’s also important to note that nurse practitioners tend to work with little to no supervision from physicians, meaning they work closely with patients, sometimes for many years. Clinical nurse specialists work in far more collaborative environments and are likely going to be responsible for seeing more patients over time.
How to Become a Clinical Nurse Specialist
The requirements for pursuing a CNS career are demanding, but this is understandable considering the impact the profession has. Research into the practice has demonstrated valuable outcomes, according to the NACNS:
- Reduced hospital costs and length of patient stay
- Reduced frequency of emergency room visits
- Improved pain management practices
- Increased patient satisfaction with nursing care
- Reduced medical complications in hospitalized patients
How long does it take to become a CNS?
The amount of time it takes to become a CNS varies by individual. Depending on whether you started with an RN-to-BSN degree or an RN-to-MSN degree, for example, would alter how long the education process takes. It also depends on whether you choose to pursue a master’s program or a doctoral degree in nursing.
On average, Master of Science in Nursing (MSN) programs take about 2 years to complete, while Doctor of Nursing Practice (DNP) programs can take 4-6 years.
Know that the minimum degree needed to be a clinical nurse specialist is a master’s, but no matter the program, you’ll learn about foundational nursing topics to serve as an APRN. Before earning a master’s or doctorate in nursing, you must first earn your Bachelor of Science in Nursing (BSN). Of course, be sure your program is accredited by the Commission of Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN).
As for courses, you’ll dive into topics such as ethics, research methods, physiology, healthcare systems management, and more.
No matter what specialty you choose, there are some basic requirements for all clinical nurse specialists.
- You must hold a current RN license.
- You must have an MSN, postgraduate, or doctoral degree.
- Your graduate program must include courses in:
- Advanced physical/health assessment
- Advanced pharmacology
- Advanced pathophysiology
- You must have worked a minimum of 500 supervised clinical hours in the population you’re specializing in.
Additional requirements may be needed for respective specialties, so make sure you research your area of interest. Certification is obtained by exam and is valid for 5 years.
Is financial aid available to help pay for my schooling?
Yes. The most common type of financial assistance is government aid. Before you can even be considered, you’ll need to fill out the Free Application for Federal Student Aid (FAFSA). In order to be eligible, the school or program you’re enrolled in must be accredited. You’ll also find other types of financial aid including scholarships, grants, private loans, and PLUS loans. Read up on ways to finance your nursing education.
Specialty certifications are available through various specialty nursing organizations, so it’s key to research the respective specialties you’re interested in. Depending on the population, disease, or other area you’re working with, here are some potential certifications:
- Adult Health
- Adult Gerontology
- Adult Psychiatric-Mental Health
- Child/Adolescent Psychiatric-Mental Health
- Home Health
- Public/Community Health
- CNS Core
- Diabetes Management-Advanced
Example: Adult-Gerontology Clinical Nurse Specialist Certification (AGCNS-BC)
The American Nurses Credentialing Center offers the Adult-Gerontology Clinical Nurse Specialist Certification, a great way to work with adult populations if you’re looking to do so.
With this certification, you’ll work heavily in health promotion and maintenance as well as differential diagnosis and disease management. This includes the use and prescription of pharmacologic and non-pharmacologic interventions.
Earning an AGCNS certification is done so by taking the certification exam through the ANCC, as long as you meet the basic requirements outlined in the educational requirements section above.
CNS Salaries & Job Growth
Given the breadth in clinical nurse specialties, salaries for this position may vary. CNSs must be registered nurses, and RNs earn a median annual salary of $70,000, according to the Bureau of Labor Statistics. Nurse midwives, which are also APRNs, earn a median of $100,590, while nurse practitioners earn $103,880.
APRNs are also looking at a job growth rate of 31% through 2026—more than 4 times that of the national average for all occupations.
Career Paths: How You Can Grow as a CNS
If you’re interested in growing your career as a CNS, it’s important to focus on education, research, and possibly consulting.
By taking continuing education courses or pursuing additional specialties, you can increase the scope of your understanding of today’s medical field. Similarly, conducting research and presenting your findings means you can increase your impact on fellow healthcare staff and patient care as a whole.
Consulting can also be a great option, as it gives you an opportunity to experience different environments, methods of care, opportunities for growth, and teaching techniques.
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