Clinical Nurse Specialist Career and Degree Guide


CNS Degrees and Specialty Certifications

If a graduate degree is part of your educational plan, consider studying to become a clinical nurse specialist.

nurse specialist consults chart with four nursing staff
nurse specialist consults chart with four nursing staff

A clinical nurse specialist is an advanced practice registered nurse (APRN) career. That means you’ll have significant responsibilities and independence compared to a standard registered nurse (RN) role.

Like all APRN careers, you’ll need at least a Master of Science in Nursing (MSN) if you want to work as a CNS. An MSN program will teach you the advanced skills and in-depth knowledge you need to take on this challenging role.

A clinical nurse specialist degree program trains nurses to be true leaders in their healthcare facilities, putting them in positions to work closely with doctors and administrators to make meaningful changes in areas related to their specialty. CNSs act as leaders and mentors. As advanced practice registered nurses, they use their advanced skills to diagnose, treat, and monitor patients. They work in hospitals and other healthcare facilities. CNSs often take on tasks such as developing new policies and initiatives, overseeing safety measures, and leading departments. Some CNSs also work in private practice, especially in rural areas.

“(These nurses) are leaders. They are advocating for their patients, they are counselors and psychologists, and they are running their own practices,” says Manjulata Evatt, DNP, RN, CMSRN, an assistant professor and program coordinator at Duquesne School of Nursing in Pittsburgh, Pennsylvania. The (CNS) program has elevated the nursing practice, Evatt says, and allowed nurses to be true leaders in the profession. “This has happened (because of) these higher-level programs and degrees.”

What Degree Do I Need?

You’ll need at least an MSN to work as a CNS. Beyond that, earning a Doctor of Nursing Practice (DNP) can really help you in your career. No matter which option you choose, you’ll need an educational foundation first. This normally means you’ll need to have completed a Bachelor of Science in Nursing (BSN) degree and hold a registered nursing (RN) license. However, some MSN programs offer bridge degrees to nurses who currently hold an Associate Degree in Nursing (ADN). A bridge program can save you time and allow you to earn your BSN alongside your MSN.

You’ll need at least an MSN to become a Clinical Nurse Specialist.

Similarly, some DNP programs allow you to enter with a BSN degree. Just like the RN-to-MSN bridge, a BSN-to-DNP bridge can save you time by allowing you to earn your MSN alongside your DNP. You can also choose to enter a DNP program after earning your MSN.

The right path for you will depend on where you currently are in your education and career path and on how far down that path you want to go.

Master’s Program Curriculum

MSN programs enhance your nursing skills and advance your knowledge of what you learned while earning your RN license. Many MSN programs focus on things like nursing ethics and healthcare policy in addition to teaching advanced clinical skills. You’ll dive deep into the research and science behind the nursing practice, and you’ll learn the leadership skills you need to hold a high-level CNS role.

What You’ll Study in a Master’s Program

Advanced nursing practice

Nursing practice courses will teach you more in-depth clinical skills. This will allow you to have a broader scope of practice once you graduate.

Advanced
pharmacology

Since CNSs often have prescriptive authority, you’ll need an advanced understanding of medications and their treatment indications.

Healthcare policy

A CNS role is a leadership role. You’ll need to understand the policies behind the way healthcare facilities operate to serve as an effective leader.

Nursing ethics

You’ll delve deeper into ethics than you did in your BSN program and learn the theories behind the principles.

Nursing leadership

Leadership coursework focuses on the specific ways CNSs can be leaders in their facilities.

Since a CNS role is hands-on, your program will also include supervised clinical practice hours. The exact number of hours you need will depend on your state and program. However, to meet the standard set by the National Association of Clinical Nurse Specialists (NACNS,) a program will need to include at least 500 hours of clinical practice. 

Doctoral Program Curriculum

A DNP is a good way to advance your career. Plus, the degree is becoming more of the standard for CNSs. Right now, earning an MSN is still a solid choice if you want to pursue a career as a CNS. However, if you’re looking to pursue leadership in your CNS career or advance your scope of practice, a DNP might be the way to go.

In fact, NACNS has issued a position statement advocating for the DNP as an entry-level standard for CNSs by 2030. A doctoral program will also focus on a specialty and allow you to increase your clinical skills and further advance your knowledge base.

Just like an MSN, earning a DNP requires clinical hours, primarily focused on your specialty. The exact number of hours you need will depend on your program and state, but the NACNS requires at least 1,000 hours.

Are There Prerequisites?

Before pursuing a graduate degree to become a CNS, you must meet the following requirements:

  • BSN from an accredited nursing school
  • Active RN license
  • Completion of a statistics course with a satisfactory grade
  • Letters of recommendation
  • A personal statement explaining the reasons you want to become a CNS
  • Satisfactory score on the Graduate Record Examination (GRE)

What Will I Learn in My Courses?

Your graduate-level courses will depend on your program, school, and specialty. However, there are some basic classes you can expect to take. These include:

  • Advanced nursing roles
  • Health promotion
  • Clinical assessment
  • Pharmacology
  • Care planning
  • Nursing ethics
  • Nursing leadership
  • Community health
  • Pathophysiology
  • Clinical management

Getting Your Specialty Certification

The certification you need depends on your area of specialization and the state in which you’ll practice. Certifications are based on the population you work with and show that you’ve mastered the knowledge you need to work as a CNS.

There are a few options for certification. Both the American Nurses Credentialing Center (ANCC) and the American Association of Critical Care Nurses Certification Corporation (AACN) offer several nationally recognized certifications for clinical nurse specialists.

One popular certification is the Adult-Gerontology Clinical Nurse Specialist Certification (AGCNS-BC) from ANCC. The certification is a great way to work with adult populations. With this certification, you can work heavily in health promotion and maintenance as well as diagnosis and management of diseases. This includes the use and prescription of pharmacologic and non-pharmacologic treatments.

Other specialty certifications from ANCC include:

  • Adult Health CNS
  • Home Health CNS
  • Public/Community Health CNS
  • Adult Psychiatric-Mental Health CNS
  • CNS Core
  • Gerontological CNS
  • Pediatric CNS
  • Diabetes Management-Advanced
  • Child/Adolescent Psychiatric-Mental Health CNS

General requirements to take a certification exam include:

  • Having a current RN license
  • A master’s degree, post-graduate, or doctoral degree from a CCNE- or ACEN-accredited school
  • At least 500 faculty-supervised clinical hours
  • Graduate courses in pathophysiology, advanced health assessment, and advanced pharmacology

Choosing a Specialty

In addition to your basic graduate-level courses, you’ll also take classes in your area of specialization. For example: neonatal classes for nurses focusing on neonatal care, or gerontological courses for those specializing in gerontology. You’ll also need to complete clinical hours along with your coursework.

Choosing a specialty is a big decision, and it should be made after carefully considering the type of work you want to do and the particular population you want to serve.


“Nurses should think about (how) their education is going to help,” says Evatt. “Who is the population that really needs their knowledge?”


How Long Will Earning a Degree Take?

Depending upon your level of dedication, a CNS degree can take the following time to complete:

Master’s program: two years

Doctoral program: two (or more) years

Attending part time is usually an option at most schools, but some may have time limits on when you must finish the program. Remember, you’ll need a bachelor’s degree first. If you don’t have one, you can look for RN-to-MSN bridge programs in your area.

Are Online Programs Available?

You can study online, but keep in mind that nursing is very hands-on. Clinical nurse specialists need clinical hours to complete their degrees and to take any certification exams.

However, this doesn’t mean online learning isn’t an option. You can still take classes online to earn your MSN or DNP. When you enroll in an online program, you’ll take courses online and then be matched with a local healthcare facility to complete your clinical hours.

Is Accreditation Important?

Yes. Accreditation is always important. CNS degrees require an MSN or DNP, so you’ll need to earn them at a university. While universities and their programs are typically accredited, it’s a good idea to double check.

Two organizations accredit clinical nurse specialist schools: the Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing (ACEN). Your school’s website will list their accrediting agency. If not, you can search the CCNE or ACEN website and look for your school.

Is Financial Aid Available?

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.

How Much Can I Earn as a CNS?

CNSs have a wide range of job responsibilities, and their salaries reflect that. Currently, the U.S. Bureau of Labor Statistics (BLS) classifies CNSs under the category of registered nurses, who earn an average annual salary of $77,460. However, RNs like CNSs who are healthcare diagnosing or treating practitioners can earn a higher salary—an average of $82,380—according to the BLS.

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

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.

Continuing ed courses can help you further your career.

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.

Another way to grow? Consider using your voice in the field to create change in your community. Getting involved in healthcare policy, for example, can have a real impact on overall patient care.

“These are some of the things you do not learn at the undergrad level,” says Evatt. “You are aware, but you don’t learn it at a higher level. Only these MSN- or DNP-level programs can prepare you.”


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


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