Think of it as a role that allows you to develop close to a 360° vision at work to optimise healthcare delivery from diverse perspectives. Clinical Nurse Specialists are advanced practice registered nurses (APRNs) with higher education, clinical training and certification in a specialty area. Working for... Continue Reading
USA 
UK 
Explore Career
What are the typical responsibilities of a Clinical Nurse Specialist?
A Clinical Nurse Specialist would typically need to:
When employed in hospitals and clinics, CNSs are typically assigned to deliver direct patient care related to their specialty. Given the diverse roles that Clinical Nurse Specialists play, their work environments vary with specific jobs, their setting, skill set and employer, and the responsibility they fulfil at any point during the day.
You must adapt to a fast-paced and complex environment if you work in critical care and emergency units. Depending on your specialty, you may also provide neonatal care or nursing services in the oncology department. Working in outpatient healthcare facilities, you may care for women's health and patients' mental health or deliver primary care. If you specialise in caring for patients with specific chronic conditions, such as diabetes or hypertension, you help them develop and implement personalised treatment plans. If you work in long-term care facilities, such as nursing homes, you will likely care for elderly patients and collaborate with their caregivers. You may provide services across multiple departments in a healthcare facility if required.
Depending on their responsibilities, Clinical Nurse Specialists use various equipment, from a basic stethoscope to portable diagnostic equipment and in-room equipment, including automated IV pumps, patient-controlled analgesia pumps, and wound and other drainage systems. You may need training and certification to use complex machines, such as ventilators and blood gas monitors. Some specialty areas may require specific equipment, such as a peak flow system for asthmatic patients.
Whether performing clinical duties, engaging in administrative work or exercising leadership, Clinical Nurse Specialists collaborate closely with physicians, other nurses, pharmacists, physical therapists and other healthcare professionals, to all of whom they may also provide expert consultancy.
Clinical Nurse Specialists who engage in research may work in laboratories or collect data through observation, interviews of patients, caregivers and staff and other methods. As clinical educators, they guide and train new nurses and other healthcare staff. Those with a master’s or PhD degree must know they can work alongside administrative departments and staff, including managers, supervisors, department secretaries and researchers.
Clinical work may expose you to diverse risks, such as workplace violence, pathogens and chemicals. Hence you must receive and apply safety training as well as wear personal protective equipment (PPE) as required or recommended.
Clinical Nurse Specialists may expect to work more than 40 hours a week. Since they provide direct patient care, they may be placed on shifts and may also need to be on call to attend to emergencies, which means they may work late nights and early mornings, and on holidays and weekends. Newly hired nurses may work a few days a week but in twelve-hour shifts.
While you must discharge clinical duties in person, Clinical Nurse Specialists may work part time or have some flexibility to schedule their working hours in research, administrative, educator or leadership roles. Research suggests that flexible hours and generous telework policies, where possible, appeal more than salary to the younger generation. There has been an incremental increase in employers willing to give promising employees a chance to adjust their schedules per the job demands.
Finding a new job might seem challenging. Clinical Nurse Specialists can boost their job search by asking their network for referrals, using online job boards, registering with nurse recruitment agencies, contacting healthcare facilities and other employers directly, going to job fairs and leveraging social media.
Clinical Nurse Specialists are generally employed by:
Healthcare associations, such as the National Association of Clinical Nurse Specialists (NACNS), provide unparalleled networking and educational opportunities. They offer all the certification courses members will need throughout their professional careers. Affiliated Clinical Nursing Specialists may attend conventions, seminars, and dinners frequented by peers, mentors, and other industry leaders. The events help them keep up with the latest breakthroughs and developments in the field, including plum jobs.
You may find that your national association holds membership with the International Council of Nurses (ICN), which automatically opens up membership advantages to you.
Summer internships, part-time work at an entry-level position or short-term paid/voluntary work offer a taste of the career, give valuable insight into how a healthcare facility operates, help build useful contacts and improve one’s prospects of getting a permanent job.
The experience may also help determine whether the public, private or voluntary sector is best suited to realise one’s ambitions. Your educational provider’s career service department can provide information about viable opportunities for work placements, internships and voluntary work in diverse sectors.
Once you acquire your state nursing licence as an RN (registered nurse) by passing the NCLEX-RN, you can begin to acquire the requisite experience in nursing roles before going back to school for a master’s or doctoral degree. Nursing experience and learning from expert nurses and medical professionals also help transition to leadership responsibilities later as a Clinical Nurse Specialist.
Newly licensed registered nurses may opt to join a nurse residency program lasting 6 to 12 months offered by major healthcare institutions and university hospitals. Such programs provide nursing residents with a structured way to transition into clinical practice, acquire experience and foster practical skills, such as critical thinking, analytical and evidence-based decision-making. The residency is typically a blend of hands-on work and classroom learning through which you learn to deliver patient care, interact with caregivers and work as part of a healthcare team within the framework of institutional guidelines.
Experience in management and leadership is useful for aspiring Clinical Nurse Specialists. The CNS path is particularly suited to nurses referred to as their team's go-to nurse and those with some experience or interest in research and evidence-based practice.
After acquiring their MSN (Master of Science in Nursing) or DNP (Doctorate in Nursing Practice) degree, aspiring Clinical Nurse Specialists must complete at least 500 hours of clinical experience in their chosen specialty area in a suitable setting and supervised by a faculty member or qualified CNS preceptor to qualify for the relevant certification exam. CNS candidates will benefit from tasks outside of the classroom that line up perfectly with lessons inside it. One may hear countless stories from more experienced professionals and obtain valuable hands-on experience when they turn seemingly routine incidents into unique learning moments. Since different specialities may mandate different requirements, exercise due diligence before choosing your specialisation and area of practice.
Even while in high school, you can check with a teacher or counsellor about relevant work-based learning opportunities available in your school or community that can help you connect your school experiences with real-life work.
Join some groups, try some hobbies or volunteer with an organisation of interest, so you can have fun while learning about yourself and be directed toward a future career.
Read about the profession and interview or job shadow experts working as Clinical Nurse Specialists to prove your commitment to course providers and prospective employers.
You may also acquire valuable experience working as a travel nurse in temporary nursing assignments, especially if you are free of family responsibilities at the start of your career.
The first step to becoming a Clinical Nurse Specialist is acquiring a BSN or Bachelor of Science in Nursing degree from a college or university accredited by the Commission on Collegiate Nursing Education (CCNE) or the National League for Nursing Accrediting Commission (NLNAC). The next step is to pass the standardised licensing exam administered by your state nursing board, which qualifies you to become a registered nurse (RN). Acquiring clinical work experience for at least a year is advisable before you apply for admission into a two-year accredited Master of Science in Nursing degree program (MSN).
A master’s program typically comprises various health-related courses, including advanced health assessment, disease prevention & healthcare, pathophysiology, pharmacology, acute illness assessment and treatment theory. Other courses include public healthcare policy, statistics & reasoning, program development & administration, ethics and philosophy of nursing, and its practical applications. Usually, there is also a clinical component to complete at a local hospital.
Once you graduate from a master’s program or complete a doctorate in nursing practice (DNP), you must pass the mandatory certification exam in your specialisation to qualify as a Clinical Nurse Specialist.
Remember that completing a particular academic course does not guarantee entry into the profession. Be that as it may, professional qualifications and transferable skills may open up more than one door.
Do your homework and look into all available options for education and employment before enrolling in a specific programme. Reliable sources that help you make an educated decision include associations and employers in your field.
It is advisable for aspiring Clinical Nurse Specialists to take high school courses in biology, chemistry, psychology and mathematics. English and speech classes will help you develop your research, writing and oral communication skills. Courses in business and economics can help you understand how the overall health system works.
Certification demonstrates a Clinical Nurse Specialist’s competence in a skill set, typically through work experience, training, and passing an examination. When acquired from an objective and reputed organisation, certification can help you stand out in a competitive job market and carry a significant salary premium of up to 18 per cent. Successful certification programs also protect public welfare by incorporating a Code of Ethics. You must fulfil continuing education (CE) requirements to revalidate your certification.
State nursing boards and healthcare organisations typically require Clinical Nurse Specialists to acquire certifications in their chosen specialty. Check with your state board which certifications they accept and confirm with certification bodies their specific prerequisites for certification, which vary from one to the other.
Typically, you must have passed the National Council Licensure Examination-Registered Nurse (NCLEX-RN) after you acquire your Bachelor of Science degree in Nursing (BSN) and hold an active RN licence. You must also have a master’s degree with an emphasis in clinical nursing (MSN) or a doctorate in nursing practice (DNP) and the requisite clinical experience to be eligible for the certification examination.
During your studies, you should have completed core competency courses in advanced physical/health assessment, pharmacology and pathophysiology, and at least 500 clinical hours in your medical subspecialty or working with a specific patient population and supervised by faculty.
National organisations that offer relevant certifications recognised by state boards of nursing include the American Nurses Credentialing Center (ANCC), National Certification Corporation (NCC), Oncology Nursing Certification Corporation (ONCC) Certification, American Association of Critical-Care Nurses (AACN) and Hospice and Palliative Nurses Association (HPNA).
You may obtain certifications with respect to a specific setting, patient population, medical subspeciality or kind of patient care. Certification areas include gerontology, adult health, women’s health, neonatal care, paediatrics, critical care, diabetes, oncology nursing, hospice & palliative care, adult/child/adolescent psychiatric & mental health, home health, and public or community health.
Since licensure requirements vary from state to state, practice as a CNS requires you to meet those of your particular state licensing board. You may need an Advanced Practice Nursing licence if mandated by your state nursing board. Stay current with changes to certification and licensing requirements.
Each state establishes regulations governing the role and the scope of practice as a CNS, including whether you can prescribe medication independently or in collaboration with a physician.
Clinical Nurse Specialists may also need to undergo an employment background check including but not limited to a person’s work history, education, credit history, motor vehicle reports (MVRs), criminal record, medical history, use of social media, and drug screening.
Performance, experience, and the acquisition of professional qualifications drive career progression. Employees with consistently high levels of performance may be eligible for promotion every two to three years.
As experts in nursing, Clinical Nurse Specialists chalk out their career path based on their specialty area. For instance, you may join a nursing home for the elderly or a long-term healthcare centre if you are a specialist in geriatric nursing. If certified in women’s health, you will likely work in the maternity ward of healthcare facilities.
Clinical Nurse Specialists may progress as experts in their field by taking on leadership and administrative responsibilities and becoming educators in addition to providing direct patient care. You may even make mentoring nurse coworkers the major part of your role, which can be a rewarding experience and measurable in terms of improved patient care.
You may also take up research roles with your expertise in evidence-based nursing and by acquiring a Doctor in Nursing Practice (DNP) degree.
With experience, you may advance to higher roles in research, management or administration, such as directing research projects, recruiting and training new nursing staff and working alongside other health professionals to set and achieve clinical standards in your area of specialisation.
You may eventually launch your business and provide consultancy services to diverse organisations engaged in healthcare. You may also share your research or work by getting it published in peer-reviewed books or journals.
The desire to accelerate career growth and personal development has an increasing number of millennials choosing to job hop and build a scattershot resume that showcases ambition, motivation, and the desire to learn a broad range of skills.
Studies prove that job hopping, earlier dismissed as “flaky” behaviour, can lead to greater job fulfilment. Employees searching for a positive culture and interesting work are willing to try out various roles and workplaces and learn valuable, transferable skills along the way.
Candidates with the necessary clinical, leadership and administrative skills, clinical experience, a master’s or doctoral degree in nursing, an active RN licence and specialised certification have the best job prospects.
Continuing professional development (CPD) is essential for public well-being and career progression in the healthcare sector. It embraces several new learning objectives, educational methodologies, and novel technological developments, especially in education, management and IT.
Reflective learning, interaction with peer groups, comprehensive inclusion, workshops and professional publications educate, influence, support and foster lifelong enlightenment in all career-grade Clinical Nurse Specialists.
In addition to offering the opportunity to continually upskill, regardless of one’s age, job or level of knowledge, CPD also enables the renewal of desirable certifications, which increase your chances of advancement and becoming an independent consultant. CNSs must typically renew their specialty certification every five years. Another acceptable certification renewal criterion is publishing your reports in peer-reviewed books or journals.
If you wish to enter research and contribute to improving healthcare processes on a wider scale, you may pursue a Doctor of Nursing Practice program or DNP. A doctorate helps you progress in your career and will put you in an advantageous position if it becomes the required qualification for the role of CNS in the future.
You may join a professional association to benefit from their industry resources and continuing education and networking offerings, such as workshops, seminars, webinars and conferences, to stay current with the advancements in the field. You can also update yourself and your organisation by reading professional journals and sharing research on the most recent evidence-based improvements and practices related to healthcare.
Scope of Practice
Clinical Nurse Specialists acquire expertise and practise in a defined specialty area in which they have acquired certification following their master’s degree or doctorate. The scope of their work has established parameters related to a specific population, such as children or adults, a health speciality, such as diabetes or gynaecology, or a setting, such as the critical care unit or emergency room. Their expertise enables them to deliver patient care and serve as consultants and coaches to other healthcare professionals within their specialty.
Some Types of Clinical Nurse Specialists
Working in their specialty area, Clinical Nurse Specialists deliver patient care, provide education and support to patients and their caregivers, and train other healthcare professionals.
Adult Health CNS: Working typically in multispecialty hospitals, clinics, nursing homes and long-term care facilities, they look after the medical needs of adult patients with diverse acute or chronic illnesses, such as coronary disease, diabetes and respiratory disorders.
Paediatric CNS: Working typically in paediatric hospitals or clinics, multispecialty healthcare facilities and schools, they focus on caring for children, ranging from newborns to adolescents, with various health conditions.
Gerontological CNS: Working typically in long-term care facilities, nursing homes, assisted living facilities and hospitals, they tend to the medical needs and care of older adults with age-related conditions, such as dementia, and chronic health issues, including heart disease, diabetes and arthritis.
Oncology CNS: Working typically in hospitals, clinics and cancer centres, they focus on the care of cancer patients with cancer, which includes diagnosis, treatment and symptom management.
Psychiatric-Mental Health CNS: Working typically in psychiatric hospitals, community mental health centres and private practices, they care for patients with mental health issues, including depression and schizophrenia.
Neonatal CNS: Working typically in neonatal intensive care units (NICUs), birthing centres, maternity clinics and multispeciality hospitals, they look after newborn infants, including premature babies or those with complex medical issues.
Women's Health CNS: Working typically in obstetrics and gynaecology clinics, women's health centres and multispecialty hospitals, they focus on women’s health across the lifespan.
Critical Care CNS: Working typically in intensive care units (ICUs), emergency departments, and trauma centres, they deliver medical care to critically ill patients.
Advanced Practice Registered Nurse (APRN)
An Advanced Practice Registered Nurse (APRN) holds a master’s degree in nursing or a doctorate and has passed the relevant national certification exam. The four types of ARPNs are the certified registered nurse anaesthetist (CRNA), certified clinical nurse specialist (CNS), certified nurse-midwife (CNM) and certified nurse practitioner (CNP).
The Three Spheres of Influence
Patient Sphere: Direct patient care in diverse settings falls within this sphere. Clinical Nurse Specialists typically collaborate with other nurses, consulting with them and other healthcare professionals to improve and implement plans of care based on evidence-based recommendations within their speciality area.
Nurses/Nursing Sphere: Influencing patient outcomes by advocating and incorporating evidence-based practices and changes into nursing operations fall within this sphere. CNSs aim to apply cutting-edge scientific research to daily clinical practice. They do so by engaging with nursing staff within their specialty area to discuss their work and derive potential research questions while, in turn, coaching them to adopt the latest scientifically proven practices rather than just those that are in customary use.
System/Organisational Sphere: Using their expertise to influence the future of the overall healthcare system falls within this sphere. Recognising the growing complexity and costs of healthcare, CNSs may conduct cost-benefit analyses of upcoming medical products, procedures and programs and also evaluate preventive protocols. Their independent but evidence-based findings can be integrated into medical policy.
Related Alternative Careers
Registered nurses (RNs) typically require only a bachelor's degree to work, unlike Clinical Nurse Specialists. However, like CNSs, they may specialise in a medical field, such as neonatal nursing and cardiovascular nursing. Similar to CNSs, physician assistants must hold a master's degree. However, they carry out many of the duties of physicians working under their supervision.
The Role of Clinical Nurse Specialists Worldwide
Equipped with advanced and specialised knowledge, skills, aptitude and qualifications, Clinical Nurse Specialists in the US carry out their duties in diverse healthcare settings. However, the role has varying job descriptions and titles worldwide, such as Clinical Nurse Consultant, or may not even possess a protected title. What may be common to the role in its various forms is the need to acquire postbaccalaureate qualifications, which likely lead to certification, since job responsibilities include delivering patient care to vulnerable patients and those with complex conditions, educating and mentoring nurses and other healthcare professionals, and bringing about innovation and evidence-based improvements in healthcare systems to achieve optimal outcomes for patients/populations.
There is a global need for what a CNS does, but formally implementing the role across countries and settings requires supporting relevant education and regulation. The challenges in formalising the role include securing title protection, defining the scope of practice and core competencies, establishing educational standards and the requisite theoretical curriculum, practicum, certification and regulation. For global recognition of their role and success in delivering their services and to promote wellness universally, CNSs must be accessible to the public, and their role must be integrated into healthcare systems and patient care.
Current Scenario
The employment outlook of a particular profession may be impacted by diverse factors, such as the time of year (for seasonal jobs), location, employment turnover (when people leave current jobs), occupational growth (when new roles are created), size of the occupation, and industry-specific trends and events that affect overall employment.
While data specific to Clinical Nurse Specialists may not be available, the employment of Registered Nurses and other categories of Advanced Practice Registered Nurses (nurse anaesthetists, nurse midwives and nurse practitioners with similar education and training to CNSs) is expected to grow over the next few years. Qualified, compassionate and diligent nurses play critical roles in caring for patients, assisting physicians and other healthcare professionals, and keeping healthcare systems and institutions running smoothly.
The pandemic created a spurt in the demand for nurses. In addition, the ageing generation of baby boomers that lives longer thanks to medical advances but deals with reduced health and mobility also needs nurses. With a more precise definition and better regulation of their qualifications and scope of practice, Clinical Nurse Specialists may play increasingly pivotal roles across countries and medical facilities.
Potential Pros & Cons of Freelancing vs Full-Time Employment
Freelancing Clinical Nurse Specialists have more flexible work schedules and locations. They fully own the business and can select their projects and clients. However, they experience inconsistent work and cash flow, which means more responsibility, effort and risk.
On the other hand, full-time Clinical Nurse Specialists have company-sponsored health benefits, insurance, and retirement plans. They have job security with a fixed, reliable source of income and guidance from their bosses. Yet, they may experience boredom due to a lack of flexibility, ownership, and variety.
When deciding between freelancing or being a full-time employee, consider the pros and cons to see what works best for you.
With their advanced knowledge, skills and experience, Clinical Nurse Specialists are crucial components of healthcare systems. They deliver direct patient care and manage nursing teams, procedures, practices and facilities. Using results-driven strategies and guiding the deployment of evidence-based treatments, they influence and implement improvements to optimise the well-being of patients. The bonus they earn each day is deep satisfaction from a job well done and sincere respect from the public for the ethical discharge of nursing responsibilities.
The field of nursing holds diverse opportunities. Before you choose a path, consider what you are passionate about - direct patient care, in which case, aim to become a Registered Nurse (RN) or a Nurse Practitioner (NP), or if you wish to add on the responsibilities of leadership, policymaking and educating others to your portfolio, in which case, aim to become a Clinical Nurse Specialist. Be aware that as a CNS, you must monitor not only the health of patients but also the functioning of the system and staff.
Nurses working in public health may use portable water collection systems to evaluate groundwater for the presence of chemical contaminants or bacteria.
What do Clinical Nurse Specialists do?
A Clinical Nurse Specialist would typically need to:
Accredited
$40,558
.jpg)
