If you are aspiring to become a Clinical Nurse Specialist (CNS). Just know you will assume the responsibility not just to have an impact on a few patients’ lives but the power to change and shape an organization as a whole! Perspective students who enjoy leadership, research, and making decisions may find this role as a great career move.

Clinical Nurse Specialist smiling with nursesQuick Summary

Would you like a nursing career where you did not just accept standards but have the power to influence, improve and change standards of practice for the better? Then maybe you should consider a career as a Clinical Nurse Specialist (CNS).

At some point, nurses may ask themselves what would happen if they tried another process to improve patient care, or they may wonder why they are, performing duties a patient may not feel is beneficial for him or her. This is a clinical nursing research question CNSs seek to improve and change.

Recommended Degree Level: Masters of Science in Nursing (MSN)

License required: Registered Nursing (RN) License

Certification Available: American Nurse Credentialing Center (ANCC) offers credentialing for Clinical Nurse Specialists needing certification. The ANCC has 10 CNS certifications that Clinical Nurse Specialists can specialize in. From Adult Health to Adult-Gerontology the CNS has many new certifications to select from.

How much does a Clinical Nurse Specialist (CNS) make? The Median annual salary is $104,740*


Table of Contents

What does a Clinical Nurse Specialist (CNS) do?

The Clinical Nurse Specialist has the potential to play a significant role in ensuring the delivery of the best quality health services for the patient, the staff, the system, and the organization. CNS has the responsibility for providing clinical care with nursing practices in mind within a hospital or specialty clinic.

CNS focus on making sure patients are satisfied and ensuring improvements in nursing care are implemented. They utilize interventions with evidence-based nursing. While working closely with physicians to develop treatment plans and health promotions to help prevent the spread of illness for families, communities, and groups. The Clinical Nurse Specialist is a project leader and is held responsible for the outcomes of the results on patient care.

Many CNS work in management roles relied upon as problem solvers within their specialty area such as adult health, mental health, or even diabetes management.

Part of the role of CNS is researching new techniques to improve safety standards, improved patient care. CNS serves as a mentor and teacher for nurses and nursing students alike. CNS stays in constant communication with nurses to see what they can do to help improve the nurse’s job.

They also can work directly with patients to tailor, gauge what is working, what needs to be enhanced by collecting patient feedback. This data from patients and staff is valuable information while interpreting this data into a qualitative data form to be analyzed.

CNS attends meetings throughout the day with physicians, unit managers, nurse managers, healthcare staff, and additional experts to develop various projects with a common goal of passing policies that directly affect the CNS department and sometimes the entire hospital for the better.

Improved patient care always has an outcome, whether the patient had a good experience or perhaps less unsatisfactory experience is often related to the duties and responsibilities of the CNS role.

The Clinical Nurse Specialist will practice in a widespread of health care environments. Some provide direct patient care with the power to influence patient care outcomes as well.

They do this by providing expert guidance by taking on the role of consultant for the nurse staff. CNS additionally implements various small and significant improvements to the healthcare system.

They also incorporate nursing practice expertise that will focus on tending patients to aid in the prevention and resolution of illness for the patient. Many accomplish this within their area of specialty by providing medical diagnosis, treatment of injuries, disease, or disability.

According to studies published by the National Association of Clinical Nurse Specialists (NACNS) website the CNS have been known to exhibit patient and system and staff outcomes such as but not limited to:

  • A reduction in hospital charges as well as a decrease in patients’ length of stay
  • A drop in the number of emergency room visits
  • Improvements in overall patient satisfaction with the care from nurses
  • A reduction for hospitalized patient’s medical complications

Leadership responsibilities duties will fall into the CNS’s hands they were many hats and spend their days in between meetings and trying to complete projects that are in progress while tending to their units.

CNS plays the key role when planning, developing innovative interventions to provide optimal patient outcomes. Also, they must figure out what are the best ways to guide project teams to implement these changes and how best to be most effective within their role.

When a Clinical Nurse Specialist plans for these changes to move from the current state of health care to their desired state of health care, they must consider how these changes relate to the healthcare team, the patient, and clients.

According to the NACNS website many CNS who reported they work in hospitals have responsibility for more than one unit: These key findings are a result of 3,370 practicing CNS survey responses.

  • 21.8% of CNS reported they are responsible for one unit in a hospital
  • 39.89% of CNS said they are responsible for two or more units
  • 44.05% of CNS stated that they are responsible for the whole system

Within the CNS area of practice, CNS will assist with many activities and duties:

  • Helping patients to aid in the prevention of illness
  • Help with the medical diagnosis along with treatment plans of disease, disability, and injury.
  • CNS are also eligible to prescribe medications (i.e. pharmaceuticals or durable equipment) and have prescriptive authority in 37 states within the United States.
  • CNS will lead evidence-based projects within their practice area
  • Take on the role of educator to teach families and patients
  • Serving as a preceptor for student nurses
  • CNS may also provide transitional care
  • Lend their expertise knowledge with evidence-based practice (EBP) projects
  • Being the leading investigator of the research
  • Help assist with patient care
  • Serve as consultant and mentor for staff and nurses

What are the Roles and Responsibilities of the CNS?

No matter what setting a Clinical Nurse Specialist practices in they must always be watchful and observant for the need of maintaining and improving the quality of care of their patients, groups, communities, and families, this is considered the CNS defined by the population. The CNS will need to conduct continual monitoring with focused assessments that could help identify problems and issues.

While many are encouraged to think outside the box while being creative with their approach when looking into options to promote changes and practices. Innovative thinking gives the CNS helps to inspire others while allowing their general principles to foster creative thinking.

CNSs are viewed as experts within a particular clinical area and have three prime foci. This is additionally known as the three spears of influence:

The Patient/Families: Innovation and changes within the patient care system are core competencies and responsibilities of the CNS. Some may work directly with patients with face-to-face conversations giving patients and families the opportunities to ask questions about the health care treatment they are receiving and taking note of their feedback. They use their clinical expertise to provide care directly to patients to continuously improve the care of patient outcomes.

And ultimately interpreting patient results in the form of medical assessments while additionally speaking directly with them. CNS demonstrates clinical expertise with using evidence-based medicine while utilizing their advanced nursing theory practices.

CNS give preference and consideration to the patient’s current clinical condition when providing their clinical expertise they further develop patient treatment plans. Their role is to be the subject knowledge expert of their specialty and may develop education programs for patients. CNS emphasis is always on safety while being at the forefront of their patient-centered care.

The Staff: CNS develops and implements educational programs that educate nurses of new innovative routines, advanced nursing techniques according to their department’s specific needs. The educational programs developed by the CNS are used to improve patient care tailored to the CNS methods are provided under the CNS supervision.

They also take on the role of educator to teach nurses their advanced knowledge and specialized skills that may be necessary to perform improved techniques as well as routines in their specialty area. Clinical Nurse Specialists may find themselves working as consultants in other disciplines to assist with planning, developing, and executing clinical research.

The System/Organization: Depending on the CNS area of specialty, they may conduct a cost-benefit analysis for product changes within an organization. Sometimes these product changes can be more expensive, however; they may lead to improved outcomes for patients and staff.

Aside from when working within an organization often have projected and the annual budget that they are held accountable not to go over. Within a hospital, there may be many of these nurse practitioners collectively to contribute a broad perspective and work as a team effort for cost-saving improvements by implementing the best clinical practices.

CNS provide their advanced nursing care following the procedures and any protocols of the healthcare organization. CNS create performance improvement models in their advanced specialty area. The CNS will conduct research with the most current up-to-date research topics that directly affect the system, organization, and patient care. It is with this knowledge and methodologies they closely measure and evaluate outcomes to achieve changes and goals within the healthcare organization.


Salary and Job Growth

What is the median annual salary for CNS? The Bureau of Labor and Statistics (BLS) states Advanced Practice Registered Nurses (APRN) such as Clinical Nurse Specialists earn approximately $104,740 per year or $50.36 per hour.

What is my earning potential?

The BLS additionally reported that the top 10 percent of APRNs include CNS. They earned over $171,560 per year.

Where does most Clinical Nurse Specialist work?

According to a survey conducted by the National Association of Clinical Nurse Specialists (NACNS) located on their website CNS find employment in a vast number of settings, however, most CNS prime work settings are found in a hospital.

  • 59.45% of CNS reported working in a non-federal hospital
  • 4.0% of CNS said working in a federal hospital
  • 3.0% of CNS said working at a hospital for veterans
  • 6.57% of CNS work in nursing education, i.e. schools and universities
  • 6.93% of CNS work in ambulatory care


What education will I need to become a CNS?

Pursuing a career as a  Clinical Nurse Specialist will put you within the elite group of the population who hold Masters’s Degrees.

To become a CNS you will need first to be a registered nurse (RN). To become an RN you will need to sit for your NCLEX-RN exam. Next, if you successfully pass your NCLEX-RN exam, then you can then apply for your nursing license within the area you wish to practice in.

Beyond your nursing license, you will need both a BSN along an MSN degree. Your BSN degree nursing program will take four years to complete. Your MSN nursing program will need to be from an accredited MSN school. There are many CNS MSN nursing programs available. Typically if you attend on a full schedule, you should be able to earn your Master of Science in Nursing within two short years.

Once you have completed your CNS nursing program, you will need to take your state examination with your State Board of Nursing. Or you can apply for your Advanced Practice Nursing licensure with The American Nurses Credentialing Center (ANCC). They offer over six certifications for the CNS to specialize in.


Career Outlook

The job outlook for CNS and nursing in general for that matter is excellent with no sign of changing shortly. The nursing specialty of Clinical Nurse Specialists is expected to grow much faster than average within the U.S. Whether CNS work within in a hospital setting or ambulatory care setting CNS will continue to be in high demand.

Read also – Registered Nurse to Bachelor of Science in Nursing – RN to BSN Guide

Check out our other Nursing School Guides.