Part of what makes the nursing profession rewarding is that you positively impact patient lives. The most straightforward way of doing this is by administering direct patient care, which includes diagnosing, treating, evaluating, and assisting patients as they manage acute or chronic health concerns. Other ways nurses make an impact include educating patients, performing clinical research, and directing the formation of health care policies.
If you are interested in a nursing career that incorporates all the above, you might want to learn more about the clinical nurse specialist (CNS) role. What is a clinical nurse specialist, exactly? What does the job entail? Let’s take a closer look at these questions and many others to determine whether the career path is right for you.
A clinical nurse specialist is an advanced practice registered nurse (APRN). Generally, the CNS has earned either a master’s- or doctoral-level degree in the nursing profession — meaning a higher level of knowledge and training is required than for other RNs. The role usually involves diagnosing patient problems and then developing and implementing treatment plans. In addition to providing direct patient care, clinical nurse specialists may perform or lead medical research. Clinical nurse specialists often work in health care management, which may include leading nursing teams or developing nursing policies for a hospital or medical institution.
What are the most common CNS specialties?
One thing that distinguishes the CNS profession is that clinical nurse specialists tend to work in specialty fields, providing direct, focused care. In other words, clinical nurse specialists are usually not found in generalist or primary care roles. Instead, they work in specialties such as:
● Women’s health
● Geriatric care
● Pediatric care
● Psychiatric or mental health care
● Wound care
● Rehabilitation services
● Pain management
● Critical care
How does the CNS role compare with similar roles?
As you contemplate whether a CNS position is right for you, it may be helpful to compare it with other, similar roles.
For example, the position is sometimes compared with the role of the certified registered nurse practitioner (CRNP). These two roles are extremely similar, with one significant distinction: The role of the CRNP usually allows you to deliver patient care in a more independent, autonomous way, whereas most clinical nurse specialists work in conjunction with other clinicians, including physicians who may provide some basic practice oversight. In other words, these roles are similar in their day-to-day duties but different in their level of independence.
Keep in mind that clinical nurse specialists typically begin their careers as registered nurses (RNs). The main distinctions between these roles include the level of training, education, and specialization, as well as the ability to lead teams or influence policy. If your goal is simply to care for patients each day, then you may find the RN position to be plenty rewarding. If you want a role with greater responsibility, then becoming a CNS could be a logical next step, allowing you to both care for patients and have more significant decision-making power.
The next step in considering a role as a clinical nurse specialist is to review the basic job description: What does a clinical nurse specialist do on a day-to-day basis? Answers may vary but generally encompass at least some level of patient care, which may include assessing and evaluating conditions, and ordering and interpreting diagnostic tests. The job can also involve providing leadership and support to a team of nurses or implementing change within an organization to ensure compliance with the latest standards of evidence-based care.
What are the primary responsibilities of the clinical nurse specialist?
One way to look closely at what clinical nurse specialists are and what they do is to divide the position into four basic roles: expert clinician, educator, researcher, and consultant. In becoming a clinical nurse specialist, your responsibilities may involve all four of these roles, though not necessarily in equal proportion.
The first of the four CNS roles is expert clinician. This is the part of the job that involves direct interaction with patients, including evaluation, treatment, and ongoing care management.
In some ways, this aspect of the job does not differ much from what you would do as an RN. The main distinction is that as a CNS, you have more advanced training in a specialized field of care. What this means is that your practice will focus more narrowly on geriatric care, pediatric care, oncology care, or a similar field. Because the role of the CNS encompasses the greatest expertise, it often means handling the more complex or difficult cases.
The clinical nurse specialist may also serve as an educator, which comprises education for not only patients and their families but also other nurses and technicians. Indeed, because the role of the CNS involves a higher level of training and clinical knowledge, it can often include instruction or coaching for other nurses under your supervision.
Additionally, as a clinical nurse specialist, you may be tasked with developing educational programs to be used in your organization, such as for onboarding new nurses or providing base-level knowledge in your field of specialty.
Clinical nurse specialists are also often involved in research. Note that clinical research often requires an advanced practice nurse to be on hand, advising patients, ensuring their safety, and disseminating treatment for trial participants with chronic or acute conditions.
As a clinical nurse specialist, you may participate on a research team or even lead your own research endeavors.
Finally, many health care organizations look to clinical nurse specialists for insight into improving standards of care and bringing their own practices into better alignment with the latest evidence-based methods.
As a CNS, you will have much sought-after knowledge that may help hospitals, clinics, or medical practices deliver better patient outcomes or improve internal efficiencies.
More specifically, clinical nurse specialists may be called upon to monitor operations and suggest improvements to accomplish any of the following goals:
● Reduce hospital/practice costs
● Decrease length of stay
● Minimize readmissions
● Reduce medical complications for inpatient care
● Increase patient satisfaction
● Improve pain management practices
Where do clinical nurse specialists work?
The job description and work environment of the CNS are highly variable. While a majority of clinical nurse specialists work in hospital settings, others find employment in the following practice environments:
● Private practices
● Nursing homes
● Rehabilitation facilities
Also note that clinical nurse specialists can sometimes find work in health corporations, where their role is to help research and develop new policies or standards of practice.
Having learned more about what a clinical nurse specialist is, we now turn to the next topic: how to become a clinical nurse specialist.
What are the steps to become a clinical nurse specialist?
Steps include the following:
1. Become an RN. A clinical nurse specialist is an APRN, which makes this an essential step. Becoming a CNS requires you to complete a degree in nursing, and then to become certified as an RN. This typically takes about two years. After you become an RN, you may immediately begin pursuing CNS credentialing, though it may also be helpful to practice as an RN for a few years, gaining some practical experience as a clinician.
2. Apply to advanced nursing programs. To become an APRN, you will need to pursue education in a certified program. This can mean completing either a master’s- or a doctoral-level program, though a doctoral-level education may earn you more prestigious job opportunities and a higher salary range.
3. Complete faculty-supervised training hours. You will need to amass 500 faculty-supervised hours of nursing care in your field of specialty (e.g., geriatric nursing, pediatric nursing).
4. Take the exam. Before you can become certified as a CNS, you will need to pass an exam that confirms your level of nursing skill. To find out more about these exams, seek details from one of the two primary accrediting bodies: the American Nurses Credentialing Center (ANCC) or the American Association of Critical-Care Nurses (AACN).
5. Apply for certification. You will need to fill out an application to practice as a clinical nurse specialist in the state of your choice. The application criteria may vary by state.
6. Keep your certification up to date. Once you begin practicing, you will need to renew your CNS certification once every five years. This will typically involve completing some continuing education hours, though the specifics can vary by state.
What are the key skills for becoming a clinical nurse specialist?
In determining how to become a clinical nurse specialist, another vital consideration is developing the right set of skills. Through RN practice, classroom education, and additional clinical hours, you can develop essential skills, such as the following:
● Analytical skills. Analytical skills will be invaluable to your role as a clinician, as well as consultant and policymaker. Being able to analyze symptoms is essential for formulating a patient diagnosis and ultimately a treatment plan. Likewise, to make improvements to health policies, it is important to be able to analyze current processes and results.
● Communication skills. Success in this field requires you to communicate treatment plans with your patients and their family members. You will also need to collaborate with other practitioners and educate or coach nurses on your team.
● Compassion skills. Even when your practice starts to focus more on policymaking than on direct patient care, empathy remains vital. Successful nurses can truly relate to what their patients are going through and convey the appropriate levels of empathy and concern.
● Leadership skills. The clinical nurse specialist showcases leadership to other nurses in the organization. Having leadership skills means knowing how to set a vision, inspire, and deal with conflicts on the team.
These are just a few examples of the kinds of skills that define what a nurse specialist is and that you should hone if you choose to pursue a career in this role.
What’s the best way to determine a nursing specialty?
Something else to think about as you make plans to become a clinical nurse specialist: You will ultimately need to decide which field of care you wish to focus on, whether that is pediatrics, geriatric care, or something else.
There is no right or wrong answer here; it all comes down to the type of care environment you wish to work in and the kinds of patients with whom you want to spend your time. For example, if you want to work in a psychiatric health care facility or if you feel passionate about helping the mentally ill, then psychiatric care makes the most sense. If you tend to feel uncomfortable around children, then pediatrics is a field to avoid.
Career goals are also important to consider. For example, if you ultimately want to have your own private practice, then pediatric or adult-gerontology care may be better options than more niche fields.
Now that you know more about what a clinical nurse specialist is and some of the requirements for becoming one, you may have some additional career-related questions. Information about the clinical nurse specialist salary, as well as the overall career outlook, is outlined below.
What is the typical clinical nurse specialist salary?
According to June 2021 data from PayScale, the median annual clinical nurse specialist salary is around $91,722.
Of course, several factors can determine your specific salary range, including the following:
● Level of experience. Generally speaking, clinical nurse specialists with more years of experience will command higher salary levels.
● Education level. Some positions may offer a higher salary range for those who have a doctoral-level degree than for those who have just a master’s-level degree.
● Geographic location. The clinical nurse specialist salary can also vary by geography, simply depending on the local demand for APRNs.
More generally, salary expectations for RNs can depend on the practice environment. The U.S. Bureau of Labor Statistics (BLS) indicates that RNs who have government jobs earn the highest salaries, followed by those who work in hospitals and then those who work in ambulatory health services. Those who work in schools or universities tend to have the lowest salaries.
What is the clinical nurse specialist job outlook?
It is also important to think about job outlook. That is, how easy will it be for you to find work as a clinical nurse specialist?
According to BLS data, the job market for RNs, including clinical nurse specialists, is growing at about 7% annually. This represents faster job growth than the projected average for all vocations, which is closer to 4%.
One of the many possible explanations for this is the expected physician shortage. As America’s population ages and as we see a rising need for health care providers who can assist with chronic disease management, the pool of doctors simply is not large enough to keep up with demand. APRNs can play a critical role in filling this gap; this may explain the optimistic job outlook.
As you determine whether this role is right for you, consider several factors. A good first step is establishing whether you are primarily interested in providing direct patient care or would feel more satisfied working as an educator, policymaker, or nurse leader. If you are in the former category, it might make just as much sense to become an RN or a nurse practitioner (NP). However, if you crave additional responsibility, the CNS trajectory may hold promise.
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