A clinical nurse specialist (CNS) is an advanced practice registered nurse who has a master’s degree or higher from a clinical nurse specialist program. CNS graduate education includes studying areas such as a selected clinical nursing specialty, medical research, ethics, health policy, health promotion, human diversity, organization and financing of healthcare, and social issues.
A primary defining characteristic of clinical nurse specialists is that they have clinical expertise in a specialty defined in one of the following terms:
- Population (such as children or seniors)
- Practice setting
- Medical subspecialty (such as diabetes or oncology)
- Type of care (such as psychiatric or rehabilitation)
- Type of problem (such as wounds, pain, or stress)
Clinical nurse specialists combine conventional direct patient-care nursing responsibilities with the ability to diagnose and treat medical conditions within their chosen specialty independent of physician supervision.
Becoming a CNS
The first step to becoming a CNS is to become a Registered Nurse (RN). Nurses then attend a clinical nurse specialist master’s, post-master’s, or doctorate program that offers training in areas such as:
- Acute care
- Adult health
- Adult/geriatric critical care
- Community health
- Geriatric health or gerontology
- Neonatal care
- Palliative care
- Pediatric health or pediatric critical care
Each state has its own licensing requirements for clinical nurse specialists and also defines the scope of practice of a CNS in the state.
Certification is available in some, but not all, CNS specialties. The American Nurses Credentialing Center (ANCC) offers CNS certification in the following specialities:
- Adult Health
- Adult Psychiatric and Mental Health
- Child/Adolescent Psychiatric and Mental Health
- Diabetes Management – Advanced
- Home Health
- Public/Community Health
Other certifications available to clinical nurse specialists include:
- Critical Care Nurse Specialist (CCNS) from the American Association of Critical Care Nurses Certification Corporation
- Orthopaedic Clinical Nurse Specialist – Certified (OCNS-C) from the Orthopaedic Nurses Certification Board
- Advanced Oncology Certified Clinical Nurse Specialist from the Oncology Nursing Certification Corporation
What Else to Expect from CNS Jobs
Clinical nurse specialists work in a range of health care settings, including hospitals, clinics, and private practice, schools, nursing homes, corporations, and prisons. They work in staff nursing positions, in administrative positions, and in leadership positions. A CNS might also provide expert consulting services for nursing staff or become involved in improving health care delivery systems.
A CNS is well-versed in evidence-based practice (EBP), is often a leader in translating research findings into patient care, and may be involved in activities such as evaluating research proposals, overseeing design of EBP studies, applying research results to practice, or coming up with new evidence-based standards and protocols.
The National Association of Clinical Nurse Specialists estimates that 69,017 Registered Nurses in the U.S. have the education and credentials necessary to practice as clinical nurse specialists. The report went on to show that annual CNS salaries generally range from $65,000 to over $110,000 depending on specialty and geographic location.