Clinical Nurse Specialist

What Is a Clinical Nurse Specialist?

A clinical nurse specialist (CNS) is an advanced practice nurse who has hands-on expertise, advanced knowledge, and a certification in a given specialty. The graduate-level nursing education and extensive training that the CNS must go through preparing them to practice autonomously and to adequately assess, diagnose, and manage patient problems. The type of specialty area that a clinical nurse specialist works in is defined by the patient population types that they're treating, the kind of care needed, the medical setting, or the type of disease or illness. Although they're both advanced nurses, clinical nurse specialists shouldn't be confused with nurse practitioners as their respective scopes of practice are different. Whereas nurse practitioners tend to carry out tasks like taking patients' health history and acting as their primary care provider, clinical nurse specialists usually tend to focus on research, education and consulting.

What Are Some Clinical Nurse Specialist Duties?

Common tasks and duties that are carried out by clinical nurse specialists include:

  • Design, implement and evaluate population-based as well as patient-specific programs of care
  • Work alongside other healthcare professionals to optimize patient care
  • Teach, mentor, advise other nurses
  • Supervise nurses and other healthcare staff
  • Act as an expert on the specific subject matter
  • Diagnose patient health problems
  • Research, develop, and help to maintain departmental policies, procedures, and standards
  • Stay current on new developments and conduct research within the respective specialty
  • Diagnose patient health issues
  • Order tests and analyzes them
  • Design tools which allow healthcare professionals to assess the quality of patient care and educational programs

Where Do Clinical Nurse Specialists Work?

RNs in CNS roles enjoy a wide variety of high-level employment opportunities in settings such as:

  • Hospitals
  • Community health centers
  • Medical/surgical units
  • Outpatient settings
  • Doctors' offices
  • Mental health facilities
  • Student health centers

How to Become a Clinical Nurse Specialist

The journey to becoming a clinical nurse specialist is a long and arduous one. CNS aspirants must know that they will be required to achieve a graduate-level education in nursing. While earning a graduate degree, students take courses in advanced pharmacology, advanced pathophysiology, and advanced physical/health assessment. Other prominent topics will include ethics, research methods, and healthcare systems management. Upon completing an MSN or DNP program, prospective clinical nurse specialists can apply for various CNS certifications such as adult health, pediatric health, and others through organizations such as the American Nurse Credentialing Center (ANCC) and the American Association of Critical-Care Nurses (AACN).

Step 1: Educational Requirements

To become a CNS, the following educational requirements must be met:

  • You must have successfully completed the NCLEX-RN exam
  • You must hold a currently active and unrestricted RN license
  • You must hold a Bachelor of Science in Nursing (BSN) degree
  • You must hold an MSN or DNP degree (DNP if you plan on focusing on research)
  • The graduate program must include courses in the following areas:
    • Advanced pharmacology
    • Advanced pathophysiology
    • Advanced physical/health assessment
    • Theory and ethics
    • Research methods
  • You must have worked at least 500 supervised clinical hours within the population you plan on specializing in

Do Clinical Nurse Specialists Need an RN Degree?

Not only do clinical nurse specialists need to possess an active and unrestricted RN license, but they must also have graduate-level degrees (i.e. MSN, DNP) and certifications in their respective specialty area.

Step 2: Required Clinical Nurse Specialist Certifications / Credentials

Clinical nurse specialists can become certified in the various specialties that are available through the American Nurses Credentialing Center (ANCC) or the American Association of Critical-Care Nurses (AACN).

The American Nurses Credentialing Center (ANCC) offers an Adult-Gerontology Clinical Nurse Specialist Certification (AGCNS-BC). Requirements for this certification are as follows:

  • Currently active and unrestricted RN license
  • Hold an MSN, postgraduate, or DNP degree which includes three separate courses in:
    • Advanced pharmacology
    • Advanced pathophysiology
    • Advanced physical/health assessment
  • Have worked no less than 500 supervised, clinical hours in a CNS role working with the population of the specialty

*Certification must be renewed every five years

The American Association of Critical Care Nurses (AACN) offers Clinical Nurse Specialist certifications in Adult-Gerontology, Pediatric, and Neonatal. Eligibility requirements are as follows:

  • Hold a current and unrestricted RN or APRN license
  • Completion of a graduate-level advanced practice education program at a nationally accredited school of nursing.
  • The curriculum must be consistent with the competencies of the specialty

Clinical Nurse Specialist Jobs, Salary & Employment

An aging population combined with a sharp rise in obesity - which has increased rates of heart disease and diabetes - are both contributing factors to the continued growth of the healthcare sector. Furthermore, nurses with the highest levels of training and education - which often include clinical nurse specialists - tend to be in the highest demand. According to a survey carried out by the U.S. Department of Health and Human Services, 91% of clinical nurse specialists were moderately or extremely satisfied with their work

Job Description & Information

  • Essential Skills Needed - Strong critical thinking skills, excellent leadership abilities, research skills, data analysis, diagnostic and assessment abilities, great communication skills
  • Job Outlook - Demand for advanced practice nurses such as clinical nurse specialists is projected to grow by an astounding 31% between 2012 and 2022. The fact that clinical nurse specialists can provide specialized care at a lower cost than physicians is a key driving factor in the increasing demand for these healthcare professionals.

What Is the Average Salary of a Clinical Nurse Specialist?

According to, the average annual salary for clinical nurse specialists is about $87,502. The earning potential of a CNS will depend on factors like location, how much experience they have, their employer, their education level, and the certifications they hold. Employee benefits that the CNS can expect to receive if employed full-time include medical, dental, vision, and prescription insurance coverage. They can also expect to receive some paid vacation/sick time each year - generally about two to four weeks.

How Much Do Clinical Nurse Specialists Make per Year?

  • $65,000 – $116,000 annually

How Much Do Clinical Nurse Specialists Make per Hour?

  • $39.66 average hourly wage

Clinical Nurse Specialist Resources