How to Become a Clinical Nurse Specialist

A degree may open the door to a variety of opportunities and diverse career paths. The degree programs offered at CTU will not necessarily lead to the featured careers. This collection of articles is intended to help inform and guide you through the process of determining which level of degree and types of certifications align with your desired career path.

Even though nurses may love their work as patient caregivers, some of these health care professionals may want to continue progressing in their field. One option for advancement, while continuing in-patient care, is becoming a clinical nurse specialist (CNS). CNSs have been a part of the health care industrial complex in the U.S. for over 60 years and provide safe, low-cost and effective evidence-based health care services to those seeking medical attention. CNSs provide direct care to patients in a number of specialties and work in a wide variety of health care settings. The CNS can hone their area of clinical expertise based on nursing experience and area of clinical interest.¹

Skills and Characteristics

Because clinical nurse specialists work closely with a mixture of physicians, nursing staff and patients, they should develop strong interpersonal skills. A CNS should be able to satisfy nine core advanced practice competencies. These competencies include direct care, consultation, system leadership, collaboration, coaching, research, ethical decision-making, moral agency and advocacy.²

CNSs also may be overseeing the care of multiple patients who have complex health situations.¹ Superior communication skills can be elemental when relaying this complicated information to patients, their families, other health professionals or even administrators. A clinical nurse specialist should also be an enthusiastic worker with the ability to lead, manage, educate and coach.²

Required Education

A clinical nurse specialist career begins as a registered nurse (RN) with a Bachelor of Science in Nursing (BSN) degree, and then needs to complete the minimum of a Master of Science in Nursing (MSN).¹ Some suggest that a doctorate in nursing will become the required educational level for future CNSs.³ With continued physician shortages expected to worsen over the next decade, advance practice registered nurses, including clinical nurse specialists, may expect to find themselves increasingly busy.⁴

The official organization for clinical nurse specialists, the National Association of Clinical Nurse Specialists (NACNS), was formed in 1995 as a professional organization for CNSs. This organization, which credentials 2,000 members, provides continuing education to CNS candidates and active practitioners via its website.⁵

Certifications and Licenses

All CNSs must be licensed in the state in which they work. For certification credentials, the American Nurses Credentialing Center (ANCC), a branch of the American Nurses Association (ANA), provides certification for clinical nurse specialists. To keep certification active and valid, a CNS must recertify every five years with 75 continuing education hours. Twenty-five of those hours must cover pharmacotherapeutics.⁶ There are several certification specialties for clinical nurse specialists through the ANCC, including:

• Adult Health CNS
• Adult-Gerontology CNS
• Adult Psychiatric–Mental Health CNS
• Child/Adolescent Psychiatric–Mental Health CNS
• Pediatric CNS⁷

Job Market for CNSs

Because of the level of education required to become a CNS, the career falls under the category of advanced practice registered nurse. The highest employment level estimates depend on geographic area, with New York, California, Florida, Texas and Ohio leading across the country.⁸

The U.S. Bureau of Labor Statistics shows a positive outlook for APRNs in the coming years as a result of increased emphasis on preventative care and the aging baby boomer population.⁹ According to the NACNS, as of 2013, over 72,000 clinical nurse specialists have successfully achieved the education and earned the credentials necessary to work in their chosen profession.¹⁰

What to Expect on a Day-to-Day Basis

CNSs are expected to provide an advanced level of care, leadership and systems innovation in their chosen workplace, whether in a hospital or other clinical setting. The daily routine might vary for each clinical nurse specialist depending on the specialization. However, across all specialties, a CNS can be expected to take on responsibilities including patient diagnosis, treatment and on-going management. Their expertise may also be consulted to help support fellow medical professionals and ensure best practices are used to achieve the best possible patient outcomes.¹

Take Your First Steps

A master’s degree in nursing is a necessary foundation for becoming a clinical nursing specialist.¹ Colorado Technical University offers RN-BSN and MSN programs built on a prior nursing knowledge which are designed to provide students with the necessary tools to deliver health care and drive change in the medical industry. The Bachelor of Science in Nursing degree program at Colorado Technical University is accredited by the Commission of Collegiate Nursing Education (http://www.ccneaccreditation.org) and can be completed in as little as nine months.*

1. "What is a CNS?" Retrieved from: http://nacns.org/about-us/what-is-a-cns/(Visited 6/26/17).
2. "Clinical Nurse Specialist Core Competencies." Retrieved from: http://www.nacns.org/wp-content/uploads/2017/01/CNSCoreCompetenciesBroch.pdf (Visited 6/26/17).
3. Foster, Jan and Sonya Flanders. "Challenges in Clinical Nurse Specialist Education and Practice." Retrieved from: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-19-2014/No2-May-2014/Challenges-in-CNS-Education-and-Practice.html (Visited 6/26/17).
4. “New Research Reaffirms Physician Shortage.” Retrieved from: https://news.aamc.org/press-releases/article/workforce_projections_03142017/ (Visited 6/26/17).
5. “National Association of Clinical Nurse Specialists: History.” Retrieved from: http://nacns.org/about-us/history/(Visited 6/26/17).
6. "2016 Certification Renewal Requirements." Retrieved from: http://www.nursecredentialing.org/renewalrequirements.aspx (Visited 6/26/17).
7. “ANCC Certification Center.” Retrieved from: http://www.nursecredentialing.org/Certification.aspx(Visited 6/26/17).
8. "Occupational Employment and Wages, May 2016." Retrieved from: https://www.bls.gov/oes/current/oes291171.htm#st (Visited 6/26/17).
9. "Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners: Job Outlook." Retrieved from: https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm#tab-6 (Visited 6/26/17).
10. “Impact of the Clinical Nurse Specialist Role on the Costs and Quality of Health Care.” Retrieved from http://nacns.org/wp-content/uploads/2016/12/CNSOutcomes131204.pdf (Visited 6/26/17).

* Assumes a student will be awarded the maximum credit for transfer, licensure, prior experiential learning, and professional certifications, will be continuously enrolled, and satisfactorily completes all program requirements for graduation. Timing reflects an accelerated pace for the nursing component of the program. Additional courses, such as general education requirements, may be necessary dependent on credits transferred to CTU. The total program length may change due to academic failure of courses and or withdrawals and drops. CTU cannot guarantee transfer or other credit will be accepted; please see University Transfer Credit policy.

For important information about the educational debt, earnings, and completion rates of students who attended this program, go to www.coloradotech.edu/disclosures. CTU cannot guarantee employment or salary. 1199543 7/17