Nurses are encouraged to review the requirements outlined in their state board of registered nursing. Clinical nurse specialists have a unique role. What Are Some Pathways for Nurses Who Want to Focus on Teaching? CNSs that prescribe controlled substances are also required to secure DEA controlled substances registration. Specialty areas can be based on: These five specialty areas may overlap as well. How do clinical nurse specialists practice? How to Become a Clinical Nurse Specialist. CNSs often work in direct patient care, but some work in administrative, consulting, research, and supervisory positions where direct patient care is not required. Additionally, over 90% of CNSs report feeling moderately-to extremely satisfied in their job. As advanced practice registered nurses (APRNs) that serve a dual role as both clinician and change agent, clinical nurse specialists (CNS) contribute to advancing the practice of nursing through education, consultation, project management, clinical expertise, and research. A clinical nurse specialist is required to have a master's or doctoral degree in nursing, their registered nursing license, and clinical nurse specialist licensure or certification. While the Bureau of Labor Statistics does not have statistics specifically for CNSs, the growth for advanced-practice RNs, in general, is expected to rise 31% by the year 2024. They serve as mentors, educators, and advocates. However, not all work areas are risky, such as research and education. Some states require continuing education for renewal, while others recognize maintaining national certification as meeting the requirements for continuing education. Salary can vary depending on the city/state of employment, additional certifications held, experience level, and the organization. CCNE-accredited CNS programs provide graduates with entry-level knowledge and competencies specific to the CNS role and a patient population focus, and ensure that they meet the requirements for certification through the American Nurses’ Credentialing Center’s (ANCC) or the American Association of Critical-care Nurses (AACN). This means adhering to practices that have been proven effective through clinical research. In most states, CNS licensure renewal occurs annually or biennially, usually along with RN licensure renewal. U.S. Department of Health and Human Services, National Association of Clinical Nurse Specialists, American Association of Colleges of Nursing, Clinical Nurse Specialist: The International Journal for Advanced Nursing Practice, Diagnose, treat, and manage chronic and acute illnesses, Nursing students enrolled in a BSN program complete in about four years, Pharmacology for advanced practice nurses, Context of health care for advanced-practice nursing, Child/adolescent psychiatric mental health, Graduate program must include three separate courses in, Worked a minimum of 500 supervised, clinical hours in the CNS role and population of choice, Submit verification of completion of a graduate degree program, Submit transcripts of the completed graduate degree program, Provide verification of certification from an organization/ association (such as the ANCC), Examining patients and diagnose illnesses, Treating disease unique to their specialty, Conducting research in their area of specialty, Assisting in creating, upholding, and revising policies and procedures as well as standards of care using current evidence-based research, Provide clinical expertise in various clinical areas, Gather data from medical records and patients to improve care and health care services, Collaborate with the interdisciplinary health care team to create, review, and revise treatment plans, Designing evaluation tools to assess the quality of different patient care and education programs, Act as a supervisor or manager to nursing and ancillary staff. As leaders, they can also promote and facilitate change. Even among states that do not require national certification or do not license CNSs, national certification represents an advanced level of knowledge in a specific CNS population and is therefore pursued by most graduates of CNS programs, regardless of state requirements. They demonstrate expertise in their specialty area and maintain strong clinical skills. The following states allow CNSs full prescriptive authority: The following states allow CNSs prescriptive authority, but only under the supervision of a collaborating physician: The following states do not grant prescriptive authority to CNSs: RNs interested in becoming clinical nurse specialists must study their state board of nursing laws and regulations regarding licensure and scope of practice to ensure they meet all state requirements for legal practice as a CNS. Many states also require you to also go through a certification process in order to be licensed to practice as a clinical nurse specialist. All trademarks are the property of their respective trademark holders. The certifying bodies for clinical nurse specialists are shown here with the various patient population focus certifications they offer: American Association of Critical-Care Nurses (AACN), American Nurses Credentialing Center (ANCC). International Journal of Nursing Studies, 50, 1524-1536. doi: 10.1016/j.ijnurstu.2013.03.005 2 Canadian Nurses Association. While serving as advanced clinicians, CNSs also evaluate patients’ experience, nursing personnel, and organizational domains, with the ultimate goal of improving patient care and positively influencing healthcare delivery at all levels. As of October 2015, 28 states recognized the CNS role and adhere to the APRN Consensus Model, which allow CNSs to practice independently with no written collaborative agreement or supervision with a physician: Another 13 states recognize the CNS role but require collaboration with a physician as a condition to practice: The following states recognize the CNS, but not as an APRN role, which means licensure requirements often vary: The following states do not recognize the CNS role in any capacity: CNS prescriptive authority—which authorizes CNSs to prescribe pharmacologic and non-pharmacologic therapies—also widely varies from one state to the next. Nurses should be able to work well in groups and utilize a team approach to healthcare. Many clinical nurse specialist graduate programs hold accreditation through The Commission on Collegiate Nursing Education (CCNE). By definition, CNSs specialize in a particular patient population focus. (2009). Nurses looking to advance to a CNS should value evidence-based practice. Leadership skills are also a must with CNSs. They serve as mentors to nurses and bring their knowledge of bedside nursing to organizational leadership to improve clinical practice. The time to complete your education to become a clinical nurse depends on your chosen pathway. As APRNs, clinical nurse specialists must possess a graduate-level nursing education, national certification and, in most cases, state licensure: For RNs with licenses in good standing, the first step to becoming a clinical nurse specialist is to earn a Master of Science in Nursing (MSN) or higher degree specific to the CNS role and a patient population focus of choice. What Is the Difference Between a Nurse Manager and a Nurse Leader? population (such as: pediatrics, geriatrics, women’s health); setting (such as: critical care or emergency room); disease or medical subspecialty (such as: diabetes or oncology); type of care (such as: psychiatric or rehabilitation); or. According to a survey by the U.S. Department of Health and Human Services, there were 59,242 CNSs in the United States, the second largest group of advanced-practice RNs. In states that license CNSs, the licensure process usually includes completing an application and providing the state board of nursing with: CNSs must ensure they maintain their national certification, RN license, and APRN-CNS license.