Clinical Nursing Leadership (CNL): A Day in the Life

Clinical Nursing Leadership (CNL): A Day in the Life

The role of a clinical nurse leader serves as one of the most important in the healthcare system. By coordinating with other healthcare providers and leading the design and implementation of evidence-based practices, CNLs strive to improve care outcomes for all patients.

While the U.S. Bureau of Labor Statistics (BLS) does not specifically track job data for clinical nurse leaders, the bureau projects a faster-than-average 7% employment growth rate for all registered nurse occupations from 2019-2029.

This page takes an in-depth look at the typical day of a clinical nurse leader. Covered topics include job duties, work locations, and how to prepare for a career as a CNL.

What Is the Role of a Clinical Nurse Leader?

Clinical nurse leadership is a newly emerging specialization in the healthcare field, and the first new role in nursing in more than 35 years. The American Association of Colleges of Nursing (AACN) developed the role in 2003 in response to calls for change across the healthcare system.

As an advanced generalist professional, the clinical nurse leader holds a master’s degree and can work with all types of patients across all healthcare practice settings. CNLs work in multidisciplinary teams (alongside physicians, therapists, etc.) to address quality of care issues for individuals and patient cohorts.

As an advanced generalist professional, the clinical nurse leader holds a master’s degree and can work with all types of patients across all healthcare practice settings.

Visit the links below to learn more about the role of a clinical nurse leader.

Read More About Clinical Nurse Leaders Clinical Nurse Leader vs Clinical Nurse Specialist Clinical Nurse Leader vs Executive Nurse Leader

What Does a Clinical Nurse Leader Do?

A clinical nurse leader ensures that patients receive well-coordinated, safe, and evidence-based care throughout their journey in the healthcare system. Clinical nurse leaders achieve this by managing care plans and advocating for patients at the point of care.

Clinical nurse leadership is not an administrative role. CNLs work at the point of care and interact directly with patients.

The AACN developed the CNL role in direct response to systemic issues seen in patient care delivery. A 2018 study by Johns Hopkins University revealed that more than 250,000 Americans die due to medical error each year — making it the second leading cause of death in the U.S. ahead of respiratory disease. Clinical nurse leaders work to improve and assume accountability for patient care outcomes across their unit.

Clinical nurse leadership is not an administrative role. CNLs work at the point of care and interact directly with patients, their families, and other medical professionals including physicians, therapists, and nurses. Logistical challenges of this role include anticipating risk and handling lack of integration or communication between different care providers and settings.

The following list explores the duties and qualities of a nurse leader in detail, including primary and nonstandard tasks.

Main Duties of a Clinical Nurse Leader

  • Monitor and Evaluate Treatment Plans: Clinical nurse leaders ensure treatment plans meet the needs and preferences of patients in their care. This requires daily review of medical charts and careful assessment of patient concerns, planned procedures, and treatment options. CNLs also work to ensure the safe delivery of treatments.
  • Assess Risks and Measure Outcomes: To better protect the patient safety during treatment, clinical nurse leaders must determine, assess, and measure risks and outcomes associated with patient care plans. Maintaining thorough documentation of these key factors helps inform clinical decision-making to improve treatment and delivery of care.
  • Coordinate With Other Professionals: The typical day of a clinical nurse leader requires communication and close collaboration with many other professionals, including nurses, physicians, physical therapists, pharmacists, and social workers. CNLs improve patient care outcomes by ensuring all involved parties agree on plans and procedures.
  • Implement Evidence-Based Practices: Clinical nurse leaders carry the responsibility of maintaining up-to-date knowledge of current research and best practices in their field. CNLs must act as change agents, using patient persistence to advocate for needed improvements. CNLs assist other healthcare professionals in adjusting to newly-implemented practices and procedures.
  • Act as a Go-To Resource: As advanced generalists, clinical nurse leaders maintain a broad knowledge of the medical field and regularly serve as a resource for patients, families, and other professionals in their unit. CNLs may be tasked with locating research information, understanding and explaining protocols, or developing patient education materials.

Nonstandard Duties for Clinical Nurse Leaders

  • Manage Nursing Staff: Clinical nurse leaders work closely with other nurses in their unit, serving as a mentor and delegator, but CNLs typically do not engage in management tasks like recruiting or establishing work schedules. However, the CNL role can vary by employer, and some CNLs may need to complete select supervision or management tasks.
  • Provide Specialized Care: As advanced generalists, clinical nurse leaders possess robust education not focused on any particular specialization. Unlike a clinical nurse specialist, CNLs typically do not provide focused care. Exceptions may occur for CNLs working in specialized units or facilities, such as long-term memory care centers.
  • Work Outside Their Unit: Clinical nurse leaders focus on the clinical microsystem, encompassing patients, their families, and care providers. Rather than evaluating performance and care at an entire facility, their work centers on their particular unit or department. Infrequent exceptions may occur as required by employers, especially at small workplaces where CNLs carry broader evaluation duties.
  • Work in Administrative Areas: Though clinical nurse leaders generally do not work as administrators, some roles may require occasional overlap into administrative areas. For example, CNLs do not directly handle budgeting, but their work may require researching their facility’s financial data to help identify and address trends in patient care and satisfaction.
  • Handle Emergency Situations: Clinical nurse leaders primarily focus on the big picture of improving day-to-day patient care at healthcare facilities. However, due to the nature of working in a healthcare setting, CNLs may sometimes need to respond to high-stress emergency situations, especially common for CNLs working in emergency departments.

The Anatomy of a Typical Day of a Clinical Nurse Leader

Many clinical nurse leaders work day shifts, covering nursing schedules of three 12-hour shifts or five eight-hour shifts each week. Certain positions may require CNLs to work nights or otherwise irregular hours.

Upon arrival at the workplace, clinical nurse leaders begin their day by reviewing patient information and charts. CNLs must be aware of vitals, lab results, and any changes that occurred overnight. CNLs then participate in a morning huddle with all staff, which offers the opportunity to exchange information and share announcements.

Throughout the day, CNLs typically shadow physicians on their rounds, discussing last-minute needs with patients due for discharge, and ongoing needs with patients still in care. CNLs maintain records of these rounds and meet with nurses as needed to assess and reiterate duties.

Clinical nurse leaders also maintain communication with case managers, physical and occupational therapists, pharmacists, and other professionals involved in patient care. CNLs regularly touch base with these team members on treatment plans, discharges, and safety concerns, providing updates as needed.

Before leaving for the day, clinical nurse leaders conduct a final meeting with their team to review plans for the next day. They provide reports to prepare staff for the night shift.

Where Clinical Nurse Leaders Work

Clinical nurse leaders work in many different healthcare settings, including inpatient, outpatient, community health, long-term care, and hospice. Many CNLs find employment in hospitals and inpatient clinics, providing leadership to interdisciplinary nursing teams, physicians, and therapists.

Work location can impact how much a CNL earns. According to BLS data, registered nurses who work in state, local, and private hospitals earn higher median salaries ($76,840) than those who work in nursing and residential care facilities ($68,450).

A clinical nurse leader’s duties and goals can also differ according to their work environment. While a CNL working in a hospital may focus on improving treatments leading to discharge, for example, a CNL working in a long-term care facility may focus on improving programs and therapies to enhance resident health and satisfaction.

Since clinical nurse leadership remains a relatively new specialization, aspiring CNLs can experience difficulty finding work in some areas. Opportunities may occur more frequently in urban areas. Urban hospitals and other healthcare facilities tend to maintain larger budgets, employ larger care teams, and treat a greater number of patients. As more employers in the healthcare sector move to implement the CNL role, job opportunities should expand accordingly.

See How Location Affects Salary for Clinical Nurse Leaders

Should You Become a Clinical Nurse Leader?

Pursuing CNL certification can be an extremely rewarding career choice for the registered nurse with a passion for improving the healthcare system. CNLs serve as advocates for their patients’ needs and make significant, direct impacts on the quality of care delivered in hospitals and other facilities across the country.

Pursuing CNL certification can be an extremely rewarding career choice for the registered nurse with a passion for improving the healthcare system.

Like all professionals, however, CNLs face their share of challenges.

Interdisciplinary collaboration is perhaps the most important aspect of a CNL’s job. Without the cooperation of healthcare professionals on their team, CNLs may face obstacles to patient safety and quality of care. Common obstacles to collaborative relationships in healthcare include:

  • Generational differences
  • Gender bias
  • Varying levels of preparation
  • Resistance to change
  • Differences in personal values and expectations
  • Use of unfamiliar language or jargon

Clinical nurse leaders can address these issues with effective communication, leadership, conflict resolution measures, and by fostering a team environment that encourages open and honest discussion without fear of ridicule.

How to Become a Clinical Nurse Leader Explore Clinical Nurse Leadership Programs Online CNL Programs

How to Prepare for a Career as a Clinical Nurse Leader

To work as a clinical nurse leader, you need to maintain a current RN license and complete an accredited master of science in nursing program. CNLs must also obtain certification from the Commission on Nurse Certification.

These requirements demand significant commitments of time, money, and mental and emotional energy. Many MSN students opt to hold down a job while they study, as juggling the two important workloads can cause increased strain. Learners can minimize this strain by realigning their priorities, seeking support from mentors, and looking for opportunities to learn on the job.

The three-hour CNL certification exam consists of 140 multiple-choice questions. To better your chances of success, sign up for practice exams, review recommended reading lists, and make sure to start studying early.

Frequently Asked Questions

  • What is a clinical nurse leader's job description?

    The clinical nurse leader job description varies slightly depending on the employer. However, most CNLs work to improve the quality of patient care through interdisicplinary leadership, assessment and evaluation, and implementation of evidence-based procedures.

  • What is a clinical nurse leader's salary?

    Several factors can impact clinical nurse leader salary potential, including geographic location, employer, and years of experience. According to data CNLs earn an average of $83,180 per year as of July 2021.

  • How does a clinical nurse leader influence patient care?

    Clinical nurse leaders influence patient care in a variety of ways. They research and implement new evidence-based practices, collaborate with other health professionals, and measure risks and outcomes to improve care.

  • Is a clinical nurse leader a nurse practitioner?

    No. Clinical nurse leader and nurse practitioner are two separate, distinct designations for registered nurses with a master’s degree. While they both work in clinical settings, their job duties differ greatly.

  • What are the qualities of a nurse leader?

    The most important qualities of a nurse leader include team leadership, emotional intelligence, advocacy and mentorship, critical thinking skills, and the ability to communicate effectively with laypersons and other professionals.

Featured Image: The Good Brigade / DigitalVision / Getty Images

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