What Is a Clinical Nurse Specialist?

What Is a Clinical Nurse Specialist?

A clinical nurse specialist (CNS) is an advanced practice registered nurse (APRN) with a master of science in nursing (MSN) or a doctor of nursing practice (DNP). CNS professionals need an RN license to practice in their state and CNS certification. A lucrative career field, clinical nurse specialists made an average annual salary of $91,722 as of June 2021, according to PayScale.

CNS nurses receive training in a specialization area and in general pharmacology, physiology, and physical assessment. Clinical nurse specialists can pursue leadership positions using evidence-based practices to improve healthcare outcomes and patient satisfaction. They typically work in hospitals, community health clinics, and schools, collaborating with medical professionals like physicians and other nurses.

A lucrative career field, clinical nurse specialists made an average annual salary of $91,722 as of June 2021, according to PayScale.

This page covers clinical nurse responsibilities, how to become a CNS, plus career and salary outlook information.

Specialties for Clinical Nurse Specialists

CNSs can specialize in a population, setting, disease, type of care, or type of problem. Some specializations require certification from the American Nurses Credentialing Center (ANCC) or the American Association of Critical-Care Nurses (AACN).

Specialization Description Required Education Licensure and Certification Requirements Career Titles Within This Specialization
Geriatrics/Gerontology CNSs specializing in geriatrics may work in nursing homes, hospitals, and long-term care facilities. They treat and assess older adults and find ways to improve patient safety. MSN or DNP RN license; Adult-Gerontology Clinical Nurse Specialist Certification from ANCC Gerontology clinical nurse specialist
Pediatrics Pediatric clinical nurse specialists work with patients from birth to young adulthood. MSN or DNP RN license; ACCNS-P (Pediatric) from AACN Pediatric clinical nurse specialist
Psychiatric Health CNSs who specialize in psychiatric health work with patients with psychiatric health conditions. MSN or DNP RN license; Adult Psychiatric-Mental Health Clinical Nurse Specialist Certification (PMH data-title=”Careers”CNS-BC) from ANCC Psychiatric clinical nurse specialist
Neonatal CNSs with a neonatal specialization provide care to neonatal patients. MSN or DNP RN license; ACCNS-N (Neonatal) from AACN Neonatal clinical nurse specialist
Women’s Health Clinical nurse specialists specializing in women’s health provide care to women of all ages. They may work in a hospital maternity ward or at a women’s health clinic. MSN or DNP RN license; No certification available at this time Women’s health clinical nurse specialist

Compare Clinical Nurse Specialists to Different Nursing Roles and Subspecializations

CNS vs. NP CNS vs. CNL APRN vs. NP

History of Clinical Nurse Specialists

The 19th-century founder of modern nursing, Florence Nightingale, laid the groundwork for the clinical nursing profession. The CNS field originated in the 1940s when nursing leaders increasingly began calling for clinical expertise in nursing. Around the same time, nursing leaders started introducing specializations.

Nursing professionals refined the clinical nurse specialist role in the 1960s, when the profession took off. CNSs’ scope of work has evolved over the decades to include changes in healthcare delivery, education models, research, and patient care needs.

Although CNSs diagnose and treat patients, they also conduct clinical research, train other nurses, provide expert consultation, and develop policies to improve patient satisfaction and outcomes.

The clinical nurse specialist role stands out from other nursing positions because of its emphasis on improving nursing care, collaborating with other healthcare providers, and creating evidence-based standards of care. Although CNSs diagnose and treat patients, they also conduct clinical research, train other nurses, provide expert consultation, and develop policies to improve patient satisfaction and outcomes.

The Clinical Nurse Specialist Role

What is a CNS nurse? A type of APRN, clinical nurse specialists provide care to complex patient populations, support and educate other healthcare staff, and promote safety and excellence within healthcare systems. Their advanced nursing training lets them diagnose and treat patients within their specialization area.

They specialize by population, working with pediatrics or adults, or by setting, in critical care or emergency rooms. CNS nurses also specialize by type of care (like rehabilitation or psychiatric), type of problem (like wounds or pain), and disease or medical subspecialty (like oncology or diabetes).

Typical duties for the clinical nurse specialist role include evidence-based nursing practice, healthcare administration, improving patient outcomes, and teaching and training. CNS nurses work in hospitals, schools, and community health clinics. They also work closely with other healthcare professionals, including other nurses and physicians. Below, we discuss some key skills for successful clinical nurse specialists.

Key Soft Skills for Clinical Nurse Specialists

  • Communication: Excellent communication skills help clinical nurse specialists accurately convey information to patients and their families. Effective communication helps CNSs develop appropriate treatment plans. This skill is also important when collaborating with other medical professionals.
  • Critical-thinking: CNSs need strong critical-thinking skills to make the correct medical decisions under pressure. They need to evaluate evidence and consult with other healthcare workers to assess changes in a patient’s health status and devise a treatment plan.
  • Organization: Clinical nurse specialists must stay organized to provide efficient, timely, and accurate patient care. Organized CNSs can detect problems or changes in a patient’s status more quickly.
  • Compassion/Empathy: CNSs need compassion and empathy when taking care of patients. This ability helps them develop strong relationships, gain the trust of patients and their families, and offer better care.

Key Hard Skills for Clinical Nurse Specialists

  • Teaching/Training: Clinical nurse specialists teach and train nurses under their supervision. CNSs demonstrate nursing techniques, navigate medical environments, work with other healthcare professionals, including mentoring other nurses.
  • Clinical Research: CNSs analyze and conduct clinical research. They evaluate proposals, devise new protocols, and provide input on the design of new studies. Some CNS research positions require a DNP.
  • Direct Patient Care: Most clinical nurse specialist roles require direct patient care. Specific duties vary depending on patient population and work environment but may include wound care, monitoring vital signs, administering medications or treatments, and drawing blood.
  • Developing New Policies: CNSs help develop new policies and procedures to improve patient satisfaction, healthcare delivery systems, and health outcomes.

CNS Salary and Career Outlook

Clinical nurse specialists face a strong career outlook with competitive salaries. The BLS projects 7% job growth (faster than average) for RNs from 2019 and 2029, with an estimated 175,900 openings for registered nurses each year.

PayScale reports an average annual salary of $91,722 for CNSs as of June 2021. Factors that influence clinical nurse salaries include specialization, experience, education, and location.

Demand for qualified healthcare professionals will increase as the U.S. population continues to age and as chronic health conditions proliferate. Learn more about CNS salary and career outlook below.

Clinical Nurse Specialist

Annual Average Salary


$91,722


Source: PayScale

How to Become a CNS

Becoming a clinical nurse specialist usually takes more than six years. Prospective CNSs first earn a BSN from an accredited program, which typically takes four years. Next, they must pass the NCLEX-RN to get their RN license.

Clinical nurse specialists must go back to school and earn either an MSN or DNP focused on a CNS specialization. After completing an MSN or DNP, graduates can apply for certification in their specialty. CNS certifications usually require renewal every five years.

The links below explain more about the process of becoming a CNS.

Find out what it takes to become a CNS. Steps to Becoming a Clinical Nurse Specialist Learn about the top online CNS programs. Online Clinical Nurse Specialist Programs Learn how to earn certifications for CNSs. Certification for Clinical Nurse Specialists

Resources for Clinical Nurse Specialists

Professional Organizations for Clinical Nurse Specialists

  • National Association of Clinical Nurse Specialists

    NACNS represents over 70,000 clinical nurse specialists. The membership organization offers continuing education opportunities, a CNS program directory, professional certification information, and a career center. Students can also find scholarships, clinical resources, and information about events.

  • American Nurses Credentialing Center

    CNSs can find information about credentialing requirements and certifications at the ANCC website. A subsidiary of ANA, ANCC offers credentialing programs and accredits healthcare organizations that offer continuing education.

  • American Nursing Association

    Founded in 1896, ANA represents the nation’s 4 million RNs. The organization promotes a safe work environment, encourages wellness for nurses, and advocates on healthcare issues. Member benefits include free webinars, certification discounts, publications, and the ANA mentorship program.

  • American Association of Critical Care Nurses

    The largest specialty nursing group in the world, AACN supports the critical care nursing profession. AACN offers some certifications for CNSs. The organization also facilitates conferences and events and helps guide critical care nursing standards.


Frequently Asked Questions

  • What does CNS stand for?

    CNS stands for clinical nurse specialist, a type of advanced practice registered nurse who needs an MSN or DNP to practice.

  • What are the types of clinical nurse specialists?

    The clinical nurse specialist role includes many specialties that focus on patient population, work setting, type of care, type of problem, and disease/medical subspecialty. Common types of clinical nurse specialists include pediatric CNS, emergency room CNS, critical care clinical nurse specialist, and adult-gerontological CNS.

  • What is the difference between a nurse practitioner and a clinical nurse specialist?

    Nurse practitioners (NP) and clinical nurse specialists are both types of advanced practice registered nurses. Both require an MSN or DNP to practice. However, clinical nurse specialists focus more on collaborative research, education, and using evidence-based practices to improve healthcare. Nurse practitioners focus primarily on direct patient care and are more likely to practice independently.

  • How much does a clinical nurse specialist make?

    PayScale reports that clinical nurse specialists earned an average annual salary of $91,722 as of June 2021. Factors that impact salary include specialization, experience, education, and location.


Reviewed by:

Portrait of Brandy Gleason MSN, MHA, BC-NC

Brandy Gleason MSN, MHA, BC-NC

As an assistant professor of nursing and entrepreneur with nearly 20 years of varied nursing experience, Brandy Gleason offers a unique perspective. She currently teaches within a prelicensure nursing program and coaches master’s students through their culminating projects. Brandy brings additional expertise as a bedside nurse and a nurse leader, having held past roles at the supervisory, managerial, and senior leadership levels. Her passion and area of research centers on coaching nurses and nursing students to build resilience and avoid burnout. Brandy is also an avid change agent when it comes to creating environments and systems that contribute to the wellbeing of students and healthcare professionals. Brandy is a paid member of Red Ventures Education’s freelance review network.


Featured Image: FatCamera / E+ / Getty Images

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