Press Room

For his first edition, NACNS President Rick Bassett discusses CNS duties, the future of the CNS role, advice for a new CNS and more.

1. I am a new Neonatal ICU CNS. Could you share a list of duties you expect from this role?

Congratulations on your new Neonatal ICU Clinical Nurse Specialist (NICU CNS) role! The NICU CNS is a vital advanced practice role focused on improving outcomes across the three CNS spheres of influence: patient care, nursing practice, and healthcare systems. Here’s a comprehensive list of duties typically expected from a NICU CNS:

Patient Care Sphere

• Conduct advanced assessments of critically ill neonates.
• Develop, implement, and evaluate evidence-based plans of care.
• Serve as a clinical expert and resource for complex or high-risk neonates.
• Support and guide staff during difficult clinical situations or deteriorating patient conditions.
• Participate in family-centered care, helping families understand diagnoses, treatments, and outcomes.
• Lead efforts in reducing neonatal morbidity and mortality through evidence-based interventions.

Nursing Practice Sphere

• Provide formal and informal education to NICU nurses and interprofessional teams.
• Mentor and precept nurses pursuing advanced roles (e.g., NNPs, CNS students).
• Identify gaps in nursing knowledge or performance and implement targeted education or quality improvement initiatives in coordination with NICU Educators and Management.
• Promote and model evidence-based practice (EBP) at the bedside.
• Facilitate competency development and skill validation for NICU nurses in coordination with NICU Educators.

Systems/Organizational Sphere

• Lead quality improvement and patient safety initiatives (e.g., CLABSI, VAP, NEC prevention).
• Analyze NICU metrics (infection rates, length of stay, unplanned extubations) and initiate system-level changes.
• Collaborate with NICU leadership and interdisciplinary teams on protocols, policies, and care pathways.
• Serve on hospital committees related to neonatal care, perinatal services, and ethics.
• Participate in neonatal transport team development or performance improvement (if applicable).
• Champion initiatives that support safe transitions (e.g., discharge planning, follow-up care coordination).

Additional Key Responsibilities

• Policy & Procedure Development: Write, revise, and implement NICU clinical guidelines and procedures.
• Research & Innovation: Lead or support clinical research or EBP projects focused on neonatal care.
• Regulatory Readiness: Ensure unit compliance with Joint Commission, CMS, and state regulations.
• Technology & Equipment Evaluation: Assess and recommend NICU-specific technologies or devices (e.g., incubators, respiratory equipment).
• Advocacy: Advocate for neonatal patients and families at organizational, community, and policy levels.

2. Do you expect a doctorate to be required in the future to become a CNS?

This is a great question that may need a bit of context. To provide a brief answer to the question, I don’t see a doctorate required to become a CNS in the immediate future, but I do see an eventual transition to the DNP as an entry-level program for CNSs. I always support and see the value in professionals pursuing further academic preparation. There is much to learn, and those experiences are valuable to us and can be valuable to our patients and staff we serve. Please ask this question in another decade; the answer might be more definitive.

3. I currently work in paranesthesia nursing, and I am dual certified with CPAN and CAPA certifications. Additionally, I am enrolled in an MSN program and part of NPD for paranesthesia practice. I provide specialized training and education. How do I become a CNS?

Sounds like you are on the right path and well-positioned to take the next step in becoming a CNS. If possible, I would recommend that you find a colleague that is currently in the CNS role. They provide valuable insight and information into your journey to become a CNS. I would encourage you to take a look at the NACNS CNS Program Directory to get an idea of what programs are available to you. Some programs also have online forums or introduction meetings for prospective CNS students to attend and learn more about both the CNS role and the academic journey.

4. What do you think is most important for CNSs to do to advocate for the role?

Just like the CNS role, this answer is multifaceted but I can give you the essentials:

• Introduce yourself as a clinical nurse specialist and gently correct anyone who introduces you as someone other than a CNS.
• Be articulate in describing the role of the CNS. This is an example: A Clinical Nurse Specialist (CNS) is an Advanced Practice Registered Nurse (APRN) prepared by a master’s, doctoral, or post-graduate certificate-level CNS program. CNSs diagnose, prescribe, and treat patients and specialty populations across the continuum of care. The CNS improves outcomes by providing direct patient care, leading evidence-based practice, optimizing organizational systems, and advancing nursing practice.
• Be aware of the licensure, title protection, and full scope of practice opportunities in the state you are licensed in. NACNS and your NACNS Affiliate will likely have great resources to help you advocate at the state level.
• Be persistent and consistent in educating your colleagues locally, regionally and nationally about the unique and valuable role CNSs play in a variety of healthcare settings.

5. What is your advice for a CNS just entering the field?

• Set reasonable goals for your first year in the CNS role.
• Keep your focus on the essentials. Most organizations, leaders and staff who have CNSs know their value and desire their involvement in multiple activities and efforts. You are or will become very popular. Set reasonable limits and gradually expand your capacity as you become more experienced in your role.
• Find a CNS mentor. Some organizations have a formal program where they pair up a new CNS with an experienced CNS for a period of months.
• If not already, become a member of NACNS and the area NACNS Affiliate. Those are two excellent ways to surround yourself with resources and other CNS colleagues.
• See the answer to question #4 🙂.