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What is a clinical nurse specialist?
The clinical nurse specialist has been a part of the health care industrial complex in the United States for more than 60 years. Through the decades, the profession has become widely accepted in the health care system as a standardized, licensed, and fully regulated health care occupation, and one that significantly impacts the nation’s economy by providing safe, low-cost, and effective evidence-based health care services.
Clinical nurse specialists are advanced practice registered nurses who have graduate preparation (Master’s or Doctorate) in nursing. Like other advanced practice registered nurses, they are trained in physiology, pharmacology and physical assessment in addition to their particular areas of specialty.
Clinical nurse specialists are leaders in health care.
How do clinical nurse specialists practice?
Clinical nurse specialists are advanced practice registered nurses who are expert clinicians in a specialized area of nursing practice. A clinical nurse specialist’s specialty may be defined by:
- 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
- type of problem (such as: pain, wounds, stress).
How do clinical nurse specialists influence health care delivery?
Clinical nurse specialists provide diagnosis, treatment, and ongoing management of patients. They also provide expertise and support to nurses caring for patients at the bedside, help drive practice changes throughout the organization, and ensure the use of best practices and evidence-based care to achieve the best possible patient outcomes.
Clinical nurse specialists have the skills and expertise to identify where the gaps are in health care delivery. They can help design and implement interventions, and assess and evaluate those to improve overall health care delivery.
Research into clinical nurse specialist practice demonstrates outcomes such as:
- reduced hospital costs and length of stay;
- reduced frequency of emergency room visits;
- improved pain management practices;
- increased patient satisfaction with nursing care; and
- reduced medical complications in hospitalized patients.
Read more about how clinical nurse specialists can positively impact health outcomes in the policy paper: Impact of the Clinical Nurse Specialist Role on the Costs and Quality of Health Care.
What are the requirements to practice as a clinical nurse specialist in my state?
State laws and administrative rules for nursing practice are issued by state licensing boards and they vary from state to state. Consult your state licensing board for specifics. In 2015, NACNS in collaboration with the National Council on State Boards of Nursing collected information on state laws regarding prescriptive authority and independent practice on CNSs. Click here to learn more about your state.
In 2008, the nursing community endorsed a consistent regulatory model that defines advance nursing practice and specialty, identifies the titles to be used, describes the emergence of new roles and population foci, and presents strategies for implementation. This document is known as the Consensus Model for APRN Regulation.
The Consensus Model for APRN Regulation, often referred to as the APRN Consensus Model, is available in the Advocacy & Policy section of our site.
What certifications or specialty certifications are available for clinical nurse specialists?
The APRN Consensus Model states that clinical nurse specialists who practice in the majority of states must obtain certification based on a population area. Current certification examinations based on population include:
For more information on population-level credentialing, please contact The American Nurses Credentialing Center (ANCC) or the American Association of Critical Care Nurses Certification Corporation. Specialty certifications are available through various specialty nursing organizations. Please contact your specialty nursing association for more details.