Why You Should Consider Becoming a CNS

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A Day in the Life of a Clinical Nurse Specialist by Johns Hopkins University School of Nursing

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What Chief Nursing Officers Are Saying About the CNS Role


What is a CNS?

What is a clinical nurse specialist?

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.

Clinical nurse specialists are leaders in health care.

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 role has become widely accepted in the health care system and one that significantly impacts the nation’s economy by providing safe, low-cost, and effective evidence-based health care services.

How do clinical nurse specialists practice?

Clinical nurse specialists are advanced practice registered nurses with advanced clinical expertise in a specialized area of nursing practice. The work of the CNS includes, but is not limited to, diagnosis and treatment of acute or chronic illness in an identified population with emphasis on specialist care for at-risk patients and/or populations. CNS practice extends from wellness to illness and from acute to primary care.

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.

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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.

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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:

  • Adult/Gerontology
  • Pediatrics
  • Neonatal

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.

Why It Is Important for CNSs to Have an NPI Number

Did you know there are currently 89,000 CNSs in North America, but only 12,569 are registered with an NPI (National Provider Identifier) number? NACNS’s goal is to change that! Check out the video to see why having an NPI number is important & how to register!

Source: Sean Reed (2022). Clinical Nurse Specialists in the United States Registered with a National Provider Identifier: 2022 Update. Unpublished Data.

Register for an NPI Number