- Overview
- CNS Role & Definition
- Talking Points
- Outcomes
- Cost Exemplars
- CNS Job Description
- Resume & CV
- Precepting
- Social Media
- Resources
Advocacy Toolkit Overview
Clinical Nurse Specialists (CNSs) play a vital role in healthcare and often advocate for their contributions across all levels—from administrators to the community. By leveraging their advanced practice expertise and unique talents, CNSs have powerful opportunities to shape and elevate care delivery.
The various Toolkit Tabs offer targeted information on key topics that support and enhance advocacy for the Clinical Nurse Specialist (CNS) role. The subcommittee’s goal is to ensure that individuals can easily find and use the content most relevant to their interests and advocacy efforts.
We encourage you to take a few moments to explore each tab and make use of the resources provided—they’re designed to empower and support you in championing the value of your role.
The Toolkit Tabs offer focused resources on key topics to support and strengthen advocacy for the Clinical Nurse Specialist (CNS) role.
How to Use:
Select the tab that aligns with your interests, explore the content, and apply the tools and templates provided to effectively advocate for the CNS role.
Other resources to discuss the CNS role that are not specifically discussed in the previous toolkit tabs
CNS Role & Definition
Clinical Nurse Specialist Definition and Role Description (PowerPoint)
A Close Look at the Clinical Nurse Specialist Role (Podcast)
In this episode of the Cleveland Clinic’s Nurse Essentials podcast, Rivera and Kayla Little, MSN, APRN, AGCNS-BC, PCCN, a clinical nurse in the Heart, Vascular and Thoracic Institute, discuss the CNS role. They delve into:
- The core tenets of being a clinical nurse specialist
- The difference between a nurse educator and a CNS
- The support a CNS can provide to clinical nurses, nurse leaders and healthcare organizations
- How a CNS helps improve nursing-sensitive quality indicators and align policies with evidence-based practices
- Steps to take to become a clinical nurse specialist
Johns Hopkins Day in the Life YouTube
Johns Hopkins professor Dr. Michelle Patch, DNP, Clinical Nurse Specialist track coordinator, describes a day in the life of a CNS.
Talking Points for CNS
Prepare your elevator speech:
Example Elevator Speech: I’m a Clinical Nurse Specialist specializing in [insert specialty or patient population]. I provide advanced clinical expertise, lead evidence-based practice initiatives, and collaborate with healthcare teams to improve patient outcomes, safety, and system efficiency.
“I am one of the four advanced practice providers….”
Consider having one ‘Professional Elevator Speech’ and one ‘Layman’s Terms Elevator Speech’
- Professional Elevator Speech – How would you explain your position and impact to a Chief Nursing Officer?
- Layman’s Terms Elevator Speech – How would you explain your position and impact to a patient or family member?
Consider a detailed signature block
Example:
Barna Fintstone, PhD, APRN, ACNS-BC
Adult-Gerontology CNS, University of Bedrock
National Association of Clinical Nurse Specialists
Office: 245-254-5422
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.
Outcomes of CNS Work
Published CNS Outcomes Tracking Document
Prepare CNS outcomes for dissemination to executive leadership.
Sanchez, K., Winnie, K., & de Haas-Rowland, N. (2019). Establishing the Clinical Nurse Specialist Identity by Transforming Structures, Processes, and Outcomes. Clinical nurse specialist CNS, 33(3), 117–122. https://doi.org/10.1097/NUR.0000000000000438
In this article is an example of a CNS outcomes tracking tool: nur_2019_03_20_sanchez_cns-19-12_sdc1.xlsx (example Excel tracking doc from article)
CNS Score Card
CNS score card focused on three categories: Revenue generation, cost avoidance, and cost savings.
Toth, C., Miller, K., Hart, A., & Kidd, M. (2024). Clinical Nurse Specialist Role Advocacy: Quantifying the Financial Contributions Via Development of a Scorecard. Clinical nurse specialist CNS, 38(2), 91–97. https://doi-org.kumc.idm.oclc.org/10.1097/NUR.0000000000000802
CNS Outcomes Literature Search
The following table is provided to assist the Clinical Nurse Specialist in utilizing published research and evidence-based practice projects to better advocate for your desired role, project, and/or change to current practice. Locate the CNS Sphere(s) of Impact/Core Competencies you are interested in on the left side of the table and review the associated articles.
Cost Exemplars of CNS Work
Cost Analysis Toolkit
A Business Guide for the Clinical Nurse Specialist
Today’s health care landscape is ever-changing. Initiatives to improve patient care and safety must take cost savings into account. Through their direct work with patients and families, nurses at the bedside and hospital and health system leaders, clinical nurse specialists are uniquely prepared to assess, analyze and improve the business of health care while continuing to put the patient first. The CNSs ability to translate value impact in the clinical setting is crucial.
CNS Job Description
General Summary/Description
The Clinical Nurse Specialist (CNS) is a licensed registered nurse that has graduate preparation (master’s or doctorate) in nursing as a clinical nurse specialist. CNSs are one of four categories of APRNs as identified by the APRN Consensus Model, National Council of State Boards of Nursing (NCSBN), State Boards of Nursing, American Nurses Association (ANA) and International Council of Nurses (ICN). The role of a CNS provides leadership and clinical expertise within the National Association of Clinical Nurse Specialists (NACNS) spheres of impact by utilizing unique and advanced level competencies. The CNS provides expert comprehensive nursing care directly to patients, supports and develops registered nurses at the point of care and serves as a leader in redesigning systems to improve access, quality, and safety in a cost-effective manner. The CNS improves patient care by putting the best evidence and innovations into practice while solving challenging patient care issues and monitoring patient outcomes for clinical effectiveness. (www.nacns.org)
Key Accountabilities (Based on 3 Spheres of Impact)
Direct Patient Care
- Conducts comprehensive wellness and illness assessments including development of a differential diagnosis
- Provides interventions to prevent or treat illness including identification and treatment of symptoms, functional problems, risk behaviors,
- Uses advanced communication skills to address complex situations and conversations.
- Intervenes to educate, guide and coach the patient, family, and caregiver(s) to establish a patient centered plan of care and navigate complex healthcare systems.
- Leads discovery of innovations in patient care.
Nursing/Nursing Practice
- Utilizes evidence-based practices to guide nursing practice and support patients and their families.
- Develops population profiles and conducts clinical inquiries to determine the need to change practice.
- Utilizes advanced clinical knowledge and communication skills through role modeling, consultation, and education with nurses and healthcare providers to support nursing practice and improve patient outcomes.
- Creates and develops evidence-based policies, procedures, protocols, and best practice models/guidelines using advanced clinical and specialty knowledge.
- Assists nurses and the interprofessional team to evaluate and change practice standards and ensure nursing practice is evidence-based.
Organization/Systems
- Leads systematic quality improvement and safety initiatives based on gap assessments and data analysis.
- Drives translation of best evidence into practice and facilitates integration of multiple programs and disciplines across the healthcare system to ensure positive patient outcomes.
- Collects and analyzes data while utilizing collaborative systems thinking to achieve quality, cost-effective patient care and outcomes.
- Advocates for the improvement of health care through participation in professional, private, and governmental agencies.
- Creates healthy communities and works to enhance a culture of health beyond the healthcare system.
- Utilizes expert leadership skills to influence policymakers and advocate for equitable healthcare.
- Participates as members and leaders in state/national and specialty nursing/healthcare organizations including NACNS.
Practice Setting Expectations
APRN Practice Component
- APRN practice will be defined as outlined by specific State Boards of Nursing
- The Clinical Nurse Specialist role allows for autonomy to assess, diagnose, and initiate orders for treatment and therapy to include prescriptive authority for pharmacologic and non-pharmacologic therapies. (www.nacns.org)
Job Requirements/Qualifications
Education/Certification/Licensure Requirements
- Graduation from an accredited Clinical Nurse Specialist program
- Master’s Degree; (Doctoral Degree [DNP or PhD] preferred)
- Board certification in area of specialty or population foci
- As required by State Boards of Nursing, the applicant has met all requirements to practice as a Clinical Nurse Specialist.
- Current, unrestricted (State) licensure as a registered nurse
- Current unrestricted (State) licensure as an advanced practice registered nurse as required by State Boards of Nursing.
Resumé & Curriculum Vitae (CV)
- A resumé and a curriculum vitae have different formats, content, and purposes. A CV is a representation of your full history and academic credentials. A resumé is a concise depiction of your skills and qualificationsA resumé emphasizes your skills when applying for positions in your industry. It is no longer than two pages with added page for publications and presentations if applicable for the position you are applying for
- A CV emphasizes your academic accomplishments. It is usually provided when applying for academic positions and/or grants. Its length is dependent on your experience to include your publications, presentations, and posters.
Precepting A CNS Student
A structured, evidence-based protocol was created to support Clinical Nurse Specialist (CNS) preceptors by promoting collaborative relationships, shared goals, and reflective learning. This model improves CNS transition, retention, and satisfaction through goal-setting, journaling, debriefing, and formal evaluations.
Bloomingdale, R., & Darmody, J. V. (2019). Clinical Nurse Specialist Preceptor Protocol. Clinical nurse specialist CNS, 33(5), 228–236. https://doi.org/10.1097/NUR.0000000000000470
Precepting Expectations
| School Expectations | Preceptor Expectations | Student Expectations |
|---|---|---|
| Establish or verify clinical agreement | Reviews course objectives | Review course objectives Share syllabus, objectives, and projects for clinical |
| Ensure student has met all requirements to participate in clinical, CPR, HIPPA training | Be present for all interactions until preceptor feels comfortable with student. | Make sure all requirements for clinical are met. i.e., CPR, paperwork, onboarding at site. |
| Make sure that students clinical experience aligns with course objectives | Facilitate a learning environment to ensure that objectives are met | Provide schedule. Work with preceptor to coordinate a reasonable schedule that works for preceptor. |
| Make sure location matches clinical and student needs | Acknowledge findings reported by student. Review student documentation in chart. | Arrive prepared for the day. Have your equipment. Have assignments completed if requested by preceptor. |
| Evaluates student’s assignments | Complete student evaluations. | Complete preceptor and clinical site evaluation. |
| Assist with student goals. | Timely communication with school and instructor if there are concerns | |
| Ask questions to the student to ensure clinical understanding | ||
| Showing the student when and how to reach out to others when help is needed. Explain the collaboration. | ||
| Provides real time feedback Gives clear and useful feedback | ||
| Thinks aloud to demonstrate critical thinking and help explain the process Talk about different situations with different outcomes. What would be different if the situation were different. | ||
| If preceptor out of office coordinate with another to help meet student’s needs or other learning opportunities as appropriate | ||
| Timely communication with school and instructor if there are concerns |
Resources
Link to NACNS Position Statements:
https://nacns.org/advocacy-policy/position-statements/
Link to NACNS Toolkits:
https://nacns.org/resources/toolkits-and-reports/
Link to maps NACNS website prescriptive authority by state and scope of practice:
https://nacns.org/advocacy-policy/policies-affecting-cnss/scope-of-practice/
General Information Regarding Social Media/Social Networking
Social Media Foci Examples of Resources, Policies, and Documents
Reference:
Barry, J., Hardiker, N., (September 30, 2012). Advancing nursing practice through social media: A global perspective. OJIN: The Online Journal of Issues in Nursing, 17(3), Manuscript 5.DOI: 10.3912/OJIN.Vol17No03Man05