Category: Blog

RISE Up By Giving A Hand Up

Succession Planning To Advance The CNS Profession

Jan Powers, in her recent National Association of Clinical Nurse Specialists President’s Letter titled “We Rise By Lifting Others,” stated:

“As CNSs, we must look to the future and work to improve the pipeline of qualified CNSs to fill positions of vital need. We must have an intentional focus on succession planning and simultaneously encourage younger nurses to explore and step up to the role of CNS.”

Five generations of nurses are now working together with the oldest generation reaching retirement. As a matter of fact, nearly 20% of CNSs will reach retirement age over the next five years. Succession planning is an important way to fill this potential retirement gap in the ranks of the about 89,000 CNSs in North America.

Succession planning is defined as the systematic process of recognizing and creating future leaders who ready and able to accept the roles and responsibilities of those leaving the workforce via retirement, resignation, or promotion. Succession planning is a future-oriented process.

In short, it’s about giving younger nurses a “hand up” by introducing them to the role of the CNS and encouraging them to pursue the career. It is primarily through this effort that we advance the CNS role and ensure it thrives well into the future.

The Big Question

Ask yourself this question:

Who will replace you when you retire or leave the organization?

To truly RISE UP as a profession we must lead others forward. This is where succession planning is so critical because our current CNS positions must pave the way for the next CNS to take our place. Below are some tips and ideas to think about as you begin a succession plan.

CNS Succession Planning Tips

1. Establish accountability

  • Agree who has the responsibility to make the succession decision. Establishing clear responsibility of organizational succession early on is key to avoiding confusion later and is important to ensure a CNS has input into the process.

2. Focus on learning, not just performance

  • Provide potential successors opportunities to experience the future role and be educated on responsibilities before the succession itself is decided and implemented. This is where mentoring is important.

3. Turn succession short-term by breaking down tasks

  • Succession planning is a journey with many steps. People tend to think better in the short-term so breaking down the succession process into smaller projects rather than trying to make a switch all at once has a better chance of success.

4. Build transparency with the scientific method

  • Be upfront about succession planning and use CNS data skills to measure a potential successor’s performance and leadership ability. Establish standards to measure the success of a transition and share this information. This not only makes the succession process cleaner, but it builds trust among coworkers and the organization generally.

Is 90,000 Enough?

There are about 89,000 CNSs in North America and it is not nearly enough. The pandemic is swallowing resources while the online job boards scream for more CNSs. Our goal should be to retain and add more CNS to the workforce every year. We can do this with mentoring, succession planning, advising younger nurses, speaking at nursing programs among may other things. In sum, by giving a hand up to younger nurses to become CNSs we ensure the continuity of our profession and truly “RISE By Lifting Others.”

Lt Colonel David Bradley Armed Forces Affiliate Interview with NACNS

Lt. Colonel David Bradley Interview – Q&A

Q. What prompted the reinvigoration of the military affiliate within NACNS?

A few colleagues and I have been attending the National Association of Clinical Nurse Specialist (NACNS) Annual Conference for years and always found it exciting and informative. We decided there was a real
need for a military affiliate, and — in true military fashion — we just went ahead and completed all the paperwork and executed the mission. We plan to launch NACNS’s military affiliate in October with representation across three branches of the military — Navy, Air Force and Army. We’ve had a lot of interest already.

Q. What do you hope to accomplish with the creation of the Armed Services affiliate?

People are just unaware of the Clinical Nurse Specialist’s (CNS) role. They ask: “What are your skill sets and how can we better utilize you?” There is a great need for education and awareness around the CNS in the military. We want to make sure that the role of the CNS is understood and valued. The best ambassadors for this effort are the CNSs themselves, so we want to put our heads together and have an organization to build awareness and appreciation of our role.

Being an affiliate linked to a national organization can support and help with visibility and grow awareness. Our second goal is to share and collaborate on evidence-based practice and research. NACNS gives us the best forum for accomplishing these goals.

Q. Can you tell us more about the benefits of a NACNS military affiliate?

The primary benefit of the NACNS military affiliate is that it establishes a platform to better market the role of the CNS. An active affiliate will highlight the great things CNSs are doing across the nation as well as showing how CNSs are making an impact in military healthcare. We also plan to use the military affiliate to network and establish a robust mentoring program for newer CNSs. That’s an area of opportunity for the military affiliate, providing experienced mentors for recently graduated CNSs.

Q. Do you have anything else you would like to share about the role of the CNS?

I’m always looking for better ways to describe the role of a CNS. When the message gets through, people really do understand the unique value we bring to the table. I’ve found that analogies go a long way in this regard; they’re a simple way to explain what otherwise can sound like a complicated role. Here’s one of the best analogies about CNSs that I’ve heard:

A CNS is like a pitching coach in baseball. Now, can you play baseball without a pitching coach? Absolutely. So, why do they have pitching coaches and pay them so much money?

Teams invest in pitching coaches because pitching is the most important position on the field. For a team to be great, it has to have great pitching. So, even small improvements to a pitcher’s mechanics, to his pitch selection, or to something as simple as how he grips the ball can have significant impact on the team. The pitching coach can look at the spin of the ball, the velocity, or the way the ball leaves a pitcher’s hand and be able to offer insight that no one else on the field can see. The pitching coach will see things others miss. “You’re dropping your shoulder,” he’ll tell the pitcher who can’t find the strike zone. This advice and corrective action can and regularly does change the outcome for a pitcher and for the game.

A CNS plays a similar role to the pitching coach, providing expertise and guidance at key moments, relying on their deep expertise, to improve the quality of care and outcomes in hospitals and health systems across the country.

A Few Minutes With the 2021 CNS of the Year — Brittany Rhoades

Brittany RhoadesThis year’s CNS of the Year hails from the Lone Star State and is a clinical nurse specialist providing direct care to heart transplant and left ventricular assist device (LVAD) patients at Baylor St Luke’s Medical Center in Houston, TX. We caught up with Brittany Rhoades, Ph.D., APRN, CCNS, and she shared her thoughts on being a CNS, the CNS role, and the tip that Houston weather is excellent for gardening.

What role do you play at St. Luke’s Medical Center?

I started as a CNS for the transplant and LVAD program in an educational role for nursing and multidisciplinary staff. After a couple years, I transitioned to direct patient care practice. As a CNS, I can go from education roles to direct practice to quality or regulatory roles. The CNS role is very fluid, flexible, and necessary.

How did you become a CNS?

I started my nursing career at the University of Alabama at Birmingham. Many of the leaders in various areas of cardiology were CNSs. UAB also had a clinical nurse specialist program. That’s how I was introduced to the CNS role. It has provided me a way to become an advanced practice nurse while creating change at an organizational level.

What’s the biggest challenge facing CNSs?

Visibility and a clear understanding of the role is probably the biggest challenge. I’ve encountered individuals familiar with the CNS role who love CNSs and really know how to utilize them. But we need to educate more of our colleagues about the unique role of the CNS and how healthcare can benefit from CNSs’ expertise.

What’s the unique skill set that a CNS brings to an organization?

As an example, I’m an APRN and a Ph.D. researcher. I’m very passionate about qualitative research and learning how patients perceive things. I like to connect the two of those together. Clinicians have a particular perspective of illness and healthcare, and patients have their own unique perspectives. As a CNS, I want to bridge those perspectives to improve the healthcare experience for both patients and clinicians.

Why did you join NACNS?

I wanted to become a CNS because I wanted a broader scope than direct patient care and loved the CNS role. I quickly got involved with the Texas NACNS group as soon as I moved here. They are very encouraging, supportive and stress the importance of national membership.

It’s a great way to connect with like-minded people in the profession.

What do you do for fun?

I am a wife and mother to two beautiful girls. We enjoy gardening — Houston has terrific weather most of the year for being outside and gardening. We also appreciate the arts, museums, and theatre. We are always looking for a new place to explore.

These are the most lucrative nursing careers right now

3 highest paying clinical nursing jobs today

Which nursing careers pay the highest annual salary or hourly rates? Nursing jobs vary by specialty, setting, location, degree, and certification requirements. Nurses can specialize in treating a population (geriatrics, pediatrics, etc.) or specialize in a therapeutic area (oncology, dermatology, etc.) Additionally, shifts low in supply and high in demand can cause pay rates to grow in certain types of jobs.

Below are the nursing careers that generally pay the highest salary across all locations, specialties, and clinical settings. Most of the highest-paid nursing careers are APRNs, or advanced practice registered nurses, which are registered nurses who obtain a master’s level degree and additional experience or specialization after completing their Bachelor of Science in Nursing degree and RN certification.

1. Nurse Anesthetist (CRNA) – Nurse anesthetists administer anesthesia to patients who are undergoing medical procedures in a hospital, outpatient surgery center, or medical office. With additional documented experience in ICU or surgery, plus completing an additional program and passing certification requirements, RNs can become CRNAs and earn an average of $181,040 annually, according to the Bureau of Labor Statistics. CRNAs can make up to $230,000 annually, while most CRNA salaries range between $171,130 and $205,506, according to

2. Nurse Practitioner (NP) – Nurse practitioners also complete additional training and education to get their NP degree which enables them to treat patients more autonomously than many other types of nurses. Some states allow NPs to practice independently and prescribe medications while other states require NPs to work with a licensed physician. As of February 2021, nurse practitioners earn an average of $109,025 annually, according to data from

3. Clinical Nurse Specialist (CNS) – A clinical nurse specialist has obtained a minimum of a master’s degree, plus additional training in a specialized area of nursing practice, according to, which reports that the median salary for clinical nurse specialists as of May 2020 is $106,604. Clinical nurse specialists may specialize in a therapeutic area or population, and specialty certifications are available in gerontology, pediatrics, and neonatal care, according to the National Association of Clinical Nurse Specialists.

Honorable Mention – Registered Nurse (RN) – While not among the very top-paying jobs, RNs are well-paid. Additionally, becoming an RN is somewhat of the “gateway” milestone along the way to achieving higher-paying advanced practice nursing jobs. Completing an RN opens many doors and provides nurses with many more options for advanced degrees and more lucrative nursing roles. According to the Bureau of Labor Statistics, the average (mean) income for RNs nationally as of 2019 (the most recent BLS data available) is $37.24 per hour which translates to $77,460 annually, assuming a full-time schedule of about 40 hours per week.

Of the nearly three million RNs employed nationwide, the highest earners are those who work in outpatient care centers or hospital settings, with an average hourly income of $40.73 ($84,720 annually), and $38.20 per hour ($79,460 annually) respectively.

Where you work as an RN also impacts your hourly wage and annual income. California and Hawaii are the top-paying states for RNs, with hourly rates of $54.44 and 50.03, respectively, followed by Washington, D.C., Massachusetts, and Oregon as top-paying states, where the cost of living is also higher.

Other ways nurses may increase their annual income

In addition to high-paying clinical nursing careers, another way to grow your nursing career and annual income is to shift into leadership, administration, or teaching. Nurse administrators such as hospital CNOs, medical directors, etc. earn more than $100,000, and nurse instructors earn an average of $83,160 annually and up to $133,000 in the 90th percentile.

Changes in supply and demand can also factor into nursing salaries, causing pay fluctuations in either direction. For example, critical care nursing is in unusually high demand in 2020-2021 due to the coronavirus pandemic. This is causing pay rates in some areas to quadruple, as demand also grows by a reported 400-500%, multiple experts report. Switching practice areas may be a more feasible career change than obtaining a new advanced degree for some nurses.

If none of the above are an option, another way for nurses to potentially grow their annual income is to consider trying out a new part-time side-gig for a few extra hours a week. This may be a more realistic method to increase earnings for nurses who are unable to shift full-time into a new, higher-paying nursing career.