Clinical nurse specialists (CNSs) are a type of advanced practice registered nurse (APRN). Their primary function is improving outcomes for patients, nurses, and system-wide organizations.
Like a nurse practitioner (NP), a CNS specializes in specific patient populations. While NPs focus on direct patient care, a CNS spends more time educating nurses and improving patient outcomes. Although their responsibilities still include providing high-level patient care, CNSs can also become supervisors on healthcare teams.
Clinical nurse specialists commonly take on five basic roles:
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Clinical nurse specialists can also specialize in the following areas:
A clinical nurse specialist's job varies depending on the type of facility they work at and their chosen specialty. However, their primary goal is always to improve outcomes. Therefore, they constantly ask questions like:
According to CNS Andrea Paddock, CNS responsibilities may change daily:
“My day-to-day can transition from being in my office planning for a project. So I'm doing a lot of reading, researching, writing, things like that. Other days, I'm out on the unit helping the nurses, running to codes, running simulations, teaching classes, running meetings, etc. No one day is ever the same.”
In fact, according to the 2020 NACNS survey, CNSs said they spent 26.6 percent of their day providing direct patient care, 22.1 percent consulting with nurses and other staff, 26.5 percent teaching nurses and staff, and 19.7 percent leading evidence-based practice projects. The majority of their time is spent precepting students (32.5%).
Clinical nurse specialists will also perform the following activities according to the survey:
In other words, CNSs wear several hats and are valued members of healthcare teams.
What does a clinical nurse specialist do every day? Clinical Nurse Specialist Andrea Paddock shares a day in her life, including what a CNS does and her journey to become one.
The median annual salary for clinical nurse specialists is $94,545 or $45 per hour as of July 2024, according to ZipRecruiter.
Clinical nurse specialists' salaries range between $71,000 and $137,000, with some making upwards of $162,500 annually. Your salary as a CNS may vary depending on your location, employer, and specialization.
Some hospitals or medical facilities seek out specific CNS roles with specialized skills. Sought-after positions like these often offer higher, more competitive wages.
Clinical nurse specialist positions require graduate degrees. So, pursuing this career path takes a lot of time, dedication, and education. It takes between 7-9 years to become a CNS, depending on your career and degree path.
Before becoming an APRN, you must earn your registered nursing (RN) licensure. To become an RN, you must complete an accredited Bachelor of Science in Nursing (BSN) or Associate Degree in Nursing (ADN) program. Since most CNS programs require BSNs, the process will be smoother if you go for a BSN right away.
After passing the NCLEX-RN exam, you'll earn your RN license and be able to start gaining valuable experience. Depending on the CNS program you want to attend, you may need 1-2 years of full-time RN experience.
You need at least a Master of Science in Nursing (MSN) degree with a clinical nurse specialist focus to enter this career field. However, over 20% of CNSs also choose to complete a Doctor of Nursing Practice (DNP), according to the National Association of Clinical Nurse Specialists (NACNS).
Administered by the American Nurses Credentialing Center, CNS certifications allow you to choose a specialty field. The most common clinical nurse specialist certifications include:
Most CNS certifications require renewal every few years.
Clinical nurse specialist programs are MSN or DNP tracks with a CNS focus. The National Association of Clinical Nurse Specialists (NACNS) lists 58 total CNS programs in the US.
From that list, we've found the best in-person and online clinical nurse specialist programs of 2024. Factors we considered in our ranking methodology include nursing school accreditation, academic outcomes, and tuition costs. We also looked at:
UTA's Adult-Gerontology Clinical Nurse Specialist (AG-CNS) program focuses on health restoration and promotion perspectives. The program also seeks to develop students' case management skills. Nurses in this program concentrate on physiological and psychosocial theories, concepts, and research underlying individuals' self-care and growth needs.
St. John Fisher College offers an Adult-Gerontology Clinical Nurse Specialist MSN and post-master's certificate. They exclusively offer these programs on campus, so online study is not an option. The MSN path covers 43-44 credit hours and 385 clinical hours over two years.
The University of Detroit Mercy's AG-CNS degree is a fully online graduate program. Throughout the course of study, students learn how to affect changes in direct patient care and facility administration.
Additionally, the university's graduates have a 100% pass rate across adult-gerontology CNS certification exams from 2016-2021. APRNs in other specialties may earn a post-graduate CNS certificate at the University of Detroit Mercy.
Alverno College's AG-CNS program prepares students to provide advanced care across the age continuum, from illness to wellness and acute to primary care. This degree encompasses 39 credits, including two capstone courses. Alverno College offers in-person courses scheduled every other weekend, and fully online options are not available to CNS students.
IUPUI offers an Adult Gerontology and Pediatric CNS degree path. The university offers flexible start dates every semester, allowing students to begin studying in the fall, spring, or summer. Although students primarily attend classes online, IUPUI does require in-person lab days.
Penn Nursing offers AG-CNS, Pediatric, and Neonatal CNS degree paths. Students can complete these programs in as little as one year while gaining clinical experience at top-ranked hospitals. These include the Children's Hospital of Philadelphia and the Penn Health System.
The CNS programs offered by Johns Hopkins University culminate in a Doctor of Nursing Practice degree. The university provides Adult-Gerontological Health, Adult-Gerontololgical Critical Care, and Pediatric Critical Care CNS paths.
Although students may attend classes online, Johns Hopkins requires some on-campus immersions and in-person clinical rotations. Notably, distance students may complete clinical rotations in their locales.
The University of Washington offers Pediatric and Women's Health CNS paths that each culminate in a DNP. UW is one of a few Women's Health Clinical Nurse Specialist programs in the country. The university only allows students to attend these programs full-time, which prepares them for board certification in three years.
The University of Wisconsin at Milwaukee offers a post-graduate CNS certificate in three specialty areas. APRNs may pursue Adult-Gerontology, Pediatric, or Maternal/Infant CNS certification through UWM. Each certificate program consists of 18 credit hours, which students can complete in just one year.
1 Eligible states for this rate are North Dakota, South Dakota, Nebraska, Kansas, Iowa, Missouri, Illinois, Indiana, Michigan, and Ohio
Rush University offers three DNP programs for interested students: pediatrics, adult gerontology, and neonatal. The cohorts are kept intentionally small to optimize clinical placement and classroom experience.
Rush University offers AG Critical Care, Neonatal, and Peds Acute Care CNS tracks that culminate in DNP degrees. The school intentionally keeps CNS program cohorts small (about 30 students per class) to optimize clinical placements and classroom experiences.
CNS certifications don't cover all specialty areas of nursing like other degrees. Currently, clinical nurse specialists can earn certifications in the following specialties:
| CREDENTIAL | CERTIFICATION | ORGANIZATION |
| ACCNS-AG | Clinical Nurse Specialist; Wellness through Acute Care (Adult-Gerontology) | aacn.org |
| ACCNS-N | Clinical Nurse Specialist; Wellness through Acute Care (Neonatal) | aacn.org |
| ACCNS-P | Clinical Nurse Specialist, Wellness through Acute Care (Pediatric) | aacn.org |
| ACNS-BC | Adult Health Clinical Nurse Specialist | www.nursingworld.org |
| AGCNS-BC | Adult-Gerontology Clinical Nurse Specialist | www.nursingworld.org |
| AOCNS | Advanced Oncology Certified Clinical Nurse Specialist | oncc.org |
| CCNS | Acute/Critical Care Clinical Nurse Specialist (Adult, Pediatric & Neonatal) | aacn.org |
| CNS-CP | Certified Clinical Nurse Specialist Perioperative | cc-institute.org |
| HHCNS-BC | Home Health Clinical Nurse Specialist Certification (retired exam) | www.nursingworld.org |
| OCNS-C | Orthopaedic Clinical Nurse Specialist - Certified | oncb.org |
| PCNS-BC | Pediatric Clinical Nurse Specialist | www.nursingworld.org |
| PHCNS-BC | Public/Community Health Clinical Nurse Specialist (retired exam) | www.nursingworld.org |
| PMHCNS-BC | Adult Psychiatric-Mental Health Clinical Nurse Specialist | www.nursingworld.org |
| PMHCNS-BC | Child/Adolescent Psychiatric-Mental Health Clinical Nurse Specialist | www.nursingworld.org |
The continuing nursing shortage creates demand for all types of nurses across all specialties, including clinical nurse specialists. As our population ages, that demand will grow even more in the coming years.
The numbers back up the projected demand for advanced practice nurses. The U.S. Bureau of Labor Statistics (BLS) predicts that APRN jobs will grow by 38% from 2022 to 2032. This increase is much faster than the growth rate of all other professions nationwide. Though the BLS prediction does not specifically address CNS growth, it's a reliable benchmark since CNSs are also APRNs.
The 2022 NACNS Census revealed that nearly one-third of CNSs plan to retire in the next five years. With a large portion of the career field taking their leave, the need for new CNSs to fill their positions will grow.
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