Steps to Become a Clinical Nurse Specialist
Step 1: Earn a Bachelor's Degree in Nursing
Aspiring CNSs must first attend nursing school. Since most CNS degree programs require the candidate to have a bachelor's degree, attending a four-year nursing school is the preferred route to take. Courses in nursing degree programs generally include pharmacology and pathophysiology basics, patient health assessment, anatomy and physiology, and nursing throughout all life stages. Student nurses also perform supervised clinical rotations.
It's important for students to maintain a minimum required grade point average. Most graduate degree programs are highly competitive and require applicants to have maintained a 3.0 minimum grade point average (GPA) in their bachelor's degree nursing program.
Students should also volunteer or get an internship. Given how most employers and all graduate degree programs require work experience, it would be beneficial to begin this process as early as possible. Volunteering at hospitals or community health clinics can be a good way to network and gain hands-on experience.
Step 2: Obtain State Licensure as Registered Nurse
All states require nurses to be licensed before practicing. CNS graduate degree programs also require applicants to be licensed as an RN. Most states require candidates to pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) administered by the National Council of State Boards of Nursing, and some states may have additional state nursing board licensure requirements. Nurses who are licensed in one state may generally apply for license by endorsement in another state.
Step 3: Gain Experience
Most CNS graduate degree programs require applicants to have gained experience as an RN in the specialty they have chosen. Generally, schools require one to two years of direct patient experience in a clinical setting. This experience can be obtained by performing RN nursing duties in hospitals, outpatient settings, or private practices.
It is essential to check program prerequisites. Candidates should verify the prerequisites for enrollment in their preferred graduate programs. This will allow them to select employment options that will meet those schools' admissions requirements.
Step 4: Meet Clinical Nurse Specialist Education Requirements
Master's degree programs for clinical nurse specialists generally take two to three years to complete, depending on their specialty. Students will develop advanced practice nursing skills including assessment, nursing practices, pharmacology, pathophysiology, and advanced nursing courses related to the specialty they have chosen. They will also gain extensive supervised clinical experience in their chosen medical specialty.
Prospective CNSs should also obtain prescriptive authority. Many employers prefer their CNSs to have the ability to write prescriptions. This authority is granted by the Drug Enforcement Administration, and it requires that the candidate complete specific training in pharmacology-related courses. These classes are generally available as part of many graduate degree programs.
Step 5: Apply for Certification
Not all CNS specialties have a certification credential available. There are certifications for advanced practice CNSs in orthopedics, by the Orthopaedic Nurses Certification Board; critical care, by the American Association of Critical Care Nurses; oncology, by the Oncology Nursing Certification Corporation; and for adult health, gerontology, psychiatric, home health and community health, by the American Nurses Credentialing Center. While qualifications for each certification vary, they generally require that the candidate be an RN, have completed a graduate degree program from an accredited school in the chosen specialty, have obtained the minimum required number of hours of clinical experience in the specialty, and pass the certification exam.
CNSs will need to maintain certification. Generally, the certification period for most CNS specialties is five years. Requirements vary by specialty but usually include being an RN and having completed some combination of the following: a minimum number of hours of clinical experience in the practice specialty, a minimum number or required continuing education hours in the specialty, academic class hours, professional publications or presentations, research, or other specific demonstrations of expertise and competence. Recertification requirements for RN licenses vary from state to state.
Step 6: Obtain Advanced Practice Nursing License from State Nursing Board
Many states require CNSs to be certified or licensed by the state nursing board. Requirements generally include maintaining an RN license, having a graduate degree from an accredited advanced practice nursing school, and being certified by a recognized CNS certification authority. For the CNS specialties that do not have certification, some states will accept school transcripts and other demonstrations that the candidate meets the minimum state licensing requirements as an advanced practice clinical nurse specialist.
Clinical Nurse Specialist Career Information
|Degree Level||Master's or post-graduate certificate; doctorate for researchers|
|Degree Fields||Bachelor's degree in nursing, master's degree in a CNS specialty|
|Licensure||All states require licenses for registered nurses (RNs); most states offer licenses for CNSs|
|Certification||CNSs can obtain certification in some advanced practice specialties|
|Experience||2+ years work experience|
|Key/Technical/Computer Skills||Leadership, teaching, research, written and verbal communication skills; medical equipment related to the specialty including heart monitoring devices, IV devices, EEG, catheterization devices, medication delivery devices, ventilation devices, nebulizers, and suction devices; basic word processing, data entry, and automated medical records software|
|Median Salary||$88,085 (2019)*|
What is a CNS nurse? A clinical nurse specialist (CNS) is an advanced practice registered nurse (RN) who specializes in a nursing practice identified by population, medical specialty, setting, or type of care. CNSs focus on research and theory in formulating diagnoses and promoting wellness, providing evidence-based advanced nursing care according to their specialty. Many practice in a hospital setting, but they can also be found in community health, outpatient, and corporate settings. Nursing can be physically demanding, with many hours spent standing and sometimes needing to lift or turn patients.
CNSs have a master's degree or a post-master's certificate as a clinical nurse specialist in a variety of practice specialties. A doctorate degree is necessary for those wishing to conduct research. All states require licensing for RNs; licensing is available in most states for CNSs. CNSs can obtain certification in some advanced practice specialties. Additionally, most employers prefer at least two years of work experience.
CNSs need to be skilled in leadership, teaching, research, and written and verbal communication, and need to know how to use medical equipment related to their specialty, including heart monitoring devices, IV devices, EEG, catheterization devices, medication delivery devices, ventilation devices, nebulizers, and suction devices. They also need to know how to use basic word processing, data entry, and automated medical record software.
As of May 2018, registered nurses made an annual median salary of $71,730, according to the U.S. Bureau of Labor Statistics, as compared to the median salary for clinical nurse specialists of $88,085 listed on Payscale.com in 2019.