Clinical Nurse Specialist

Clinical nurse specialists (CNSs) play an integral role in the healthcare field. They are advanced practice registered nurses (APRNs) who provide direct patient care and serve in leadership and consulting roles. As such, they must possess a unique blend of skills, knowledge, and experience. They diagnose health needs and develop treatment plans, enabling them to help patients manage illnesses or injuries more effectively. They can also assist in developing evidence-based protocols, guidelines, policies, and procedures that can potentially improve health outcomes on an organizational level.

To become a CNS, students must complete a general education nursing program and obtain an RN license from a state’s board of nursing. After gaining some work experience, they will need to earn a master’s degree or higher in nursing, which typically requires at least two years of study and clinical practice. Many potential CNSs choose to complete a doctorate program which can open up more job opportunities and potentially higher salaries. After completing their degree, graduates must earn national certification from the American Nurses Credentialing Center (ANCC) or the American Association of Critical-Care Nurses (AACN). 

In addition to the educational requirements for becoming a CNS, many employers also require several years of on-the-job experience. This experience should include working with patients in both clinical settings and medical offices, as well as some administrative work such as overseeing staff or budgeting. Having additional certifications related to areas of expertise can also be beneficial when applying for jobs, as many employers prefer candidates who have specialized training and certifications beyond their degree requirements.  

Becoming a clinical nurse specialist requires dedication and hard work, but it can lead to a rewarding career with great potential growth opportunities. Use this guide to get started down this path and learn more about educational programs, day-to-day job duties, and earning potential.

A graduate degree is required to become a clinical nurse specialist. Options include a master’s of science in nursing or a doctor of nursing practice degree. Nurses who have already earned a master’s degree or higher in another field can opt to complete a shorter post-master’s certificate. 

Most programs offer students the opportunity to specialize in a specific population, such as pediatrics, neonatal, or adult-gerontology. All three of these specializations also have matching national certifications nurses can earn. Some schools offer specializations such as maternal/fetal medicine, which do not have associated national certifications.

To become a clinical nurse specialist, students must complete a general nursing degree and a master’s or doctorate program. Admission requirements for general nursing programs can be rigorous and demanding. Applicants must typically complete a minimum of prerequisite coursework, maintain a set GPA, provide letters of recommendation, and compose a statement of purpose that is both comprehensive and compelling. 

Depending on the number of applicants, demand for nurses in the local area, and level of rigor in the program, additional criteria may also be required, including volunteer or work experience related to the field of nursing. Additionally, some nursing programs may require applicants to participate in an interview or assessment process as part of the admissions process. 

Master’s of science in nursing and doctor of nursing practice degree programs will have similarly stringent requirements. They require a current and unencumbered registered nurse license and already having completed a general nursing degree program. Work experience requirements are much more common for these advanced degrees as well.

Accreditation for nursing degree programs is incredibly important as it is a stamp of approval from nationally-recognized organizations that the program meets rigorous standards in faculty, facilities, and student outcomes. Accreditation is also key in ensuring students’ course credits will transfer to other accredited universities and colleges, ensuring their degrees are recognized across the country. 

The Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission For Education In Nursing (ACEN) are the main national accrediting bodies for nursing programs. They are recognized by the US Department of Education.

Azusa Pacific University

At Azusa Pacific University, students complete their master of science in nursing clinical nurse specialist degree. There are two areas of concentration to choose from: adult-gerontology and pediatrics. These prepare nurses to work in an acute primary or long-term care advanced-practice setting. The primary mission of this program is to train students to develop and sustain an evidence-based practice to provide the highest level of patient care.

Graduates of this program are eligible to apply for certification as a clinical nurse specialist in California.  While this is a full-time on-campus program, students are only required to attend classes one to two days per week, allowing for a flexible schedule. Clinicals are completed in the students’ specialty at hospitals, churches, primary care clinics, and schools.

• Location: Azusa and San Diego, CA 
• Duration: Two to three years
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $860 per credit

University of Wisconsin-Milwaukee – College of Nursing

Expanding one’s knowledge and patient population can be achieved through the clinical nurse specialist certificate offered at the University of Wisconsin-Milwaukee College of Nursing. This certificate program is a collaborative effort between students and faculty. It allows graduates to take national certification exams from organizations such as the American Nurses Credentialing Center. To complete this program, nurses must already have a master’s degree in nursing. 

This certificate is made up of 18 credit hours worth of courses, with each course consisting of three credits. These courses are designed to be taken sequentially over three semesters, allowing students to complete the program within 12 months. The population focus for practicum courses will vary but will be in the students’ chosen specialty area. These areas include pediatrics, adult-gerontology, and maternal/infant.

• Location: Milwaukee, WI
• Duration: 12 months
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $1,841.21 per credit

University of Washington – School of Nursing

The Women’s health clinical nurse specialist graduate certificate at the University of Washington School of Nursing is specially tailored for already licensed and practicing clinical nurse specialists, nurse practitioners, and nurse anesthetists who wish to expand their scope of practice. By completing this program, students will have the opportunity to gain valuable knowledge and experience in providing care to families throughout the childbearing process- from prenatal and birthing to postpartum and infancy.

The certificate requires coursework in family-centered care, evidence-based practice, nursing research, current trends in women’s health, leadership and management roles for the CNS, and public health issues related to the health of mothers and infants. Students who wish to complete this certificate but are not yet advanced practice nurses should apply for the school’s doctor of nursing practice degree. 

• Location: Seattle, WA
• Duration: 12 months
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $944 per credit

The Ohio State University – College of Nursing

There are several degree options for aspiring clinical nurse specialists at the Ohio State University College of nursing. Students at the school can complete a traditional master’s of science in nursing, a post-master’s certificate, or a doctor of nursing practice degree. 

Graduates of this program are prepared to assume an advanced-practice role in nursing and put theory and research into practice in caring for individuals and families. Other skills students will gain include taking on roles such as clinical coordination, case management, staff and patient education, or staff roles in nursing research. 

This program requires advanced health assessment, pathophysiology of altered health states, and advanced pharmacology. To gain hands-on experience, all students will complete extensive practicums with targeted populations.

• Location: Columbus, OH 
• Duration: One to three years
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $1,793 per credit

Rhode Island College – Zvart Onanian School of Nursing

The certificate of graduate studies in adult/gerontology acute care for clinical nurse specialists at Rhode Island College Zvart Onanian School of Nursing is a rigorous 18-credit program designed to help highly experienced nurses with a master’s degree expand their current role as clinical nurse specialists. Admission requirements for this program are equivalent to those for the master’s of science in nursing program and include a minimum of one year of acute care experience. 

Once accepted into the program, students must complete all course requirements to earn their certificate, including health promotion across the lifespan, advanced pathophysiology and pharmacology for clinical nurse specialists, and acute care clinicals. 

Graduates can sit for the  American Nurses Credentialing Center Adult Acute exam or the American Association of Critical Care Nurses; Adult-Gerontology Acute Care NP exam.

• Location: Providence, RI 
• Duration: One year
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $964 per credit

Purdue University Northwest – College of Nursing

The online adult-gerontology master’s of science in nursing at Purdue University Northwest College of Nursing is a comprehensive educational opportunity that prepares graduates to work in various healthcare roles. The core curriculum focuses on improving patient outcomes by focusing on the impact of patient care, nursing practice, and organizational systems. Faculty members are highly experienced and share their best practices with students in ways that promote effective learning.

This is a part-time three-year program with extensive clinical experiences to ensure graduates have the skill necessary to excel in this field. Admission requirements for this program include already having completed an undergraduate degree in nursing,  and minimum undergraduate GPA of 3.0,  a current and unencumbered license as a registered nurse in the US, and prerequisite coursework in statistics.

• Location: Hammond, IN 
• Duration: Three years
• Accreditation: Accreditation Commission for Education in Nursing (ACEN)
• Tuition: $486.45 per credit

Texas Christian University – Harris College of Nursing & Health Sciences

BSN-prepared registered nurses can complete the advanced, innovative, and solution-oriented doctor of nursing practice program at Texas Christian University Harris College of Nursing & Health Sciences. This program combines online coursework with an intensive on-campus session to equip students with the knowledge and skills needed to solve complex healthcare problems and identify new opportunities in the field. 

By completing the DNP program, nurses will receive the highest academic preparation for clinical practice and become eligible for leadership positions in various healthcare settings. 

This program is designed to give students the necessary knowledge and skills to succeed in this rapidly evolving field. Required classes include the clinical nurse specialist and professional practice, decision science and informatics, and diagnostic reasoning, and advanced patient management.

• Location: Fort Worth, TX
• Duration: One to three years
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $1,870 per credit

California State University, Dominguez Hills – School of Nursing

The three clinical nurse specialist online programs offered at California State University, Dominguez Hills School of Nursing include adult-gerontology, neonatal, and pediatric. This program will equip students with advanced nursing skills to confidently provide direct care to special populations. Knowledge gained while completing this degree includes evidence-based standards, protocols, and systems that shape healthcare today. 

The program is designed with working nurses in mind. Courses are conducted online in an asynchronous format, and there are a few mandatory on-campus meetings throughout the program to supplement studies. Clinical hours focus on acquiring competencies appropriate for a population while providing wellness, acute care, and other services. 

To enroll in the program, applicants must have a foundation of one to two years of recent acute care practice within their specialty population. The program requires a minimum of 500 hours in clinical settings under qualified preceptors for graduation.

• Location: Carson, CA
• Duration: Three to four years
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $7,176 for six credits or more

Edgewood College

Edgewood College offers an outstanding online opportunity for those looking to become clinical nurse specialists. The program provides two tracks for students to choose from: completing the master of science in nursing clinical nurse specialist or continuing with their education and achieving the doctor of nursing practice executive leadership degree. Both degrees are offered completely through distance learning with full or part-time options. 

To be considered for either degree, students must have at least an undergraduate degree in nursing, two letters of recommendation from nursing supervisors, a written statement, and a current and unencumbered license as a registered nurse. After admission and prior to enrolling in the program, students must pass a background check and drug screening. 

• Location: Madison, WI
• Duration: Three to four years
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $1,072 per credit

Kent State University – College of Nursing

The graduate programs for clinical nurses specialists in adult-gerontology at Kent state offer students excellent online courses, maximum flexibility, and affordability. Degree options include a master’s of science in nursing or a doctor of nursing practice. Alternatively, there is a post-master’s certificate option for students who already hold a master’s degree. 

As part of this program, students are required to complete 525 clinical practicum hours with qualified clinical nurse specialist preceptors in their primary state of residence, exposing them to various populations and care styles. With faculty mentorship and advising from nationally certified advanced practice nurses, students can be sure they receive a quality education. Flexible enrollment means students can start in the fall or spring semester and complete the entire program full or part-time. 

• Location: Kent, OH
• Duration: Four years
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $525 per credit

Becoming a clinical nurse specialist typically takes approximately seven to nine years of study and work experience. Before becoming certified, individuals must have obtained either a doctorate or master’s degree in nursing from an accredited program and must be licensed as a registered nurses. After completing the academic component of their education, prospective clinical nurse specialists must pass a national certification exam.

Step 1: Graduate from High School or Complete a GED (Four Years)

Earning a high school diploma or a GED is the first step in the educational journey to becoming a clinical nurse specialist. This base level of education prepares students for additional studies and demonstrates an ability to complete an educational program. 

Students should focus on math, biology, anatomy, and chemistry classes, as well as advanced placement classes, to help prepare them for the rigors of nursing school. 

Step 2: Complete a Nursing Program (Two to Four Years)

To ensure that nurses are competent and well-versed in the current medical landscape, they must complete an associate’s degree in nursing or a bachelor’s of science in nursing. These general nursing programs provide the baseline skills necessary to be competent and safe nurses. While either degree will often suffice, employers and graduate programs increasingly require a bachelor’s degree at a minimum. 

Step 3: Become a Registered Nurse (Timelines Vary)

The next step after completing nursing school is obtaining a registered nurse license from the state board of nursing. Requirements will vary, including passing the National Council Licensure Examination (NCLEX) and providing proof of a completed nursing program. 

Step 4: Gain Work Experience (One Year Minimum)

After obtaining a license to practice as a registered nurse, it is necessary to gain some work experience before applying to graduate school. It can be advantageous to work in a specialization if the goal is to pursue education in that area, such as pediatric or adult-gerontology. 

Step 5: Complete a Graduate Degree in Nursing (Two to Four Years)

Clinical nurse specialists need to complete either a master’s of science in nursing or a doctor of nursing practice degree. This degree can take between two to four years to earn depending on previous education. 

Step 6: Obtain National Certification for Clinical Nurse Specialist (Timelines Vary)

National certification as a clinical nurse specialist demonstrates a high level of competency in this field and is required in most states to obtain a license. More details on certification can be found in the certification and licensure section below. 

Step 7: Obtain State Licensure (Timelines Varies)

All states require that clinical nurse specialists obtain a license to practice. The requirements vary by state but typically include education, background checks, and national certification. More details on certification can be found in the certification and licensure section below.

Clinical nurse specialists typically work in acute care settings such as hospitals, long-term care facilities, and physician offices. They also may serve as consultants for other healthcare organizations, including ambulatory care centers, home health services, schools and universities, correctional institutions, community health agencies, and insurance companies. 

Job duties will vary based on the population served and the place of employment but will typically include:

• Writing, implementing, and monitoring evidence-based patient care plans based on each patient’s individual needs
• Administering medications and treatments, monitoring their effects, and managing any adverse reactions
• Collaborating with interdisciplinary teams to coordinate holistic patient care
• Educating patients, families, and staff on proper nursing processes, medical conditions, treatments, and safety practices 
• Performing health status assessments through physical examination, laboratory tests, observation, and interviews with patients and their families 
• Developing policies that are aimed at improving patient care outcomes while ensuring compliance with federal regulations 
• Participating in research projects related to clinical practice areas of interest
• Maintaining accurate documentation of patient progress notes and treatment records in accordance with HIPAA guidelines 
• Facilitating family conferences to evaluate treatment plans and provide education about home health management techniques for long-term care/chronic illness patients 
• Participating in continuing education activities to stay up-to-date on best practices within the field of nursing

Licensure is required in all 50 states in order to practice as a clinical nurse specialist. Requirements for certification will vary from state to state but will typically include:

• Complete an approved or accredited master’s or doctorate-level clinical nurse specialist degree program. 
• A current, active, and unencumbered registered nurse license 
• Hold a national certification as a clinical nurse specialist
• Pass a background check and drug screening
• Pay application and licensing fees 

Certification as a clinical nurse specialist is a voluntary step but is required by most states to obtain a license. The primary certification agencies are the American Nurses Credentialing Center (ANCC) and the American Association of Critical-Care Nurses (AACN). 

To be eligible for the Adult-Gerontology Clinical Nurse Specialist (AGCNS-BC) certification from the ANCC, candidates must have:

• A current and active RN license in the US 
• A master’s, post-graduate certificate, or doctor of nursing practice degree from an adult-gerontology clinical nurse specialist (AGCNS) program accredited by the Commission on Collegiate Nursing Education (CCNE),  the Accreditation Commission for Education in Nursing (ACEN), or the Commission for Nursing Education Accreditation (CNEA)
• The degree or post-master’s certificate must include a minimum of 500 faculty-supervised clinical hours 
• Complete three separate courses in advanced physiology/pathophysiology, advanced health assessment, and advanced pharmacology
• Proof of coursework with content in health promotion and/or maintenance and differential diagnosis and disease management

The AACN offers certifications as ACCNS-Neonatal, ACCNS-Pediatric, or ACCNS-Adult-Gerontology. The eligibility requirements 

• Have a current, unencumbered RN or APRN license
• Complete a graduate-level advanced practice education program in adult-gerontology, neonatal, or pediatrics that meets curriculum and clinical practice requirements 

The Bureau of Labor Statistics does not have salary data for clinical nurse specialists but does detail the related occupation: nurse practitioners. The 234,690 nurse practitioners and clinical nurse specialists in the United States earn $118,040 per year on average. Here are the salary percentiles:

• 10th percentile: $79,470
• 25th percentile: $99,540
• 50th percentile (median): $120,680
• 75th percentile: $129,680
• 90th percentile: $163,350

Here are some alternatives to a career as a clinical nurse specialist. 

Become a Nurse Practitioner

Nurse practitioners provide quality healthcare services to patients throughout the US, ranging from advanced assessment and diagnosis to disease prevention and management. By leveraging their expertise in medical science and care delivery, nurse practitioners can provide comprehensive healthcare services, including ordering and interpreting diagnostic tests, prescribing medications, writing referrals for medical procedures, and providing preoperative assessments. 

• Typical Education: Master’s of science in nursing or doctor of nursing practice 
• Licensing or Certifying Organization: American Academy of Nurse Practitioners (AANP), American Nurses Credentialing Center (ANCC), American Association of Critical-Care Nurses (AACN), National Certification Corporation (NCC), Pediatric Nursing Certification Board (PNCB), American Midwifery Certification Board (AMCB), Dermatology Nursing Certification Board (DNCB), Nephrology Nursing Certification Commission (NNCC), Orthopaedic Nurses Certification Board (ONCB), Oncology Nursing Certification Corporation (ONCC) 

Become a Nurse Anesthetist 

A nurse anesthetist is a highly trained healthcare professional specializing in administering anesthesia. They are responsible for assessing and monitoring patients before, during, and after anesthesia is administered. They will also collaborate with surgeons, nurses, and other healthcare personnel to ensure patient safety. 

In addition to their duties related to anesthesia, they may assist with post-anesthesia care, pain management, the prevention of infection, or developing new guidelines for the safe administration of anesthesia. 

• Typical Education: Master’s of science in nursing or doctor of nursing practice
• Licensing or Certifying Organization: National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA)

Become a Certified Nurse Midwife

Certified nurse midwives are advanced practice registered nurses trained to provide well-women, gynecological, prenatal, and postpartum care. They have expertise in normal, low-risk pregnancy, labor, and childbirth and are qualified to prescribe medications and manage labor pain during delivery. 

They also provide various services such as contraceptive counseling and management, screening for sexually transmitted infections, preconception health services, primary care for women throughout their lifespans, and more.

• Typical Education: Master’s of science in nursing or doctor of nursing practice
• Licensing or Certifying Organization: American Midwifery Certification Board (ACMB)

Kimmy Gustafson

Writer

At HealthcareDegree.com, Kimmy Gustafson has delivered in-depth and insightful articles since 2019, aiding prospective students to navigate the complexities of choosing the right healthcare degree. Her recent work includes topics such as the ethics of gene editing and physician assistant’s fight for autonomy.

Kimmy has been a freelance writer for more than a decade, writing hundreds of articles on a wide variety of topics such as startups, nonprofits, healthcare, kiteboarding, the outdoors, and higher education. She is passionate about seeing the world and has traveled to over 27 countries. She holds a bachelor’s degree in journalism from the University of Oregon. When not working, she can be found outdoors, parenting, kiteboarding, or cooking.