The Résumé Rx

Becoming a Clinical Nurse Specialist: What It Takes and How to Get There

Amanda Guarniere

As a highly respected, advanced-practice registered nurse (APRN), a Clinical Nurse Specialist (CNS) plays a pivotal role in the healthcare field. These professionals are known for their expertise, leadership skills, and commitment to enhancing patient care.

If you are a nurse seeking to develop your career further, becoming a CNS could be an excellent pathway for you. This article will provide an informative guide on the duties, work expectations, and career trajectory of a Clinical Nurse Specialist.

Table of Contents

What does a Clinical Nurse Specialist Do

Clinical nurse specialists (CNS) are a distinct group within the realm of advanced practice registered nurses (APRNs). These healthcare professionals boast specialized knowledge and skills, having undergone rigorous academic and practical training to handle complex patient needs. 

As their title suggests, they provide direct patient care, with a laser focus on a specific patient population or healthcare specialty. Whether it’s geriatrics, pediatrics, mental health, or oncology, CNSs are well-versed in caring for certain demographics. 

Among their many responsibilities, clinical nurse specialists assess, diagnose, and manage patients’ health conditions. They are adept at identifying health-related problems, devising accurate diagnoses, and overseeing the management of patients’ health conditions to ensure optimal care. 

They also play a pivotal role in developing and implementing treatment plans. They have the authority to prescribe medications and therapies, making them key players in the patient’s recovery journey. 

CNSs are team players, often collaborating closely with other members of healthcare teams. By blending their unique expertise with that of doctors, other nurses, and therapists, they strive to improve patient outcomes and promote evidence-based practice

Their role extends beyond clinical duties. They provide education and counseling to patients, families, and other healthcare professionals, ensuring everyone involved in the patient’s care understands the treatment plan and expectations. 

Furthermore, clinical nurse specialists are frequently involved in research, quality improvement initiatives, and policy development. Their insights and experience are invaluable in shaping healthcare policies and practices

As leaders and advocates for their patients, CNSs contribute significantly to the advancement of nursing practice. They are passionate about enhancing patient care and are often at the forefront of innovative healthcare solutions. 

Clinical Nurse Specialist Salary Info (How much do they actually make?)

According to the Bureau of Labor Statistics (BLS), the median annual wage for nurse practitioners, which includes the role of a clinical nurse specialist, was a whopping $109,820 in May 2019. That’s a figure that might make your eyes pop, right? 

However, the range of salaries isn’t just random. It’s influenced by a number of different factors, which we’ve laid out for you below: 

  • Location: The region where you work can significantly impact your paycheck. In places where the cost of living is high, you can typically expect higher compensation. Likewise, in areas where the demand for healthcare professionals is high, salaries often follow suit. 
RegionAverage Salary for Clinical Nurse Specialists
New York, NY$115,000
San Francisco, CA$130,000
Houston, TX$97,000

As you can see, salaries for clinical nurse specialists can vary significantly across different regions. Therefore, when planning your career pathway, consider these factors along with your personal and professional goals.

  • Experience: As with most careers, the more experience you have, the higher your potential earnings. A nurse specialist just starting out in their career will likely earn less than a seasoned professional with years of experience under their belt.
  • Specialization: Some specializations within the nursing field may command higher salaries. For instance, a clinical nurse specialist with a focus on oncology or cardiology may earn more than one specializing in general practice.
  • Work Setting: The nature of your workplace also affects your earnings. Clinical nurse specialists working in a large hospital setting, with its more complex cases and demanding pace, might earn a higher salary than those working in a smaller, more relaxed private practice.

So, while the figures may seem enticing, remember to consider these variables when envisioning your future as a clinical nurse specialist. It’s not just about the dollar signs, but about finding a role and a setting that suits you best.

Clinical Nurse Specialist Sub-Specialties: Roles, Requirements, and Salaries

Pediatrics CNS 

What does a Pediatrics Clinical Nurse Specialist do?

Pediatric nurses work with young patients, usually infants through the age of 18, although some may work with patients as old as 21. They keep patients healthy, carry out care plans, and see patients with a variety of conditions. 

A pediatric clinical nurse specialist (CNS) is sometimes referred to as a parent-child nurse. They are highly trained nurses who have at least a master’s degree and they focus on the holistic care of children and their families. With their expertise, they work hand in hand with parents in making healthcare decisions for children.

What’s required to become a Pediatrics Clinical Nurse Specialist? 

To become a pediatric CNS, you will need to have a bachelor’s degree in nursing. After that, you will need to get a master’s degree, frequently with a specialty in pediatrics. To practice, you’ll also need certification in pediatrics along with your RN license. Something to take note of is that the National Association of Clinical Nurse Specialists has recommended that a doctorate in nursing practice (DNP) be required for CNSs by 2030. 

How much does a Pediatrics Clinical Nurse Specialist make?

According to salary.com, the average salary for a pediatric CNS in the U.S. is $92,386.  

Neonatal Clinical Nurse Specialist

What does a Neonatal Clinical Nurse Specialist do?

Neonatal clinical nurses care for infants who have a variety of medical conditions. They often work in a neonatal intensive care unit, providing support for extremely vulnerable patients. Duties may include feeding, bathing, changing diapers, providing medication, and assessing the baby’s condition. 

What’s required to become a Neonatal Clinical Nurse Specialist?

The first step is to become a registered nurse, which means completing an associate’s degree or bachelor’s degree and passing the NCLEX exam. You should then gain experience working with neonatal patients and complete certification.

How much does a Neonatal Clinical Nurse Specialist make?

Salary.com says that the average base salary for a neonatal nurse is $86,281. 

Psychiatric Clinical Nurse Specialist 

What does a Psychiatric Clinical Nurse Specialist do?

These nurses specialize in mental health. They work with a team of psychiatrists, physicians, and social workers to create better mental health for a variety of patients. Specific duties include creating treatment plans, evaluating patients, counseling patients, and administering medications. 

What’s required to become a Psychiatric Clinical Nurse Specialist?

You need to be an RN first, so an associate’s or bachelor’s degree is required. You’ll then need to pass the NCLEX-RN exam. Certification is not required, but many psychiatric nurse specialists will complete mental-health credentials through the American Nurses Credentialing Center (ANCC), the Addictions Nursing Certification Board, or the American Holistic Nurses Credentialing Corporation.

How much do Psychiatric Clinical Nurse Specialists make?

According to salary.com, the average annual income of a psychiatric CNS is $82,300. 

Critical Care Clinical Nurse Specialist

What does a Critical Care Clinical Nurse Specialist do?

Working in ICUs, step-down units, and telehealth centers, critical care nurses provide support to patients with injuries and illnesses. Duties vary widely depending on the patient and their condition, but responsibilities can include monitoring vitals, administering treatments, setting up medical devices, and providing emergency life-saving care, such as CPR.

What’s required to become a Critical Care Clinical Nurse Specialist?

You will first need an associate’s degree or bachelor’s degree in nursing. You can then become a Registered Nurse (RN) by completing the NCLEX-RN exam. Most will work in a critical care setting as an RN, then complete specialty credentialing. Options include the Adult Critical Care Nurse (CCRN) credential through the American Association of Critical-Care Nurses. 

How much do Critical Care Clinical Nurse Specialists make?

Information from salary.com says that critical care nurses earn an average salary of $82,800.

Career Path to Becoming a Clinical Nurse Specialist

Step 1: Acquiring a Bachelor’s Degree in Nursing (BSN) 

You’ve probably guessed it, but the first step is indeed obtaining a Bachelor of Science in Nursing (BSN). This is the essential foundation that sets the stage for your future specializations. 

After your BSN, you’ll need to clock in for some hours (usually 2-3 years) working as a registered nurse. It’s an essential prerequisite before diving into your MSN and CNS studies. 

Step 2: Master’s Degree (MSN) 

With your BSN in the bag, it’s time to level up. The next stage is a Master of Science in Nursing (MSN). Here, you’ll start diving deeper into advanced nursing practices, making it a crucial step toward becoming a clinical nurse specialist. 

Step 3: CNS Certificate Specialization

With your MSN, you can proceed to earn your Clinical Nurse Specialist (CNS) certificate. This is where you get to choose a special field (like geriatrics, pediatrics, or oncology) and become an expert in it. 

Step 4: Doctorate Degree (optional) 

For those who dream of reaching the pinnacle, a Doctor of Nursing Practice (DNP) degree is the ultimate achievement. Although not mandatory, it’s a crowning glory that can boost your career and expand your opportunities. 

Continuing Education Requirements for a Clinical Nurse Specialist

In the healthcare galaxy, clinical nurse specialists (CNS) are akin to shooting stars. They are advanced practice registered nurses (APRNs) who have decided to specialize in a distinct realm of healthcare. 

Every shooting star, though, needs to replenish its glow. For clinical nurse specialists, this comes in the form of continuing education. Depending on their location and certifying organization, the requirements will vary. However, many states have a constant: the need for an active RN license and APRN certification. This typically involves earning continuing education units (CEUs) on a regular basis.

Like a cosmic map guiding their journey, CEU requirements often specify a particular number of hours or credits in content areas vital to their specialty. They might study pharmacology, diving deep into the world of medicines, or pathophysiology, learning about the ways diseases affect our bodies. Evidence-based practice could be another area of exploration, understanding the best ways to apply clinical research to real-world patient care. 

There’s also a time factor to consider. Just like how shooting stars can’t shine forever, CNSs are often required to complete a certain number of CEUs within a given time frame, such as every two years, in order to maintain their certification and licensure. 

So, how do they acquire these CEUs? The universe is their oyster. They might attend conferences, workshops, seminars, or webinars related to their specialty. Online courses or self-study modules can also offer valuable knowledge treasures. 

In addition, some certifying organizations for clinical nurse specialists, like the American Nurses Credentialing Center (ANCC) or the National Association of Clinical Nurse Specialists (NACNS), offer their own continuing education programs or resources. These can be a guiding North Star for CNSs seeking to further their knowledge. 

Lastly, clinical nurse specialists can also earn CEUs by contributing to the wider healthcare universe. They might publish research articles, share new discoveries, present at conferences to inspire others, or participate in professional organizations and committees to shape the future of healthcare.

Core Skills Required to Become a Clinical Nurse Specialist

  • Leadership Abilities. As a Clinical Nurse Specialist, you’ll often find yourself at the forefront of the healthcare team. This calls for an abundance of leadership skills. First and foremost, you’ll need to be adept at managing people, which includes everything from delegating tasks to resolving conflicts. Secondly, you’ll need to be a decision-maker, someone who can quickly assess a situation and make informed decisions. Finally, prepare to step up and inspire others, leading by example to foster a positive, productive environment. 
  • Education and Research Skills. You better love learning because as a Clinical Nurse Specialist, you’re in for a lifetime of it! You’ll consistently be called upon to contribute to research, diving into the world of medical literature, identifying gaps in current knowledge, and perhaps even spearheading your own studies. Furthermore, you’ll be responsible for implementing new policies based on your findings and the latest evidence-based practices. Lastly, prepare to educate others in the healthcare team, sharing your knowledge and providing guidance to ensure the best patient care. 
  • Communication Skills. Last, but certainly not least, you’ll serve as the crucial link between the patients, their families, and the healthcare team. This means you’ll need to be able to decipher and explain complex medical terminologies in a way that’s easily comprehensible to all. Additionally, you’ll need to be a good listener, able to understand and empathize with patients and families’ concerns. And don’t forget about written communication – you’ll be jotting down notes, writing reports, and more. 


How long does it take to become a clinical nurse specialist?

The path to becoming a clinical nurse specialist will vary. It depends mostly on how much experience you need and which degree you complete. Here is the general process: 

  • Education: 2- 4 years. If you complete an associate’s degree, you can finish the education in two years. A bachelor’s will require four years of study. 
  • Experience: Roughly 3 years. Many of the best credentials require years of experience and a specific number of hours. For example, the ANCC Psychiatric–Mental Health Nursing Board certification requires three years of experience with a total of 2,000 hours of clinical practice. However, the CCRN (Neonatal) credential only requires two years and 1,750 hours working as an RN or APRN. 

With an associate’s degree and certain credentials, you can become a clinical nurse specialist in as little as four years. Other paths with a bachelor’s degree may require nine years in total. 

Are clinical nurse specialists in demand?

Definitely! A CNS is like a Swiss Army knife in the healthcare field. They are registered nurses with advanced training in diagnosing and treating illnesses in their area of expertise. From patient care and consultation services to implementing improvements in healthcare systems, they do it all. In fact, NurseJournal says that critical care is the most in-demand specialization, followed by midwifery, dialysis, operating room, and nurse case managers. 

What is the career outlook for a clinical nurse specialist?

According to the Bureau of Labor Statistics, the growth for Registered Nurses will be 6% between 2021 and 2031. This is higher than the growth for all professions, which is expected to be 5%. By the end of 2031, the BLS expects over 3.3 million RNs in the United States. 



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