How to Become a CNS (Clinical Nurse Specialist) – All You Need to Know

How to Become a CNS (Clinical Nurse Specialist)

Are you a nursing student who is future-focused? As early as now, are you thinking of advancing your nursing career? 

Or perhaps you are already a Registered Nurse who wants to take your career a step further? 

Well, becoming a Clinical Nurse Specialist (or CNS for short) is a great idea!

Clinical Nurse Specialists are one type of Advanced Practice Registered Nurses (APRNs). 

They engage in higher administerial work, management positions, and research tasks while enjoying higher salaries and more job opportunities. 

But the BIG question is… How do you become one?

The job sounds nice, but the process seems overwhelming, right? 

Well, that’s why we are here!

We want to organize and summarize the most important things for you to know about how to become a CNS (Clinical Nurse Specialist). 

This can serve as your roadmap to reaching your end goal. 

We’ll also answer some other important questions, such as: 

  • What does a CNS do? 
  • How much is a CNS paid?
  • What cities give the highest salaries to a CNS?

Although the journey may seem tough, just remember to take it one step at a time and enjoy the process. 

We sure have a lot to talk about, so let’s dive right in! 

How to Become a CNS (Clinical Nurse Specialist): 5 Simple Steps 

Here are the 5 steps to becoming a CNS:

  1. Become a Registered Nurse (RN) and Gain Experience
  2. Complete a Master’s or Doctoral Degree 
  3. Take the National Certification Exam (Optional in Some States)
  4. Apply for Your CNS License
  5. Keep Your RN and CNS Licenses Active 

Step #1: Become a Registered Nurse (RN) and Gain Experience 

Before you can advance your nursing practice, you first have to master the basics, right?

Well, if you want to become a Clinical Nurse Specialist, you will first have to become a registered nurse! This is the basic requirement. 

You can read this article for more details about how to become an RN, but let’s highlight a few important things for you to remember. 

Choose between an ADN or a BSN 

One of the things you have to decide is what nursing education program to take. 

You have two choices – an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). 

An ADN will only take you about two years to complete, while a BSN will take you about four years. 

This makes an ADN sound more appealing, right?

Well, that’s true. But the thing is… If you want to become a CNS, you’ll have a harder time with an ADN.

Most CNS programs require a BSN as the minimum educational requirement. 

If you graduate with an ADN, you can still find ways to become a CNS, but you will need to take additional steps. You will most likely need to enroll in a bridge program first. 

This can take more time and money, and you’ll need to enroll in a school that offers these bridge programs. 

We suggest you just go straight for a BSN. 

But, ultimately, the choice is yours. 

Get Your RN License 

After graduation, you need to take the National Council Licensure Examination for RNs (NCLEX-RN). 

This is a national exam that evaluates if you are ready to practice as an entry-level registered nurse. 

To be able to take the exam, you need to send an application to your state’s regulatory board of nursing. 

The board will evaluate your nursing school records, your criminal background, and other documents to see if you qualify. 

Once they accept your application, you can take the exam. If you pass, they will issue you your RN license. 

But what if you are already an RN in one state but are transferring to another state? 

Well, you also have to transfer your RN license through endorsement. 

The nursing board of the state you are transferring to will evaluate your current RN license, your criminal background, your school records, etc. 

If they accept your application, then you can get a new RN license in the state you transfer to. 

But if you come from a state that is part of the nursing compact and are transferring to another nursing compact state, then your RN license will be credited without having to go through the endorsement process. 

If you want to look up the details for your specific state, you can check this website here

Gain Relevant Nursing Experience 

This is another important part of your nursing journey before you can become a CNS. 

You can’t rush into advanced practice without first gaining experience working as an RN. 

Most CNS programs require at least 1-2 years of experience before allowing you to enroll. 

This is crucial so that your practice will really be based on experience and not just theories. 

Also, it’s a good time for you to recalibrate and determine if you want to pursue advanced nursing practice. 

Step #2: Complete a Master’s or Doctoral Degree 

To engage in more advanced or specialized nursing practice, you also need to have further training. 

A master’s is the minimum educational requirement to become a CNS, but a doctorate can improve your credentials even more. 

Types of Nurse Specialists

The exact CNS program you take will depend on what population you want to focus on and what type of care you want to provide. 

Here are some possible CNS specializations you can look into (although the exact titles may slightly differ per state).

  • Adult Health Clinical Nurse Specialist
  • Gerontological Clinical Nurse Specialist
  • Pediatric Clinical Nurse Specialist
  • Maternal-Child Health Clinical Nurse Specialist
  • Neonatal Clinical Nurse Specialist
  • Perinatal Clinical Nurse Specialist
  • Family Clinical Nurse Specialist
  • Women’s Health Clinical Nurse Specialist
  • Medical-Surgical Clinical Nurse Specialist
  • Community Health Clinical Nurse Specialist
  • Psychiatric/mental Clinical Nurse Specialist
  • Acute Care Clinical Nurse Specialist
  • Cardiovascular Clinical Nurse Specialist
  • Emergency Clinical Nurse Specialist
  • Home Health Clinical Nurse Specialist
  • Oncology Clinical Nurse Specialist

Coursework and Clinical Experience  

Master’s programs and doctorates usually have two main parts – coursework and clinical experience. 

These will be geared toward the population and type of care you want to focus on. 

You will also be required at least 500 hours of clinical experience, and even more, depending on the requirements of your state. 

Step #3: Take the National Certification Exam (Optional in Some States)

Remember how aspiring RNs have to take the NCLEX after graduation to become licensed?

Well, the same goes for aspiring Clinical Nurse Specialists. Graduation from a CNS program is not yet the end of the road. 

Nurse specialists still have to take a national certification exam (CNE) to become licensed in their state. 

The two national organizations that offer exams for nurse specialists are:

  • American Nurses Credentialing Center
  • American Association of Critical Care Nurses (AACN) Certification Corporation

You can check the details for your CNS specialization with these respective national organizations. 

There are some states, however, that consider national certification optional (such as California). 

As long as you pass an accredited CNS program and get the proper clinical experience, they can already credit you as a licensed CNS. 

But even if your state does not require national certification, it may still be beneficial for you to get one to ensure that you are on par with other nurse specialists around the country. 

Step #4: Apply for Your CNS License

You’ve come such a long way already, and don’t worry! This is the last step to finally getting your CNS license! 

To get your license, you need to apply with your state’s board of nursing. 

The exact requirements will differ per state. 

But to give you a general idea, you may be asked to submit the following:

  • A copy of your active RN license 
  • Transcript of Records from your accredited MSN or DNP school
  • Proof of clinical experience from an accredited provider
  • Certification from your national certifying body with the expiration date 

You will also be expected to pay an application fee. 

You can also apply for prescriptive authority if you meet the board’s requirements. 

Step #5: Keep Your RN and CNS Licenses Active

At this point, you can already work as a CNS. 

Nurse specialists are in demand, so it may not be difficult to land your ideal job. 

Just remember to keep your RN and CNS licenses active so that you can enjoy your career without a hiccup. 

If you fail to renew your licenses, your practice will be interrupted. 

Most states require you to renew your licenses every two years. They are also likely to specify how many continuing education units you need. 

If you would like to check what the continuing education requirements of your state are, you can go here. You can also look at this article for further reference.  

Frequently Asked Questions about Becoming a CNS (Clinical Nurse Specialist) 

We made it! We’ve discussed the five steps to becoming a CNS. 

But you may still have questions in your mind which we hope to answer in this next section. 

Let’s dive in! 

What does a CNS do?

Nurse specialists can have several different roles. 

They can provide direct patient care, manage or guide nursing staff, engage in research, and seek to improve the health care system. 

Nurse specialists are sometimes confused with nurse practitioners because their roles overlap at times. 

But NPs tend to focus more on direct patient care, while nurse specialists tend to focus on administration, research, and program development. 

How much is a CNS paid?

According to ZipRecruiter, the average annual salary of a CNS is $112,257. This translates to about $54 per hour. 

You may even earn up to $167,000 annually depending on your expertise and employer. 

What cities give the highest salaries to a CNS? 

According to ZipRecruiter, the top three highest-paying cities for nurse specialists are:

  1. Atkinson, NE
  2. San Francisco, CA
  3. Bolinas, CA 

In Summary

And there you have it! 

We’ve talked about the 5 steps to becoming a Clinical Nurse Specialist. We’ve given you a roadmap to guide you in your journey and to help you. 

But we suggest that you take it one step at a time and enjoy each step of the way! Although it’s good to be future-focused and have a clear goal, you should also be flexible and enjoy the moment that’s before you. 

We’ve also answered some questions that could be helpful for you to set your expectations about the CNS career. 

We hope you found this article helpful, and that it will help you on your journey!

We wish you all the best!

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