How to Become a Nurse Midwife (CNS) in Washington DC – A Complete Guide

How to Become a Nurse Midwife (CNS) in Washington DC

Want to improve your career in nursing? 

Do you want to specialize in a particular population group or nursing field? 

There are many ways to advance your nursing career and specialize in the nursing industry, and becoming a clinical nurse specialist (CNS) is one of them. 

Becoming a CNS will increase your career options, give you more chances of promotion and leadership, and get you a higher salary. 

More than that, you can focus on a field of nursing you’re passionate about! 

But how do you become one? 

This is where it can get a bit confusing, what with all the educational, certification, and licensure requirements. 

But we’re here to make it easier for you!

We’ll talk about how to become a CNS in Washington DC in 4 manageable steps. 

We’ll also answer a few FAQs.

Are you ready to start? 

Let’s go! 

How to Become a CNS in Washington DC in 4 Steps

Becoming a CNS is fairly simple. You only need to do these steps: 

  • Step #1: Become a Registered Nurse 
  • Step #2: Complete a Master’s in Nursing or Doctor of Nursing Practice
  • Step #3: Get a CNS Certification
  • Step#4: Apply for an APRN/CNS Status

A CNS is a type of Advanced Practice Registered Nurse (APRN), hence you follow the requirements to become an APRN. 

Step #1: Become a Registered Nurse

This is, by far, the longest step to becoming a CNS. You have to be a registered nurse before you can become an Advanced Practice Registered Nurse (APRN). 

If you’re already an RN, you can skip to Step #2. 

But if you are still an aspiring nurse, here’s a quick guide on how to become one:

  • Complete a Nursing Program approved by the DC Board of Nursing
  • Pass a licensing application to the DC Board of Nursing
  • Pass the NCLEX

Complete a Nursing Program

Your very first step to becoming an RN (and a CNS) is to complete a nursing program. This nursing program should be approved by the DC Board of Nursing. 

You can choose between an Associate Degree in Nursing (ADN), or a Bachelor of Science in Nursing (BSN). 

While both programs teach aspiring nurses to care for patients, there are several differences between them. 

One is the length of time to complete the program. ADN takes two years while BSN takes four years. 

Another difference is that, with the length of the program, BSN graduates have more in-depth knowledge of nursing concepts. They also have more hands-on and research experience. 

This is why most nursing schools require a BSN for you to be admitted into their master’s or doctorate programs. 

As an aspiring CNS, therefore, it’s best to take the BSN route. 

Pass a Licensing Application to the DC Board of Nursing

Once you complete your approved RN program, you can apply for licensure to the DC Board of Nursing. Note that you still have to pass the NCLEX before this application is completed. 

You can read more about the licensing application here or start your application in this portal

Pass the NCLEX

Once you pass your application, you are required to pass the NCLEX within 90 days.  The NCLEX is a national exam taken by all aspiring registered nurses, whether they took the ADN or BSN programs. 

Register for the NCLEX here. Note that you need to pay a $200 exam fee. 

If you pass the NCLEX, the governing body will notify the DC Board of Nursing. That’s when you get your RN license. 

Step #2: Complete a Master’s in Nursing or Doctor of Nursing Practice

Once you become an RN, you are eligible to take further studies and become an APRN (although some schools require that you have at least one year of work experience as an RN first).

You can take either a Master of Science in Nursing (MSN) program or a Doctor of Nursing Practice (DNP) program. 

You will be expected to complete coursework as well as clinical hours. 

Whichever program you choose, make sure it is approved by the DC Board of Nursing. 

You can find a list of approved nursing programs here. Four approved schools in DC offer APRN studies. 

What’s the difference between an MSN and a DNP?

MSN focuses on advanced nursing practices. Its curriculum also includes subjects on law, medical sciences, and medical support for other diseases and illnesses. 

On the other hand, DNP covers advanced nursing practices with an additional focus on employee management, statistics, and evidence-based research. Because the DNP is heavily focused on research, students often need to complete a research study before they graduate. 

When it comes to career opportunities, MSN graduates can pursue higher nursing positions and educators in the medical field while DNP graduates can be eligible for top-level positions concerning management and research appointments.  

Step #3: Get a CNS Certification

Just as you need to pass the NCLEX to become a Registered Nurse, you also need to pass an exam to become a Clinical Nurse Specialist. 

Unlike the RN exam (NCLEX), however, the CNS certification exam will vary depending on your specialization. Some specializations include: 

  • Adult Health CNS
  • Pediatric CNS
  • Neonatal CNS
  • Public Health CNS

There are two national certifying agencies recognized by the DC Board of Nursing that offer national certifications for CNSs. 

These are: 

You can choose which organization to gain your certification from based on your specialization. 

Both organizations will have their own set of requirements and instructions for the examination and certification.

Step #4: Apply for an APRN/CNS Status

Once you pass your CNS exams, you can apply to become an APRN-CNS in Washington DC. 

To qualify, you must: 

  1. Be an RN in DC.
  • Since Washington DC is not part of the Nursing Licensure Compact, multi-state licenses cannot be used. 
  • If you are an RN from another state and want to work in DC, you need to apply by endorsement first. 
  1. Have completed an approved master’s or doctoral degree for your CNS specialization.
  2. Be nationally certified as a CNS in good standing either by the AACN or ANCC.

If you have all three qualifications above, here are the steps to take: 

  • Log in or create an account through the DC Portal
  • Follow the instructions and submit the documents being asked at each part of the application.
    • Upload a copy of a government-issued ID
    • Upload a passport‐type photo.
    • Upload proof of name change (if the name on your application is different from the name on any of your supporting documents).
    • In general, the application process takes 30-60 minutes.
  • Pay the application fee of $230. 
  • Pay the criminal background check fee of $50. 
  • Once you complete your payment, you will receive a notification for your background check via email. 
  • Complete your criminal background check. The office will send your results to the DC Board of Nursing. 
  • Wait for your new license via email. 

You’re now a CNS!

Frequently Asked Questions About Becoming a CNS in Washington DC

Do you have some questions about becoming a CNS? Here are a few FAQs to further help you. 

What is the difference between an RN and a CNS?

Registered nurses provide direct care to patients and are often hired in staff-level positions. They either have had a 2- or 4-year program. 

On the other hand, CNSs are often hired to provide both direct care and supervisory roles. Depending on the graduate program you complete, you may also be hired to do research, managerial, or top-level responsibilities. 

CNS graduates can choose their specialization and will have different exams for that. RN graduates only take the NCLEX. 

How much is the license application fee for CNSs in DC?

The application fee is $230. There’s also a criminal background check of $50 paid during your online application. 

Do you have to become an RN to become a CNS?

Yes, you are required to become an RN first and have proof of licensure to be eligible to apply for a CNS license. 

As a CNS can I have an independent contract for practice?

In Washington DC, CNSs and advanced practice nurses, in general, can have an independent contract. 

How much does a CNS in Washington DC earn? 

According to, a CNS in Washington DC earns an average annual wage of $87,526. 


The journey to becoming a Clinical Nurse Specialist may seem overwhelming but, if you break it down into smaller steps, it becomes manageable. 

While the road is long and challenging, becoming a CNS is rewarding and opens a lot of career opportunities. So, always keep the end goal in mind when you feel discouraged!

Use this guide as a roadmap and enjoy the journey. 

You’ll become a CNS in Washington DC before you know it!

We wish you all the best! 

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