What Are CNSs (Clinical Nurse Specialists)?

What Are CNSs (Clinical Nurse Specialists)

Have you heard the term ‘CNS’ or ‘Nurse Specialist’ before but are not sure who they are and what they do?

How do they differ from other types of nurses?

What role do they play in the healthcare system?

We’ll answer all these questions and much more in this article! 

We’ll answer the following questions:

  • What Are CNSs (Clinical Nurse Specialists)?
  • What Do CNSs Do?
  • What are Some Possible CNS Specialties? 
  • Where Do CNSs Work?
  • What Qualities Should CNSs Have?
  • What is the Difference Between a Nurse Specialist and a Nurse Practitioner? 
  • Do CNSs Have Good and Viable Careers?
  • How Do I Become a CNS?
  • How Long Does It Take to Become a CNS? 
  • Which Organizations Offer CNS Certification? 
  • How Much Do CNSs Earn?

By the end of this article, you’ll have a fuller and deeper understanding of clinical nurse specialists. 

So, if you’re ready, let’s begin! 

What Are CNSs (Clinical Nurse Specialists)?

Clinical Nurse Specialists (CNSs for short) are advanced practice registered nurses (APRNs) who have expertise in a specialized area of nursing. 

As such, they can diagnose, treat, and manage patient care (depending on their state’s regulations) for an identified population. 

They also provide leadership and supervision to other nurses, sharing their expertise with them and supporting them.

Aside from that, they seek to improve patient outcomes by driving change throughout their organizations and ensuring the use of best evidence-based practices.

What Do CNSs Do?

CNSs can provide service in three particular areas:

  1. Clinical expertise 
  • CNSs can provide clinical expertise and expert clinical care for:
    • a specialized population group (e.g. geriatrics or pediatrics)
    • disease (e.g. diabetes or heart disease)
    • setting (e.g. ICU or specialty clinic)
    • type of care (e.g. rehabilitation, wound care, post-partum, etc.) 
  • This includes promoting health and wellness; educating, diagnosing, and treating patients; maintaining patient records; ordering tests and evaluating them; managing the disease; and prescribing medications.
  1. Leadership in nursing practice
  • CNSs are leaders in nursing. They seek to improve the nursing practice and patient care delivery.
  • This includes providing expert consultation; advising nurses; applying evidence-based research; and educating and training others in departmental policies, procedures, and patient care standards.
  1. Systems innovation in hospital, community, outpatient, and long-term care settings 
  • CNSs seek to improve healthcare delivery systems. 
  • They work with other healthcare professionals; evaluate, design, and implement proven systems and policies; develop and implement interventions for improved patient outcomes and increased patient satisfaction. 

What are Some Possible CNS Specialties?

CNSs choose a specialization. 

They can specialize in a specific:

  • Patient population (e.g., adult, gerontology, pediatrics)
  • Setting (e.g. intensive care unit, specialty clinic)
  • Disease or medical subspecialty (e.g., diabetes, heart disease)
  • Type of care or problem (e.g. rehabilitation, post-partum, wound care, pain management)

Some specific CNS titles include:

  • 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

Where Do CNSs Work?

CNSs can work in many different healthcare settings. 

This includes:

  • Physicians’ offices
  • Hospitals
  • Outpatient clinics
  • Private practice
  • Colleges and universities
  • Community care centers 
  • Laboratories
  • Research facilities 

What Qualities Should CNSs Have?

CNSs work with patients and other healthcare professionals. They also often have leadership roles. 

There are certain qualities that they should possess, therefore, such as:

  • Strong communication skills 
  • Ability to educate patients and other nurses 
  • Ability to build relationships across disciplines 
  • Leadership 
  • Foresight 
  • Ability to create a change 
  • Ability to decipher information
  • Mental endurance
  • Enthusiasm
  • Creativity
  • Strong clinical knowledge
  • Empathy for patients 

What is the Difference Between a Nurse Specialist and a Nurse Practitioner? 

Perhaps you’ve heard of nurse practitioners before. They are also a type of Advanced Practice Registered Nurses (APRNs). But how do they differ from nurse specialists?

The differences between nurse specialists and nurse practitioners are subtle. 

Many of their roles overlap and they both seek to improve the health outcomes of patients.

They share key responsibilities in different healthcare settings, such as getting the medical histories of patients, conducting physical examinations, analyzing patient data, creating medical care plans, administering medications and other treatments, monitoring patient progress, etc. They both have leadership roles. 

However, they also have a slightly different focus in their roles. Nurse specialists focus more on administration, research, program development, and supervision, while nurse practitioners focus more on direct patient care in a clinical setting.

These differences are not clear-cut and would depend on the circumstances. 

Do CNSs Have Good and Viable Careers?


Although the BLS does not have specific information for nurse specialists, it has information for RNs and APRNs. 

The level of employment for APRNs is expected to increase by 40% between the years 2021-2031. This indicates about 30,200 job openings per year. 

One reason for the increase in employment is that there is an increased demand for specialized healthcare services, particularly for preventive care and care for the elderly with chronic diseases.

Since APRNs can often work autonomously and can improve patient outcomes, many are looking to them as primary healthcare providers. 

How Do I Become a CNS?

Becoming a CNS is a multi-step process. 

You need to:

  1. Become a Registered Nurse (RN) and Gain Experience

The first step to becoming a CNS is to become an RN.

It is advised that you take a BSN education program, especially if you want to proceed to an MSN or DNP. 

You will also need to pass the NCLEX-RN and apply for a license in your state. 

You can read more about how to become an RN in this article

After becoming an RN, you need to gain at least 1-2 years of experience working as an RN in a clinical setting. 

  1. Complete an MSN or DNP 

After gaining relevant experience, you can proceed to take a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) degree for Nurse Specialists. 

You will need to identify what CNS specialty you want to take. 

  1. Take the National Certification Exam (NCE)

After graduating with your MSN or DNP, you can take a national exam based on your CNS specialty. 

The two certifying bodies are the American Nurses Credentialing Center and the American Association of Critical Care Nurses (AACN) Certification Corporation.

This is optional in some states (like California) which does not require national certification. 

  1. Apply for Your CNS License

After passing the exam (or your state’s requirements) you can apply for your CNS 


Different states have different requirements, so it’s important to check your state’s 


  1. Keep Your RN and CNS Licenses Active 

It’s also important to keep updated to be able to continue practicing as an RN and CNS. 

You will need to renew both licenses. 

You can read this article for a better understanding of how to become a CNS. 

How Long Does It Take to Become a CNS? 

This depends on your previous educational background, your years of experience, and the pace you set for yourself to complete your education programs. 

But as an estimate, it can take about 7-10 years to become a CNS, including the time it takes to become an RN. 

Here is a rough breakdown of the timeframe:

  • BSN – 4 years
  • Taking the NCLEX – right after graduation
  • Gaining experience – 1-2 years
  • MSN or DNP – 2-3 years
  • Taking the NCE – right after graduation

Which Organizations Offer CNS Certification? 

Two national organizations certify nurse specialists and offer national certification exams. 

These are the:

How Much Do CNSs Earn?

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. 

Top-paying Cities 

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

  1. San Francisco, CA, 
  2. Bolinas, CA
  3. Fremont, CA


And there you have it!

We’ve seen what CNSs are, what they do, where they work, what kind of careers they can have, etc. 

It isn’t easy becoming a CNS but you can make a very big impact on the lives of patients, other nurses, or the healthcare system. You can also expect more career opportunities and a bigger salary.

We hope you found this article helpful and that we answered all your questions.

If you have any more questions, just leave us a comment! 

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