Clinical Nurse Specialist

Adult Health Clinical Nurse Specialist, Advanced Practice Nurse, Cardiothoracic Surgery   More Names
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Description

Provide expert direct clinical care to patients in specialized areas of nursing practice in a wide variety of healthcare settings. Also influence patient care outcomes by providing expert consultations with nursing staffs and by implementing improvements in healthcare delivery systems. Work to integrate nursing practice, which focuses on helping patients in the prevention or resolution of illness or injury, with medical diagnosis and treatment of disease, injury, and disability. Clinical nurse specialists are advanced degree, registered nurses with experience in specialty care areas including those that involve treatment of critically-ill or seriously injured patients. They provide expert clinical care to patients in specialized areas of nursing practice. Such specialty areas may include populations (such as pediatrics, geriatrics, women's health); care setting (such as critical care, emergency room); disease or medical subspecialty (such as diabetes, oncology); type of care (such as psychiatric, rehabilitation); or type of problem (such as pain, stress, wounds).

As senior level nursing specialists, other nursing and medical staff also will come to clinical nurse specialists for high-level consultation, including other nurses who may come to them for direction and advice. They may make recommendations on clinical issues to physicians, hospital administrators, insurance companies, patients and others, and also may identify training needs and conduct training sessions for nursing l staff or nursing students.

Clinical nurse specialists may work for hospitals, nursing homes, residential care facilities, and outpatient facilities as well as for insurance companies and other healthcare consultation businesses. At present, about 69,000 registered nurses have the graduate degree education and credentials needed to practice as a clinical nurse specialist. This total represents less than 3 registered nurses out of every 100 who qualify as clinical nurse specialists.

What might the work of a clinical nurse specialist actually involve day-to-day? In a featured article on the American Association of Colleges of Nursing website, Kathleen Dracup, Dean of the University of California, San Francisco School of Nursing, gives a practical illustration:

"During the recovery from an acute illness, it's decided that the patient no longer needs to stay in the hospital but isn't well enough to return home. It's decided that the best place to continue the recovery is an intermediate-care facility. Who makes that decision? A clinical nurse specialist. Who oversees the physical and emotional rehabilitation programs at this facility? Another clinical nurse specialist."

Clinical nurse specialists often provide their expert-level services within a cycle of six primary framework activities. Under Assessment, they collect needed data concerning patients, nursing practices, and organizations and systems. Under Diagnosis, they analyze assessment data to determine needed care and treatment. Under Competency, they work with other healthcare providers to identify expected outcomes of clinical care.

Under Planning, they design evidence-based plans to improve outcomes through the development of policies, procedures, and guidelines. Under Implementation, they work to carry out plans and improve interventions and care delivery. Under Evaluation, they review and communicate progress about expected outcomes, while also working to establish a culture for continuous improvement by repeating the cycle process.

As this cycle of activities suggests, clinical nurse specialists are involved with higher-level nursing coordination, training, supervision and management. To accomplish goals and objectives, they need to have specialized nursing practice knowledge as well as very advanced communication and organizational skills.

The National Association of Clinical Nurse Specialists (NACNS) reports that research concerning the outcomes from the practice of clinical nurse specialists includes reduced hospital costs and lengths of patient stay; reduced frequency of emergency room visits; improved pain management practices; increased patient satisfaction with nursing care; and reduced medical complications in hospitalized patients.

As advanced practice registered nurses (APRNs), clinical nurse specialists - along with nurse practitioners, nurse anesthetists, and nurse midwives - are at top level of the nursing career pathway. Some may decide to become executive healthcare administrators or college faculty nursing teachers, but often they will assume these new roles while also choosing to continue with APRN activities.

Credentials Needed: The credentials needed to practice as a clinical nurse specialist include (1) holding an active RN license in a state or territory of the United States or its equivalent from another country and (2) holding a master's, post-master's, or doctorate in a clinical nurse specialty program. Both of these criteria also form the foundation for a clinical nurse specialist to further benchmark their expertise by attaining a voluntary industry-based certification.

For example, in the specialty area of clinical nursing pediatrics, the American Nurses Credentialing Center(ANCC) sponsors the Clinical Nurse Specialist in Pediatrics (CNSP) certification. To earn this certification, a candidate must be an active RN; have earned a master's degree or higher from a postsecondary program accredited by either the Commission on Collegiate Nursing Education (CCNE) or National League for Nursing Accrediting Commission (NLNAC) that also meets specific criteria for supervised clinical training hours; and pass the CNSP certification exam.

The ANCC also sponsors certifications for other clinical nursing specialty areas. The "Education & Training - Find Programs" section for this career includes links to the different ANCC certifications as well as to other relevant industry-based certifications which individuals may choose to help demonstrate their knowledge and skill competencies in this occupation.

To become a registered nurse (RN), all 50 states and the District of Columbia (plus Puerto Rico and the U.S. Virgin Islands) require that RN candidates must first graduate from an accredited nursing program and then pass the National Council Licensure Examination. After passing this national licensing exam, candidates are ready to seek licensure by the state in which they intend to practice. To check what your state may require regarding licensing or other credentials for RNs, use the "Education & Training - Find Programs" link for this career or the following alternative link to state licensing information: About Nursing Schools, Programs, and Degrees.

Some Key Things to Remember: Clinical nurse specialists are advanced practice registered nurses (APRNs) who provide expert clinical care to patients in specialized areas of nursing in a wide variety of healthcare settings. They also influence patient care outcomes by providing expert consultations with nursing staffs and by implementing improvements in healthcare delivery systems. As APRNs, they work to integrate nursing practice, which focuses on helping patients in the prevention or resolution of illness or injury, with medical diagnosis and treatment of disease, injury, and disability. The path to becoming a clinical care specialist begins with becoming a registered nurse, gaining experience in a critical care nursing specialty, and obtaining a master's or doctorate degree in advanced practice nursing. To practice as a clinical nurse specialist, an individual must have an active RN license and have earned a master's, a post-master's, or a doctorate degree in a clinical nurse specialist program. Voluntary industry-based certifications also may be earned to further demonstrate competency in various clinical nurse specialties.

Reviewed for content and accuracy by the National Association of Clinical Nurse Specialists, January 27 and 30, 2012.

More Details
Job Growth and Wages
Percent Job Growth:  
16% - Faster than average
Typical Wages (National):  
Annual: $56,190 - $83,770    Hourly: $27 - $40
Physical/Medical/Health Requirements

No specifc requirement is identified at this time.

Legal Requirements
General/Nationwide
State-Specific
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(Data Drawn from O*NET)
 
      

Career Snapshot

Typical Education:

Master's and Above (High School + 6 or more Years)
Find Programs

Percent Job Growth:

16% - Faster than average
Find Jobs

Typical Wages:

Annual: $56,190 - $83,770

Hourly: $27 - $40