A clinical nurse specialist is one of the four major advanced practice roles for nurses. Although requirements for becoming a clinical nurse specialist vary by state, they are generally registered nurses who hold both a master’s degree in nursing and certification as a clinical nurse specialist from an approved national certifying body, such as the American Nurses Credentialing Center (ANCC) or the American Association of Critical-Care Nurses (AACN). Each national certifying body has its own requirements, which generally include a master’s degree, a certain level of experience and a certification examination. Individuals should check with their state boards of nursing to determine which certifications are accepted.

Clinical Nurse Specialist Role

Clinical nurse specialists are responsible for applying expert knowledge and experience to a specific patient population, such as adult acute and critical care, in a clinical setting. In contrast with nurse practitioners, clinical nurse specialists often function as educators and consultants to the nursing staff and as experts on ensuring evidenced-based practice and quality patient outcomes. The AACN has designated the following as core competencies for clinical nurse specialists: direct care, consultation, system leadership, collaboration, coaching of staff, research, and interpretation of evidence.

Clinical Nurse Specialist Scope of Practice

Clinical nurse specialists work within a specialty area defined by various parameters. They may work with a specific population such as adults or children, a specific setting such as the emergency room, or a certain health specialty such as pain, cardiovascular, oncology and gynecology. Their expertise within their specialty area allows them to be good consultants and coaches to other staff members.

Clinical Nurse Specialist Salary

Clinical nurse specialists earn more money than traditional RNs because of their nursing specialty, advanced education and training. Many clinical nurse specialists with master’s degrees can earn around $71,000 per year. Salary will vary according to geographic location, years of experience and area of specialization. More employers are looking for RNs with advanced degrees, making the role of clinical nurse specialist a lucrative career option for RNs.



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How to Become a Clinical Nurse Specialist

Clinical Nurse Specialist Eligibility Requirements

There are many steps to becoming a clinical nurse specialist. Prior education, certification and clinical practice are among the requirements for being accepted into a relevant graduate program. Here is a step-by-step path you can take to become a clinical nurse specialist.

  1. Become a registered nurse. In order to apply to a clinical nurse specialist program, you must have completed a degree in registered nursing and be certified as a registered nurse in a U.S. state or territory. Passing the NCLEX-RN examination is required for certification as a registered nurse. Working one to two years before applying for a clinical nurse specialist program is highly recommended.
  2. Apply to programs accredited by the Commission on Collegiate Nursing Education or the Accreditation Commission for Education in Nursing. These programs must be master’s, postgraduate or doctoral programs. More information on clinical nurse specialist programs and coursework requirements can be found below.
  3. Complete 500 faculty-supervised clinical hours related to the clinical nurse specialist role and population.
  4. Apply to take the exam relevant to your specialty administered by the American Nurses Credentialing Center to earn your CNS certification. The exam tests clinical knowledge and skills. Final transcripts and proof of education are required. More information about CNS certification can be found at the bottom of this page.
  5. Apply for state CNS certification in the state where you wish to practice. Go to our state certification pages to find out what the requirements are and how to apply. Many applications can be submitted online.
  6. Once you have earned your clinical nurse specialist certification, it must be renewed every five years. In addition to renewing certification through the board, renewal through the state is also required and may require additional fulfillment of continuing education contact hours.

Clinical Nurse Specialist Programs

Clinical nurse specialist programs are considered advanced nursing degrees and may be part of the Master of Science in Nursing, doctorate, Doctor of Nursing Practice or post-graduate certificate programs of an educational institution. What program carries CNS training will depend on the school.

In order to enroll, nurses must have a Bachelor of Science in Nursing degree from an accredited college or university and at least two years of nursing experience in the field of study they wish to specialize in (adult, geriatrics, pediatrics, acute care, etc.). Some educational institutions offer CNS enrollment to RNs who hold a bachelor’s degree in another field (but also have an associate’s degree in nursing).

There are many schools that offer CNS courses exclusively online or a combination of classroom and distance learning. Students should choose the program that best fits personal and professional needs and take time to speak with department staff before enrolling.
Course requirements will vary between schools but should contain a few common components. Most programs will offer a variety of classes that explore nursing concepts, individual and family development, physiologic concepts, pathophysiology, research, and role development. Becoming a CNS also requires advanced physical assessment skills and enhanced clinical decision-making approaches. Classroom credits vary between 38 and 45 hours plus extensive hands-on clinical time of 500 hours or more.

Prescriptive authority varies by state. If a CNS practices in a state where prescription authority is granted, the CNS must first meet the state’s prescription authority requirements before being allowed to prescribe medications.

RNs who enroll in an acute care nurse practitioner education program can expect to spend two years or slightly more in classroom and clinical time. The number of credit hours the student carries and other life demands can influence training time, and attending as a part-time student can influence how long it takes to complete the degree.

After graduating from an accredited CNS program, nurses must pass a national licensure examination. To be eligible for the exam, CNS graduates must have a current RN license and proof of graduation from an accredited CNS program recognized by the National League for Nursing Accrediting Commission or the Commission on Collegiate Nursing Education.

Applicants must also provide proof of 500 clinical hours with an approved preceptor in the specialty area and passing grades in pharmacology, advanced pathophysiology and physical assessment graduate level courses.

Clinical Nurse Specialist Programs Online

For working registered nurses who do not want to put their career on pause or uproot their lives to attend a far away on-campus program, clinical nurse specialist programs online can be both a flexible and high-quality option. When looking for an online CNS program, make sure that it is high quality, with interactive features such as live classes and excellent placement services that will help you get the most out of your education. Some universities offer online programs that are identical to what they offer on campus, allowing students to earn a degree from a university they know and whose reputation they trust, without having to move there. CNS online programs are growing in popularity and are a great way to become a clinical nurse specialist.

CNS Certification

American Nurses Credentialing Center (ANCC)

Types of Certification
Various CNS specialties

Eligibility Requirements
Active RN license, master’s degree or higher from a clinical nurse specialist program with at least 500 clinical hours accredited by the Commission on Collegiate Nursing Education or the National League for Nursing Accrediting Commission

Certification Process
Initial application (two-week processing time for online applications, eight-week processing time for mailed applications), followed by a computer-based exam (offered year-round, but must be taken within 90 days of whenever the application is processed)

$270 for American Nurses Association members, $340 for American Association of Clinical Nurse Specialists and $395 for non-members
Certifications must be renewed every five years. Renewal applications are due at least three months before your certification expiration date. Fees for renewal are $200 for American Nurses Association members, $280 for American Association of Clinical Nurse Specialists and $350 for non-members.