Clinical Nurse Specialist


Clinical nurse specialists have been around since the mid-1800s, but at this time they mostly managed and cared for psychiatric patients.  It was not until the 1960s, that a more modern role was created for this type of nurse.  A clinical nurse specialist is an advanced practice nurse that pursues further education and specialization.

This type of nurse can choose to work in one of more than 15 specialties, such as oncology, pediatrics or acute care.  A clinical nurse specialist is similar to a nurse practitioner in that they too are able to diagnose and treat a variety of diseases.

Clinical Nurse Specialist

Clinical Nurse Specialist Salary

The median salary in the United States for a clinical nurse specialist is around $94,019 per year.  The lowest 10 percent earns around $77,939 per year and the highest 10 percent earns around $109,220 per year.

Many factors are involved concerning how much you can earn within this specialty.  For example, the field you go into has a major impact because certain fields, such as oncology and acute care, tend to pay more than a field like family medicine.  Your level of experience, geographic location and employer will also play a role.

Clinical Nurse Specialist Job Description

A clinical nurse specialist will work in clinical, medical offices, hospitals and other healthcare facilities.  They usually specialize in a specific area and only work here.  For example, he or she may work in cardiovascular health, acute care or gerontology.  This type of nurse will provide direct patient care, participate in research, educate patients and family members and help with facility administration.

Many responsibilities come along with this type of advanced practice nursing.  He or she will perform a wide range of exams, such as gynecological assessments, general wellness assessments and mental health examinations, depending on the area of work.  They do patient and family consultations to help educate them about the disease, illness or injury, as well as answer any questions that they may have.  This involves ensuring that they understand treatment options, diagnostic techniques and the condition as a whole.  In many cases, this type of nurse will also supervise a team of nurses and they may take on facility or clinic administration roles.

Areas of specialization may include:

  • Acute care nursing
  • Cardiovascular nursing
  • Home health nursing
  • Neonatal nursing
  • Oncology nursing
  • Perinatal nursing
  • Rehabilitation nursing
  • Women’s health nursing
  • Adult nursing
  • Community health nursing
  • Geriatric nursing
  • Infectious disease nursing
  • Occupational nursing
  • Parent-child nursing
  • Psychiatric nursing
  • School health nursing

Clinical Nurse Specialist Education

As a clinical nurse specialist you will start out as a registered nurse, most likely with a Bachelor of Science in Nursing.  You will then need to apply to a master’s degree program that focuses on this advanced practice nursing specialty.  There are also doctoral degree options if you wish to go beyond the master’s degree level.  Common coursework in this type of program includes classes like:

  • Statistics
  • Theory
  • Epidemiology
  • Advanced patient assessment
  • Research
  • Health policy
  • Pharmacology

Pursuing this degree full-time will take approximately two and a half to three years, depending on your area of specialty.  You will be expected to complete classes, as well as at least 500 hours of supervised clinical experience in the specialty you are pursuing.

To maintain certification, you must complete a minimum of 1,000 hours in your specialty in a five-year period.  You must also complete 75 continuing education hours and at least 51 percent of these must be within your chosen specialty and another 25 percent in pharmacotherapies.  There are also unique requirements that differ among the different specialties.

Clinical Nurse Specialist Certification and Licensing

The type of licensure you will require will depend on the state that you plan to practice in.  All clinical nurse specialists will need to take the National Council Licensure Examination for Registered Nurses (NCLEX-RN), and this is true for all US 50 states.  For further certification requirements, you will contact the American Nurses Credentialing Center.  This center has certification opportunities in more than 100 nursing work areas and you can take exams to increase your knowledge level and area of expertise.  Additional examinations can be taken through the National Council of State Boards of Nursing.

One example of additional licensure is the Adult Health Clinical Nurse Specialist Board Certified (ACNS-BC) that is proctored by the National Commission for Certifying Agencies and the Accreditation Board for Specialty Nursing Certification.  To sit for this test you must have an active registered nursing license, have at least a master’s degree from a Commission on Collegiate Nursing Education accredited school, at least 500 supervised clinical hours in the field of adult health and have taken the following comprehensive courses: advanced pharmacology, advanced health/physical assessment and advanced pathophysiology.  This certification must be renewed every five years and you must apply for renewal at last eight weeks prior to your expiration date.

Clinical Nurse Specialist Job Outlook

Between 2008 and 2018, the demand for clinical nurse specialists is expected to rise by 19 percent.  This high demand is partly due to this type of nurse being able to provide basic care to patients without physicians and this saves hospitals and clinics a significant amount of money.  This rate of growth is far higher than a large majority of other professions.

There is currently a shortage when it comes to advanced practice nurses.  As older nurses start to retire and the US population continues to age, the need for clinical nurse specialists will become greater.  Many hospitals are trying to increase how many advanced practice nurses they have, but the shortage is expected to continue despite recent efforts.

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