Clinical Nurse Specialist

What is a clinical nurse specialist?

A clinical nurse specialist (CNS) is a type of nurse who provides direct care to people and serves as a leader among other professionals. They must earn at least a master’s degree. 

Like primary care physicians (PCPs), clinical nurse specialists can do physical exams and make diagnoses. They’re also qualified to prescribe medications (in some states) and order diagnostic tests, like blood tests and X-rays. So, you might see a CNS for your primary care needs. They’ll refer you to other healthcare providers when appropriate.

Clinical nurse specialists can help you stay healthy, manage various conditions or arrange palliative or hospice care. They also engage in behind-the-scenes work that helps improve the quality of healthcare that you and others receive.

What does a clinical nurse specialist do?

Clinical nurse specialists provide direct care as well as indirect care.

Direct care is what you or your loved ones see or experience firsthand. This might include:

• Giving you a physical exam.
• Giving you treatments.
• Helping you learn to use medical equipment.
• Teaching you and your family about your condition.

Indirect care usually happens in places where you can’t see it (like in offices or meeting rooms). But it still affects you because it shapes the procedures healthcare providers follow and the resources they can access. Clinical nurse specialists often try to change bigger-picture issues that affect many people in hospitals.

For example, they might use data on hospital-acquired infections (like C. diff) to find better ways to identify and treat these infections. They may also teach and mentor other nurses. Some clinical nurse specialists work with community organizations that support people’s health.

How do I become a clinical nurse specialist?

In general, to become a clinical nurse specialist in the U.S., you need to:

• Complete schooling to become a registered nurse (RN). This involves earning a nursing diploma, associate’s degree or bachelor’s degree. 
• Take and pass the National Council Licensure Examination (NCLEX) to earn your RN license.
• Get a license to practice as an RN in your state. Each state has its own licensing requirements.
• Gain at least one year of experience as an RN.
• Earn a master’s degree from an accredited clinical nurse specialist program. If you’d like to conduct research, consider earning a doctoral degree.
• Take and pass a national certification exam. Professional organizations that offer these exams include the American Association of Critical Care Nurses and the American Nurses Credentialing Center. For the exam, you’ll specialize in care for a specific population. There are three available options: adult/gerontology, neonatal and pediatric. 
• Get a license to practice as a clinical nurse specialist in your state. Your state licensing board can tell you more about the requirements and process.

What’s the difference between a clinical nurse specialist and NP?

Clinical nurse specialists and nurse practitioners (NPs) are two different types of advanced practice registered nurse (APRN). Both roles involve providing direct care to people, and both require a master’s degree or higher. While both can take on leadership roles within their workplaces, clinical nurse specialists have a more primary focus on these advocacy roles within their workplace and community.

Other types of APRN include:

• Certified registered nurse anesthetists (CRNAs).
• Certified nurse midwives.

All APRNs are registered nurses (RNs) who also have graduate training. This advanced education gives them a broad and deep set of knowledge and skills.

A note from Cleveland Clinic

When you’re sick, you want a healthcare provider who understands your concerns and knows what you need. In those moments, the letters behind the provider’s name, or their credentials, might matter less to you than their ability to find out what’s wrong and treat it. But in the world of healthcare, different providers have different types and levels of training. This matters because no single provider can “do it all.” In today’s world, providers work as teams because each person brings unique skills and experiences.

In the field of nursing, there are many different credentials based on education and training. Clinical nurse specialists are one type of nurse you might work with very closely or never even see at all. No matter the level of interaction you have, you can trust these nurses are working to improve the quality of healthcare for you and many others.