A clinical nurse specialist (CNS) is an advanced practice registered nurse with at least a master’s degree who specializes in a certain nursing discipline. A CNS could focus their career in pediatrics, geriatrics, women’s health, oncology, acute care, cardiology, psychiatric mental health, wound management, etc. Clinical nurse specialists will provide direct patient care, but they mostly serve as expert consultants for helping RNs with critical or at-risk patients. Nurses look up to the CNS for guidance on diagnosing and treating illnesses within their specialty. Clinical nurse specialists also play a pivotal managerial role in implementing research-based policies that will improve their healthcare organization. A CNS acts as a vital clinical resource for helping nurses carry out the highest quality patient care plans.


According to Salary.com, the over 72,000 clinical nurse specialists in the United States make an average yearly salary of $97,599. This can be equated to $47 per hour or $1,877 weekly. On top of the base salary, a CNS usually receives bonuses, social security, healthcare, pension, and time off. Clinical nurse specialists bring home an average total income of $134,402.

Beginning Salary

When just being promoted to clinical nurse specialist, you’ll likely land in the bottom 10th percentile with a still decent annual salary of $79,884. However, an experienced CNS with greater leadership responsibilities can eventually earn a base salary upwards of $113,939 each year. In comparison, physicians make an average yearly salary of $189,760.

Key Responsibilities

Clinical nurse specialists are responsible for making primary decisions and resolving issues regarding patient care in their specialty area. Typically, a CNS will have duties related to clinical practice, research, education, consulting, and administration. Clinical nurse specialists optimize patient care by consulting with nurses, evaluating current practices, instating new policies, educating new staff, and meeting with health services managers. A CNS analyzes new specialty research and patient outcomes data to brainstorm ways to apply research results to practice. Allocating staff and financial resources in their department could also be in the job description.

Necessary Skills

Working as a CNS requires nurses to possess the clinical skills to perform patient assessments, design the treatment plan, and supervise nurses implementing care. Leadership skills are essential for clinical nurse specialists to resolve conflicts with patients, families, nurses, or other healthcare professionals. Being organized is a must for a CNS to keep paperwork, budgets, and patient records in meticulous order. Clinical nurse specialists need to have creative problem-solving, analytical, and critical thinking skills to find methods to improve patient care. Flexibility is important since the CNS can wear many hats. Most of all, clinical nurse specialists must have the interpersonal skills to effectively communicate with all members of the healthcare delivery system.

Degree and Education Requirements

Becoming a clinical nurse specialist is a long process that requires plenty of class time. First, an aspiring CNS must pursue a four-year Bachelor of Science in Nursing (BSN) from an accredited nursing school. Pursuing a two-year associate’s degree in nursing (ADN) is also feasible since there are a growing number of RN-to-MSN programs. Clinical nurse specialists must attend graduate school to receive their Master of Science in Nursing (MSN). Find an accredited program that aligns with your specialty niche, such as critical care, family health, geriatrics, forensics, or obstetrics. Obtaining a specialized Post-Master’s Certificate may be required at some schools. Pursuing the Doctor of Nursing Practice (DNP) would also provide higher level of preparation for designing and assessing care.

Pros and Cons of the Position

Like any job, being a clinical nurse specialist will offer both rewards and challenges. On the positive side, a CNS is given a plethora of career options where their work can benefit a specific population. Boredom can’t set in because clinical nurse specialists play multiple roles in a varied healthcare environment. Of course, a CNS can make a significantly higher salary than even experienced registered nurses. Their training allows clinical nurse specialists greater autonomy in making decisions less qualified RNs can’t. Job prospects are also very favorable. However, added responsibility comes with higher stress levels. A CNS has to invest significant time, money, and effort into reaching this role. Treating severely injured or ill patients can be emotionally taxing over time. Clinical nurse specialists may also suffer workplace injuries due to lifting, bending, and prolonged standing.

Getting Started

There’s several steps you must follow to become a CNS. After receiving at least an associate’s degree, you’ll be qualified in most states to take the National Council Licensure Exam (NCLEX) for becoming an RN. This license will give you the qualifications to begin applying for entry-level staff nursing positions. It’s recommended that you build at least two to five years of experience in a specialty area that interests you. Doing so will lay a solid foundation for obtaining your Master of Science in Nursing (MSN) degree later. Master’s programs typically will require you to complete extensive clinical practicum and/or internships. Once you’ve graduated, you can start applying for CNS certification through the American Nurses Credentialing Center (ANCC). There are currently certifications in Adult Health, Adult-Gerontology, Adult Psychiatric-Mental Health, Child/Adolescent Psychiatric-Mental Health, Gerontological, Home Health, Pediatric, and Public/Community Health. All require passing a 175-question exam within 3.5 hours.

Future Outlook

Demand for clinical nurse specialists is high because they can provide advanced patient care for a lower cost than physicians. The surge of aging baby boomers will likely flood the healthcare system with an increased number of patients. Older adults are living longer than ever before, so they’ll need a CNS to consult on their healthcare services. The nation’s shift toward preventive care and greater access to health insurance will also spur demand. According to the BLS, employment of advanced practice nurses, including clinical nurse specialists, will grow by 31 percent through 2024. A CNS can expect excellent job prospects in diverse settings, including hospitals, clinics, private practices, ambulatory care centers, nursing homes, residential facilities, and medical groups.

Overall, clinical nurse specialists utilize their advanced specialty knowledge to shape their health organization’s nursing system by serving as mentors and managers. In 2015, CNN Money magazine ranked CNS as the seventh “Best Job in America” with an A for personal satisfaction. If you take the journey to become a clinical nurse specialist, you’ll be rewarded with a leadership career implementing protocols that support nurses and improve patient care.