By: Nurse.org Staff

Medically reviewed by: Kathleen Gaines MSN, RN, BA, CBC

Part One What is a Clinical Nurse Specialist? 

Clinical nurse specialists are advanced practice registered nurse advanced practice registered nurses who mainly function to improve outcomes regarding patients, nurses, and system-wide organizations.

Like nurse practitioners, clinical nurse specialists specialize in specific patient populations; however, unlike NPs, they focus more on educating nurses and improving patient outcomes. CNS's also provide a higher level of patient care and can take on a supervisory role within a healthcare team.

CNS’s function in five basic sub-roles:

• Leader

• Educator

• Researcher

• Consultant

Clinical Nurse Specialists can also specialize in the following areas:

• Family/Individual/Across the Lifespan
• Neonatal
• Pediatrics 
• Psychiatric/Mental Health
• Women’s Health/Gender Specific

Part Two What Does a Clinical Nurse Specialist Do? 

Clinical nurse specialists’ jobs vary by the specialty and type of facility they work in. But their primary role is to improve outcomes. That means that they are constantly thinking about questions such as:

• How can I help the nurses at the bedside? 

• How can I help these patients on the unit? 

• How can I look back from a big perspective and see how can we improve a process throughout the whole system of the hospital? 

According to CNS Andrea Paddock, what a CNS does varies not just on where you work, but also depending on the day. “My day to day can transition from being in my office planning for a project. So I'm doing a lot of reading, researching, writing, things like that. Other days, I'm out on the unit helping the nurses, running to codes, running simulations, teaching classes, running meetings, etc. No one day is ever the same.”

In fact, according to the 2020 NACNS survey, CNSs said they spent 26.6 percent of their day providing direct patient care, 22.1 percent consulting with nurses and other staff, 26.5 percent teaching nurses and staff, and 19.7 percent leading evidence-based practice projects. The majority of their time is spent precepting students (32.5%).

Clinical nurse specialists will also perform the following activities according to the survey:

• Assist with evidence-based practice projects

• Assist other nurses/staff with direct patient care (aka act as a resource)

• Assist with research

• Teach patients and families

• Conduct research as the primary investigator

• Teach in the community

• Provide transitional care

In other words, CNSs wear several hats and are valued members of healthcare teams. 

A Day in the Life of CNS

Clinical Nurse Specialist, Andrea Paddock, shares a day in her life including what a CNS does and her journey to become one.  

Show Me All Specialized MSN Programs

Part Three Clinical Nurse Specialist Salary

The median Clinical Nurse Specialist salary is $112,257, as of November 2022, according to ZipRecruiter.  

Clinical Nurse Specialist salaries currently range between $51,100 to $159,000 with some making upwards of $167,000 annually across the United States. Clinical Nurse Specialists’ earnings can vary depending on the specialized unit and employer.

Some Clinical Nurse Specialists may be highly sought after by hospitals and medical facilities that have a specific role to fill, and therefore, salaries might be more competitive.

In fact, some institutions might even hire highly specialized travel nurses to meet their demand, offering Clinical Nurse Specialists an additional option. 

Part Four How to Become a Clinical Nurse Specialist 

1. CNS Requirements

Becoming an Advanced Practice Nurse happens after gaining experience as a Registered Nurse. To become an RN, you have to graduate from a program of study that is approved by your State Nursing Board, either a Bachelor’s degree or an Associates's degree program. Upon completion, you have to pass the NCLEX-RN.

2. CNS Education

It’s necessary to go back to school to earn at least Master’s of Science in Nursing degree, focused on a clinical nurse specialist track. However, over 20% of CNS also choose to complete their doctorate degree, according to the  National Association of Clinical Nurse Specialists (NACNS).

3. CNS Certifications

There are a number of CNS certifications you can pursue, depending on the field you want to work in. Each of them is administered by the American Nurses Credentialing Center. CNS certifications include but are not limited to,

• Adult Health CNS
• Adult-Gerontology CNS
• Pediatric CNS
• Neonatal CNS
• Public Health CNS

Certifications usually need to be renewed every few years.

Show Me All Specialized MSN Programs

Part Five Top Clinical Nurse Specialist Programs 

Choosing a Clinical Nurse Specialist (CNS) program is a big decision. Nurse.org has compiled a list of some of the best online and in-person programs for 2022. Each program included in the list below is accredited and offers high-quality academic outcomes. Other criteria include,

• Cost of attendance
• Location
• Graduation rate
• Credit hours
• Program length
• Admission requirements
• Clinical placements
• Ranking according to U.S. News & World Report

1. The University of Texas at Austin

The Adult-Gerontology Clinical Nurse Specialist program focuses on perspectives of both health restoration and health promotion while developing skills in case management. This concentration area focuses on physiological and psychosocial theories, concepts, and research underlying the self-care and growth needs of individuals.

• Tuition: $13,640 per semester
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Program Length: 1 to 2 years
• Contact Information: 512-471-7927 or nugrad@nursing.utexas.edu

2. Saint John Fisher College

Adult/Gerontology Clinical Nurse Specialist is offered at Saint John Fisher College as well as post-master’s certificate in the same discipline. This program is offered exclusively on campus.

• Tuition:  $1,003 per credit
• Accreditation: CCNE
• Program Length: 2  years
• Contact Information: cdonegan@sjfc.edu or (585) 899-3788

3. University of Detroit Mercy

The University of Detroit Mercy offers an Adult-Gerontology CNS. The program is 100% online and offers advanced principles in adult learning for teaching roles. The 2016-20 Detroit Mercy graduating classes achieved a 100% pass rate across the national certification exams for the Adult-Gerontology CNS.

• Tuition: $1,493 per credit
• Accreditation: CCNE
• Program Length: Minimum 3 years
• Contact Information: 313-993-1828 or gradnursing@udmercy.edu

4. Alverno College

Adult-Gerontology CNS is the only program offered by Alverno College. While a small program, it prepares students to provide advanced care across the age continuum from illness to wellness and from acute care to primary care.

• Tuition: $1,098 per credit
• Accreditation: CCNE
• Program Length: 3 years
• Contact Information: 414-382-6000 or admissions@alverno.edu

5. Indiana University -Purdue University - Indianapolis

The Adult-Gerontology CNS program follows a traditional semester format. Core courses are taught online, asynchronously with the exception of five on-campus lab days for advanced physical assessment. On-campus days are required further into the program. This is important to keep in mind when applying for this program.

• Tuition: $607 per credit
• Accreditation: CCNE
• Program Length: 2 to 3 years
• Contact Information: (317) 278-5699 or kelblake@iu.edu

6. University of Pennsylvania

The University of Pennsylvania offers three different Clinical Nurse Specialist tracks including Pediatrics, Neonatal, and Adult-Gerontology. Students can earn an MSN CSN in a year for full-time study while experiencing clinical placements at Children’s Hospital of Philadelphia and the Penn Health System, both ranked top in the nation.

• Tuition: $45,248 per year
• Accreditation: CCNE
• Program Length: 1 to 3 years
• Contact Information: (215) 898-8281

9. Johns Hopkins University

This program allows students to earn their DNP as Clinical Nurse Specialists. The online DNP CNS track includes three mandatory and two optional course immersions in person. Additionally, Hopkins offers one of the only critical care CNS programs in the country. There are currently three track options: Adult-Gerontological Health, Adult-Gerontological Critical Care, and Pediatric Critical Care.

• Tuition: $56,340 per year
• Accreditation: CCNE
• Program Length: 4 years
• Contact Information: 410-955-4766

8. University of Washington

The University of Washington offers two DNP CNS programs: Pediatrics and Women’s Health. This is one of only a couple of Women’s Health CNS programs in the country, Offered exclusively as full-time programs, students graduate in 9 semesters and are board eligible.

• Tuition: $925 per credit
• Accreditation: CCNE
• Program Length: 3 years
• Contact Information: 206.543.8736

9. University of Wisconsin - Milwaukee

Students can earn a DNP CNS terminal degree in three tracks at the University of Wisconsin including pediatrics, women’s health, and adult-gerontology.

• Tuition:  $27,045 per semester
• Accreditation: CCNE
• Program Length: 3 years
• Contact Information: (414) 229-5047 or uwmnurse@uwm.edu

10. Rush University

Rush University offers three DNP programs for interested students: pediatrics, adult-gerontology, and neonatal. The cohorts are kept intentionally small to optimize clinical placement and classroom experience. 

• Tuition:  $1,224 per credit
• Accreditation: CCNE
• Program Length: 2 to 3.5  years
• Contact Information: elizabeth_m_miranda@rush.edu or (312) 942-7100

Show Me All Specialized MSN Programs

Part Six CNS Certifications & Specialties

Unlike most other nursing degree and certification specialties, there are not CNS certifications and programs for every single type of nursing specialty. Currently, the following CNS specialties have corresponding certifications,

• Adult

• Pediatric

• Neonatal

• Geriatric

• Oncology

• Critical Care (Adult, Pediatric & Neonatal)

• Orthopedic

• Perioperative

• Psychiatric-Mental Health (Adult, Adolescent/Child)

Part Seven What is the Career Outlook for a CNS? 

In general, the nursing profession will offer job security for many years to come as the population continues to age. There is also a nursing shortage expected since so many current nurses will be entering retirement age in the next few years. 

Demand for Clinical Nurse Specialists

What’s more, for those with advanced nursing skills, like Clinical Nurse Specialists, job openings are expected to increase even more. APRN jobs, which include Clinical Nurse Specialists, are expected to increase by 40 percent from 2021 to 2031, much faster than the average for all occupations, according to the Bureau of Labor Statistics. However, this statistic does not specifically address the CNS occupation. 

Part Eight Clinical Nurse Specialist FAQs

• What is the Role of a Clinical Nurse Specialist?

  • CNSs wear a number of hats but the majority of their time is spent either caring for patients or working behind the scenes with other nurses and staff members.

• Are Clinical Nurse Specialists in Demand?

  • Yes! Clinical Nurse Specialists are a type of APRN. APRN jobs are expected to increase by 40% from 2021 to 2031.

• How Many Years Does it Take to Become a Clinical Nurse Specialist?

  • It takes approximately 4 years to earn a BSN, then another 2-3 years for an MSN. Though many nurses take time in between degrees to earn experience. 

• How Much Money Does a Clinical Nurse Specialist Make?

  • The median salary for Clinical Nurse Specialists is  $112,257.

• What's the Difference Between a Registered Nurse and a Clinical Nurse Specialist?

  • A Clinical Nurse Specialist is a type of Advanced Practice Registered Nurse, meaning they are Registered Nurses that have completed additional education (a minimum of a Master's degree) and training.