Looking for the chance to play an active role in healthcare policy, nursing education, and program development? The Clinical Nurse Specialist (CNS) DNP may be right up your alley. If you’ve already determined that the DNP is right for you, skip ahead to our program listings. But if you’d like some background on this program, including information on the CNS vs. NP, certification requirements, typical curricula, and examples of DNP capstone projects, read on!
Becoming a Clinical Nurse Specialist
The Modern Clinical Nurse Specialist
Often found in supervisory or management roles, a clinical nurse specialist (CNS) is an elite APRN who specializes in a select area of clinical care. According to the National Association of Clinical Nurse Specialists (NACNS), these areas include:
- Population Group (e.g. pediatrics, geriatrics, obstetrics)
- Practice Setting (e.g. critical care, ER, long-term care)
- Disease or Medical Sub-Specialty (e.g. diabetes, oncology, palliative)
- Type of Care (e.g. psychiatric, rehabilitation)
- Type of Problem (e.g. pain, wounds, stress)
No matter which specialty they choose, CNSs are expected to operate under 3 spheres of influence, providing expert clinical care to patients, education to nursing personnel, and leadership over the larger healthcare system. They diagnose and treat diseases, mentor staff, manage units, develop nursing policies, instigate healthcare programs and initiatives, advocate for patients, and – most importantly – improve patient outcomes. In some cases, that means CNSs are supporting nursing practice in complex settings such as hospitals and large healthcare organizations.
CNS vs. NP
|Clinical Nurse Specialist (CNS)||Nurse Practitioner (NP)|
|Definition||An APRN with Clinical Nurse Specialist (CNS) certification in a select specialty. e.g. acute care.||An APRN with specialty certification. e.g. Family Nurse Practitioner-Board Certified (FNP-BC).|
|Role||Provide clinical care, mentorship, teaching & consulting. Advocate for patients, research and design healthcare programs, evaluate staff & take an active role in management.||Provide direct patient care for diverse populations under the direct or indirect supervision of a physician. Diagnose and manage illnesses, prescribe medications & counsel patients.|
|Career Opportunities||CNS, program director, case manager, care coordinator, trauma coordinator, staff development coordinator, research coordinator, clinical instructor.||NP in a variety of care areas, including pediatrics, family practice, psychiatry, gerontology, and women’s health.|
|Setting||Frequently acute care (e.g. hospitals).||Frequently outpatient and primary care (unless they are specifically trained as acute care NPs).|
CNS Licensure & Certification Requirements
Many RNs pursue a DNP in order to become a Clinical Nurse Specialist (CNS). Like other specialty titles (e.g. nurse anesthetist), this is an advanced practice registered nurse (APRN) qualification. CNSs typically work in acute care facilities such as hospitals, clinics, and physician offices, or in long-term care and community-based healthcare settings.
In order to be certified as a CNS and licensed in your state, you may be required to:
- Earn an accredited bachelor’s degree in nursing.
- Pass the NCLEX exam to become a Registered Nurse (RN) in the state in which you intend to practice.
- Earn a post-baccalaureate degree (e.g. the DNP or the MSN) from a program that has been accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN).
- Pass the national exams for the CNS Core or 9 CNS specialty areas (e.g. Adult-Gerontology, Pediatric, Home Health, etc.) administered by the American Nurses Credentialing Center (ANCC).
- Maintain your certification & licensure through continuing education.
Please check with your school and your State Board of Nursing for more information on which national certifications are required to practice as a CNS. For example, an oncology nurse may need Advanced Oncology Certified Clinical Nurse Specialist certification from the Oncology Nursing Society; an acute care nurse may require certification from the American Association of Critical Care Nurses (AACN).
DNP programs should also clearly state that they are accredited and able to prepare you for CNS exams. If it isn’t already listed on the website, ask the school for its pass rates on the CNS certification exam.
Helpful Professional Organizations
- American Association of Colleges of Nursing (AACN)
- American Association of Critical Care Nurses (AACN)
- American Nurses Credentialing Center (ANCC)
- National Association of Clinical Nurse Specialists (NACNS)
The Clinical Nurse Specialist DNP
Typical DNP Curriculum
The DNP is designed to prepare CNSs become expert clinicians and leaders in the healthcare arena. That means the curriculum is a mix of advanced science, clinical practice, evidence-based research, and career training. Look for programs that give you opportunities to practice your specialty in clinical settings (e.g. hospitals, hospice programs, state agencies, etc.), expose you to relevant populations (e.g. urban, underserved patients), and allow you individualize the program to meet your goals. Good schools often state that they are following curriculum recommendations laid out by the NACNS (e.g. Clinical Nurse Specialist Core Competencies) and the AACN (e.g. Scope & Standards for Acute Care Clinical Nurse Specialists Practice).
Course-wise, you can expect to build on your knowledge of areas like physiology, pathophysiology, pharmacology, population health, and diagnostic reasoning. Most programs will also allow you to choose an area of clinical emphasis (e.g. surgery, orthopedics, trauma, etc.). Remember that – in addition to your clinical specialization – you will be taking classes in areas such as finance, public policy, ethics, research skills, and informatics. These are intended prepare you to take an active role in management and program development. If you are interested in hands-on primary care, you may wish to consider an NP DNP instead.
Examples of DNP Capstone Projects
- Effect of an Intervention to Increase Knowledge of the Danger of Delay in seeking Treatment for Chest Pain. (Case Western University)
- Identifying Gaps in Perioperative Registered Nurses Knowledge of the Cleaning and Decontamination Process for Surgical Instruments. (University of Alabama)