How To Become a Clinical Nurse Specialist

Nurses are true frontline heroes who spend long hours on their feet caring for their patients because they genuinely want to make a positive difference in the lives of others in need. If you’re looking for a way to give back to your community while building a career in a high-growth field, you might consider becoming a nurse. There are lots of specialties to choose from within the nursing field, including that of the clinical nurse specialist (CNS).

What does a CNS do, and what’s the process for how to become a clinical nurse specialist? This in-depth career guide explains everything you need to know to begin working toward your future.

In This Article:

• What Is a Clinical Nurse Specialist
• Steps to Become a Clinical Nurse Specialist
• Are Clinical Nurse Specialists in High Demand?

What Is a Clinical Nurse Specialist?

Before diving into this subfield, it’s helpful to take a step back and consider the nursing field as a whole, because the terminology can sometimes be a bit confusing for newcomers. There are many types of nurses, including licensed practical nurses (LPNs, able to provide basic care and to assist other healthcare professionals) and registered nurses (RNs, able to provide direct care to patients). RNs are more highly qualified than LPNs, with stricter education and licensure requirements.

A step above an RN in terms of qualifications is the advanced practice registered nurse (APRN). An APRN has earned a graduate degree (either a master’s or a doctorate, or both), undergone advanced training, acquired professional experience and passed a rigorous certification process. In short, all APRNs are RNs, but not all RNs are APRNs.

There are different types of APRNs, including clinical nurse specialists, nurse anesthetists, nurse midwives and nurse practitioners. Within those specialties, there is room to further subspecialize in a particular practice area or patient population.

A clinical nurse specialist has undergone advanced training in physical assessments, pharmacology, physiology and other areas of nursing, along with their chosen subspecialty. Subject to variations in state regulations, a CNS has the ability to diagnose and treat acute or chronic health problems, including by means of prescribing medications. The role of the CNS is quite versatile and can also encompass healthcare administration, patient outcome improvements, healthcare system improvements and nursing education.

These professionals can choose one of the following subspecialties based on patient population:

• Neonatal
• Pediatrics
• Adult/gerontology

Within these subspecialties, a CNS may provide acute or primary/wellness care as well as management of chronic conditions. Alternatively, a CNS with any of these three subspecialties may choose to focus on nursing education. As a nurse educator, a CNS is responsible for teaching the next generation of nurses.

Steps to Become a Clinical Nurse Specialist

If you’re still in high school and you’ve already decided that becoming a CNS is the right choice for you, consider having a talk with your guidance counselor about your career plans. See whether you can add more science and math classes to your schedule, along with any health-related courses your school may offer. It’s also a good idea to look for internships, part-time jobs and volunteer opportunities at a local hospital, clinic or home health agency.

After high school, you’ll need to earn a four-year degree in nursing. Look for an accredited Bachelor of Science in Nursing (pre-licensure) degree. As a nursing student, you’ll take a blend of classroom lectures, lab courses and clinical rotations.

Once you earn your bachelor’s degree, you will need to pass the NCLEX-RN exam to acquire your nursing license. Then, you’ll need to spend a few years as a working nurse to gain practical experience while sharpening your nursing competencies. The next step is to head to graduate school to earn either a master’s degree or a doctorate; you may also want to earn a nursing education certificate.

After completing your graduate education, you’ll almost be ready to begin working as a clinical nurse specialist. The final steps are to pass the certification exam for aspiring CNS providers, and to apply for state certification in your specialty area.

Earn Your Bachelor of Science in Nursing Degree

After high school, the first step in the process of how to become a clinical nurse specialist is to earn your Bachelor of Science in Nursing (BSN) degree. You can expect this to take four years of intensive, full-time study. During the first part of your degree program (pre-clinical), you’ll take classes and labs, studying topics such as the following:

• General, organic and biochemistry
• Human anatomy and physiology, with a look at immunity, metabolism, acid–base balance and all of the bodily systems
• Pathophysiology, including the etiology, pathogenesis and clinical manifestations of diseases and other health conditions
• Lifespan development of individuals, including their physical, cognitive, social and psychological development
• Behavioral healthcare, with a look at nursing interventions and pharmacotherapy for patients with serious and chronic mental illnesses

After you complete the pre-clinical portion of your degree, you’ll begin your clinical rotations. The clinical program is designed to enable you to take what you’ve learned at school and put it to work in a nursing environment. You’ll be assigned to a nursing unit in a hospital or clinic, where you’ll provide care to your patients under the close supervision of a licensed healthcare professional.

Acquire Your Nursing License

Upon graduating with your BSN, the next step in the process of how to become a CNS is to earn your nursing license. All aspiring RNs must pass the NCLEX-RN exam, which is a national exam that takes up to five hours to complete. If you don’t pass the exam the first time, you’ll be able to retake it.

It’s best not to make any major plans following your graduation. You’ll need to spend as much time as possible preparing for the NCLEX-RN. Try to schedule the exam within a couple of months of your graduation date so that the material is still fresh in your mind.

Acquire a Few Years of Nursing Experience and Patient Care

Once you pass the NCLEX-RN and receive your state nursing license, you’ll be ready to apply to nursing jobs. You’ll need to acquire a few years of nursing experience before heading back to school.

At this time, you may want to apply to a nursing residency program. These programs are designed specifically for new nurses who prefer a structured entry into the nursing profession. You can expect plenty of hands-on work, along with additional classroom instruction and mentorship. Residency programs are typically offered by large healthcare systems and university hospitals.

Another option to consider is becoming a travel nurse. This path can be particularly well suited to new nurses, who are less likely to have started a family. As a travel nurse, you would join a travel nurse agency that would connect you to temporary nursing jobs. Working as a travel nurse is an exciting opportunity to travel and enjoy being a long-term tourist while also working and acquiring nursing experience.

No matter which option you choose, remember that nursing involves lifelong education. Make sure to stay on top of the latest research and trends in nursing by reading professional publications and connecting with your professional network. You’ll also need to complete continuing education courses to maintain your license.

Go Back to School to Earn Your Graduate Degree

When you’re ready to head back to school, you’ll need to consider whether to earn a Master of Science in Nursing (MSN) degree or a Doctor of Nursing Practice (DNP) degree. Currently, it’s possible to become a clinical nurse specialist with a master’s degree. However, there have been some calls for the DNP to be considered the minimum qualification for an APRN. When researching MSN or DNP programs, look for programs specifically designed for clinical nurse specialists.

Both MSN and DNP CNS programs will take a deep dive into advanced topics of relevance for an aspiring CNS, such as nursing research and evidence-based practice. However, an MSN does not require original research and a dissertation, whereas a DNP program does.

Take the CNS Certification Exam and Earn State Certification

Once you graduate with your MSN or DNP CNS, you're ready to sit for your certification exam. The organization responsible for certifying new clinical nurse specialists is the American Nurses Credentialing Center (ANCC), which administers the certification programs.

To become certified, you’ll need to submit proof of your eligibility, such as all of your transcripts. You’ll also need to sit for a board certification exam, which may be available via live, remote proctoring in some cases. Upon successfully passing the exam, you’ll be able to apply for APRN certification from your state board of licensure.

Note that your board certification from the ANCC will eventually expire. When you receive your certification, make a note of the expiration date and develop a plan to complete all required professional development activities over the next few years. Be sure to submit your application for renewal well ahead of the expiration date of your certification.

Are Clinical Nurse Specialists in High Demand?

The U.S. Bureau of Labor Statistics (or BLS), which is tasked with tracking employment data, doesn’t provide statistics specifically for clinical nurse specialists. However, it does track employment data for registered nurses, as well as for other APRNs.

As of September 2021, the U.S. Bureau of Labor Statistics Occupational Outlook Handbook estimates job growth for registered nurses to increase by about 9% from 2020 to 2030 — as fast as average for all professions — accounting for an estimated increase of 276,800 jobs in the field.¹

The U.S. Bureau of Labor Statistics Occupational Outlook Handbook estimates job growth for nurse anesthetists, nurse midwives and nurse practitioners to increase by about 45% from 2020 to 2030 — about as fast as the average for all professions — accounting for an estimated increase of 121,400 jobs in the field.² Although clinical nurse specialists are not included in this projection, the professionals who are included in this category are other APRNs who have a comparable level of training and education as clinical nurse specialists.

Are you passionate about pursuing a career that would enable you to help others in need? You’ll find the nursing education programs you’re looking for at Grand Canyon University (GCU). If you think nursing might be right for you and want to get started in nursing, consider the Bachelor of Science in Nursing degree at GCU.

¹COVID-19 has adversely affected the global economy and data from 2020 may be atypical compared to prior years. The pandemic may impact the predicted future workforce outcomes indicated by the U.S. Bureau of Labor Statistics as well. Accordingly, data shown is based on September 2021, which can be found here: U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, Registered Nurses

²COVID-19 has adversely affected the global economy and data from 2020 may be atypical compared to prior years. The pandemic may impact the predicted future workforce outcomes indicated by the U.S. Bureau of Labor Statistics as well. Accordingly, data shown is based on September 2021, which can be found here: U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, Nurse Anesthetists, Nurse Midwives and Nurse Practitioners, retrieved on 06/02/2022. 

Approved by the dean of the College of Nursing and Health Care Professions on Feb. 6, 2023.