In the field of nursing, there are many different rewarding careers that you can pursue depending on your interests. Two job titles that are often confused for one another because of their names are clinical nurse leader (CNL) and clinical nurse specialist (CNS). But while these two careers sound similar, they are in fact very different.

Below we take a look at each of these roles and answer common questions that you may have about each. Keep reading to learn what CNLs and CNSs do, how they differ from one another, their job outlook, and what certifications and training you’ll need in order to succeed in the field.

What do Clinical Nurse Leaders do?

The clinical nurse leader position was created in 2003 by the American Association of Colleges of Nursing (AACN). The goal was for CNLs to oversee the lateral integration of patient care in healthcare settings—particularly in larger medical clinics and hospitals—through evidence-based healthcare practice.

In short, this means that CNLs are nurses who coordinate care for the patients under their charge. This typically involves collaborating with various medical professionals serving a patient, including other nurses, and acting as a resource that those professionals can turn to when they have challenges or questions about treatment. CNLs also work to ensure that all of an organization’s policies are being followed. Generally, CNLs are charged with improving patient outcomes and reducing the potential for medical errors.

What do Clinical Nurse Specialists do?

A clinical nurse specialist is an advanced practice registered nurse (RN) who has earned their master’s or doctoral degree in nursing. They provide direct care to patients, diagnosing and treating them as necessary. Like nurse practitioners, CNSs will often specialize in a particular field of medicine or patient population.

Differences Between CNLs and CNSs

1. Roles and Responsibilities

Although both positions are dedicated to providing the best patient care possible, there are significant differences between the roles and responsibilities of CNLS and CNSs.

As healthcare leaders who have decision-making authority, CNLs oversee facility systems, general care, and team structure—while also working as a point of contact for their patients. To accomplish this, CNLs evaluate outcomes, assess risks, create healthcare plans, and coordinate care across their teams. A CNL’s daily duties often include:

  • Collaborating with patient caregivers to provide quality healthcare
  • Monitoring and analyzing unit-wide patient healthcare outcomes and assess care plans
  • Providing oversight and communicate necessary health procedures for each patient
  • Streamlining and improve communication between members of the medical team
  • Ensuring all healthcare and quality control policies are in place and being followed
  • Researching and learning the latest medical practices, research, and technologies

While CNLs analyze how the staff, institution, and external factors impact patient care, a CNS is charged with providing direct care to patients. They do this through diagnosis, treatment, and ongoing healthcare management, and have specializations such as pediatrics, women’s care, oncology, or emergency services. Day to day, a CNS performs the following duties:

  • Recording patient symptoms and make diagnoses
  • Ordering lab tests and exams
  • Developing healthcare plans and administer treatment
  • Analyzing patient data and outcomes
  • Educating patients and families on their health
  • Conducting research and data analysis with the healthcare team, evaluate current practices, and consulting with patient care managers
  • Supporting and advising nurses providing patient care

CNLs are considered clinical generalists trained in coordinating patient care, whereas CNSs design and implement patient- and population-specific healthcare within their facilities.

2. Training and Education

Both CNLs and CNSs are masters-trained registered nurses. As such, whether you wish to become a CNL or a CNS, your education and training will share many similarities.

The first step to becoming either a CNL or CNS is to first become a registered nurse. This will require you to either earn your associate’s degree in nursing or your Bachelor of Science in Nursing (BSN). Because a bachelor’s degree will ultimately be required to enroll in a master’s degree, earning a BSN usually makes the most sense.

After you have become a registered nurse, you’ll then need to complete your graduate-level education. To become a CNL, you’ll need to earn a Master of Science in Nursing (MSN) with a CNL specialization. To become a CNS, you’ll need to earn a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) with a CNS specialization.

3. Salary and Outlook

Demand for both CNLs and CNSs is high. Between 2019 and 2029, both professions are expected to grow at a much faster rate than all professions, driven by multiple factors including an aging population in need of more healthcare services.

In terms of salary, clinical nurse leaders and clinical nurse specialists earn comparable pay. In 2021, the median salary for CNLs was approximately $92,000. Likewise, the median salary for clinical nurse specialists was $91,700. In both cases, this is a substantial increase in pay over what is earned by the average RN (at roughly $73,300 per year).

Two Potentially Rewarding Careers

Though the job titles of CNL and CNS are sometimes confused by those who are new to the field of nursing, it’s important to recognize that each is, in fact, its own distinct job. Both clinical nurse leaders and clinical nurse specialists play a critical role in modern healthcare, and each can be a fulfilling career. No matter which career path you choose, you’ll have the opportunity to make a direct impact on healthcare and ultimately change the lives of your patients.