What Does a Clinical Nurse Specialist Do?The Clinical Nurse Specialist is an expert clinician and critical component in the delivery of high quality health care in the hospital setting.
The CNS is a Master’s prepared nurse who has transitioned or is in the process of transitioning from the role of RN. As part of the leadership team, the CNS with extensive RN experience will work alongside nurses at the bedside to teach and identify process concerns and educational needs, as well as maintain their own skills.
In addition to their role of educator, the CNS is responsible for leadership development, research, consulting for other services and institutions, and, of course, clinical practice. They practice in many specialty areas including pediatrics, acute/critical care, adult health, geriatrics, oncology, acute/surgical care and community health to name a few. Their goal is to enhance the delivery of health care within their unit, and their success is defined by the success of their nurses as well as patient outcomes.
The role of the CNS is not without its challenges. They need to effectively balance the need for influence with the nurses to be able to train them successfully in the specific procedures of the unit while meeting the goals of management and leadership. The ideal situation occurs when the CNS has nurse educators in the unit that do orientation, onboarding and credentialing education. This gives the CNS the opportunity to establish themselves as the trainer/educator that delivers excellent quality training to nurses at the bedside.
In some instances, the CNS does not have a direct leadership relationship over the nursing staff, requiring them to be creative in their leadership and educator role. All nurses must have access to the same education and training opportunities, which means the schedule of the CNS has to be flexible to meet the needs of the night shift nurses.
There are several possible reporting structure reporting relationships between the CNS and management. For example, the CNS may report directly to the Director of the unit, or may have a line relationship with the Director. Other possibilities are reporting to a Director of Advanced Practice Nurses, or the Director of Education within the organization. It is very important that the CNS have a clear understanding of the organization’s reporting structure for their particular position.
There are many ways the organization can assist the CNS to ensure success. The most effective is regular goal-setting, scheduling and planning meetings between management and the CNS. Goals are set, expectations are clarified and performance and progress are measured on a regular basis. In addition, the CNS needs solid management support in the areas of funding, resources and time to successfully institute their programs and meet their goals. In some instances, professional coaching is provided for the CNS to help guide relationships between management and the nursing staff.
The AACN Statement of Support for Clinical Nurse Specialists offers a great definition of the Clinical Nurse Specialist Role:
Within the APRN community, Clinical Nurse Specialists (CNSs) play a unique role in the delivery of high quality nursing care. These clinicians are experts in evidence-based nursing and practice in a range of specialty areas, such as oncology, pediatrics, geriatrics, psychiatric/mental health, adult health, acute/critical care, and community health among others. In addition to direct patient care, CNSs also engage in teaching, mentoring, consulting, research, management and systems improvement. Able to adapt their practice across settings, these clinicians greatly influence outcomes by providing expert consultation to all care providers and by implementing improvements in health care delivery systems.
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Jill Gilliland
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