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CNL Versus CNS: What’s Best for You?
N
urses can attain several levels of
practice leadership to grow their
professional development, includ-
ing the clinical nurse specialist (CNS) and
the clinical nurse leader (CNL). However,
both roles are very different in their daily
duties and responsibilities. Nancy Froggatt,
MN, RN, CNL, of the Froedtert Hospital in
Milwaukee, WI, and Lenise Taylor, MN, RN,
AOCNS®, BMTCN®, of the Seattle Cancer
Care Alliance and the University of Washing-
ton Medical Center in Seattle, WA, provided
advice on the CNS and CNL roles and how
to assess which might be best for your career. graduate-level program that prepares a
nurse as a CNS in a defined specialty. Some
of these specialties include pediatrics, geri-
atrics, emergency care, and oncology.
CNSs are qualified to independently do
the following:
What’s a CNL? To prepare to become a CNS, you must
have a master’s degree, advanced course-
work in the “three Ps” (physical assessment,
pathophysiology, and pharmacy), and a
minimum of 500 clinical hours.
A day in the life of the CNS is often
focused on meetings with stakeholders,
quality (e.g., event reviews, product reviews),
staff discussions, evidence-based practice
work (e.g., literature reviews, policy updates,
education), program management, and
information technology (e.g., nursing docu-
mentation, physician orders).
“A lot of my time is in meetings or
The CNL role was developed by the Amer-
ican Association of Colleges of Nursing
(AACN) in collaboration with leaders from
healthcare practice and education.
CNLs are a clinical leader at the point
of care focusing on care coordination, and
their role includes the following:
• Care coordination
• Outcomes measurement
• Transitions of care
• Interprofessional communication and
team leadership
• Risk assessment
• Implementation of best practices based
on evidence
• Quality improvement
To prepare to become a CNL, you must
have a master’s degree, advanced course-
work in the “three Ps” (physical assessment,
pathophysiology, and pharmacy), and a
minimum of 400 clinical hours.
A day in the life of a CNL generally has
two parts: a practice focus and work on
programs and departments.
Practice duties might consist of chart
reviews (e.g., new admissions and previous
day follow-ups), multidisciplinary rounds, and
weekly or monthly meetings. Duties related to
programs and departments generally consist of
unit meetings, care coordination rounds, educa-
tional offerings, house-wide meetings, program
meetings, and reviewing scheduled admissions.
What’s a CNS?
The CNS provides direct care to patients
in one of a range of specialties. To become
a CNS, you must complete an accredited
• Function as an expert clinician and pa-
tient advocate (e.g., patient, family)
• Lead advancement of nursing practice
(e.g., nursing, nursing practice)
• Identify opportunities for and lead
organizational and system change (e.g.,
organizations, systems)
around the nurse area, so they can ask ques-
tions,” Taylor said.
Shared Role Responsibilities of the CNS
and CNL
CNL and CNS roles share the following
similarities:
• Advanced clinicians
• Patient advocates
• Versed in comprehensive and holistic care
• Work with all levels of care and all types
of healthcare settings
• Staff mentors
Within the realm of patient outcomes, CNLs
and CNSs translate nursing research into
clinical practice, use evidence-based practice,
participate in policy development, and coor-
dinate with the multidisciplinary team.
If you’re still not sure which role is right
for you, ask for shadowing experiences
with a CNL and a CNS outside the clinical
environment so you can understand and get
more information on which is the best fit. n
Froggatt, N., & Taylor, L. (2018). CNS or CNL: Which one is right
for me? Session presented at the ONS 43rd Annual Congress,
Washington, DC, May 18, 2018. Retrieved from https://ons.
confex.com/ons/2018/meetingapp.cgi/Session/1615
Here are resources that you can visit for more
information on the CNL and CNS, and which might be
right for you.
AACN Competencies and Curricular Expectations for the Clinical Nurse Leader Education and Practice:
aacnnursing.org/Portals/42/News/White-Papers/CNL-Competencies-October-2013.
pdf?ver=2017-08-07-093318-867
AACN Working Statement Comparing the Clinical Nurse Leader and Clinical Nurse Specialist Roles:
Similarities, Differences, and Complementarities:
aacnnursing.org/Portals/42/CNL/CNLCNSComparisonTable.pdf
AACN Scope and Standards for Acute Care Clinical Nurse Specialist Practice:
aacn.org/nursing-excellence/standards/aacn-scope-and-standards-for-acute-care-clinical-nurse-
specialist-practice
NACNS: What Is a CNS?
nacns.org/about-us/what-is-a-cns
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