A clinical nurse specialist (CNS) is an advanced practice nurse who diagnoses and treats medical ailments in health care facilities. CNSs hold graduate degrees in a specialisation area like cardiology, paediatrics, community health or oncology. According to the National Association of Clinical Nurse Specialists (NACNS), as of 2010 there are an estimated 69,017 nurses in the U.S. who meet the education and training credentials to practice as a clinical nurse specialist.
Because CNSs are specialised medical care providers, the duties of one CNS will differ significantly from the next. CNSs with a master’s degree in school health will likely oversee health care in school districts, while those with a specialisation in mental health may work in a psychiatry ward. In general, however, CNSs are responsible for patients' health. They diagnose and treat ailments and give advice to patients and their families.
CNSs practice in a wide variety of health-care settings, including general medical and surgical hospitals, private practices, community health centres, schools and government agencies. The work environment is generally safe and clean, although CNSs working in some care facilities may be exposed to infectious diseases. Most CNSs work 40-hour weeks.
Training requirements for CNSs vary from state to state. In most cases, they need an RN certification plus extensive postgraduate training, such as a master’s degree or doctorate degree. Some state licensing boards require aspiring CNSs to log a certain number of clinical work hours before awarding them licensure. In some states, CNSs must successfully complete continuing education credits to maintain licensure.
A November 2009 salary report by the private company Salary.com places the median expected salary for a CNS at £53,030. The median 50 per cent range was £48,822 through £57,741. According to the NACNS, the average annual salary of CNSs in the United States ranges from £42,250 to more than £71,500 and depends on the nurse’s geographic location and practice speciality.
The earnings of a CNS generally rise along with work experience. According to a May 2010 salary survey by Payscale.com, CNSs with less than one year of work experience earn a salary that falls between £33,150 and £44,697. Those with between five and nine years of work experience bring home between £38,997 and £51,864. That salary range increases again to £40,547 and £60,068 for CNSs who have been on the job for more than 20 years, according to the report.
Another factor that can affect earnings in the nursing profession is industry. The U.S. Bureau of Labor Statistics (BLS) calculated the salaries of RNs working in the three industries with the highest levels of employment of RNs. With an average annual wage of £41,522, RNs employed by general medical and surgical hospitals were the highest earners. Those working in the offices of doctors made £38,486 on average. The lowest-paying industry was nursing care facilities, where RNs earned £37,089 each year on average. The BLS categorises CNSs under the registered nurse (RN) profession and does not separate the two when calculating salary data. While this data is not specific to CSNs, it exemplifies how nursing salaries differ across industries.