Clinical Nurse Salary Guide

A clinical nurse, sometimes called a clinical nurse specialist or CNS, is an advanced practice registered nurse whose exact scope of practice varies by state. Individual state laws issued by state licensing boards determine their ability to practice independently and write prescriptions. These authorities along with practice setting and several other factors can dictate a CNS's salary. Clinical nurse specialists are key resources in healthcare facilities and some of the highest-paid APRNs nationwide.

A clinical nurse specialist is an advanced practice registered nurse who specializes in a specific practice area. No matter their practice setting, a clinical nurse’s specialty may be defined by patient population, disease or medical subspecialty, type of care required, type of medical problem, and work setting. However, they’re typically trained to work predominantly either with children or adults and sometimes to perform functions traditionally reserved for doctors.

To become a CNS, you must first complete the educational requirements to become a registered nurse. However, because this role requires an advanced degree, you must complete a Bachelor of Science in Nursing degree from a program accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN). An associate degree won’t work for this advanced nursing role. You must pass the NCLEX-RN exam to obtain RN licensure. You can begin gaining practice experience while you earn a Master of Science in Nursing or higher.

As expert clinicians, clinical nurse specialists have advanced education and training in specialized areas of nursing practice. Because they need an advanced degree, many CNSs work while earning their master’s degree to gain practical nursing experience. This experience can give their base salary a boost when they finish the requirements to become a CNS. As CNSs expect their salaries to continue growing as they  gain more experience in their field.

Years of experience can also help a CNS gain new skills and each additional skill mastered can prompt a higher base salary. Experience helps make them better healthcare leaders and enhances their clinical skills, which must be extensive to succeed. Their ongoing nursing experience can also help them hone their problem-solving and decision-making skills which helps them with complex cases and research tasks and can affect a clinical nurse specialist's salary.

Certifications in Basic Life Support, Advanced Cardiovascular Life Support, and Pediatric Advanced Life Support are all required, so these professional certifications may not impact a CNS’ base salary. However, a CNS who voluntarily pursues and earns other professional certifications will likely have a larger base salary than their uncertified colleagues.

Due to their advanced education and training, clinical nurse specialists can work in a wide array of facilities, which can impact how their salaries are based. For example, smaller health clinics that employ a CNS may not have as large a budget for salaries as an educational institution. The geographical location of the facility can also impact base salaries as some cities and states pay more than others and urban areas usually offer higher salaries than rural areas.

Furthering your education can play a big role in increasing your CNS salary because you must have graduate preparation in nursing and advanced knowledge of nursing practice. While you typically only need an MSN to become a CNS, you can earn your Doctor of Nursing Practice to give your salary a major boost. You can also pursue additional education or coursework within your advanced degree program that aligns with your area(s) of specialty along with other valuable classes and training in pharmacology, physical assessment, and physiology.

As a CNS, you also have numerous opportunities to earn professional certifications that help give your salary a large bump. You must choose a specialty and seek specialty certification based on patient populations. You can pursue population-level CNS credentialing through the American Nurses Credentialing Center (ANCC) or the American Association of Critical-Care Nurses (AACN).

The ANNC offers Adult-Gerontology Clinical Nurse Specialist Certification (AGCNS-BC) if you have a master's, postgraduate certificate, or DNP from an accredited adult through gerontology clinical nurse specialist program. The program must contain at least 500 faculty-supervised clinical hours; graduate-level courses in advanced physiology/pathophysiology, health assessment, and pharmacology; and content covering health promotion and/or maintenance and disease management and differential diagnosis.

The AACN offers three entry-level advanced practice board certifications for CNSs educated at the graduate level. Each covers the continuum of healthcare services, wellness through acute care, for a specific patient population. Its Acute Care CNS Adult-Gerontology (ACCNS-AG) covers the adult through gerontology patient population, Acute Care CNS Pediatric (ACCNS-P) covers the pediatric patient population, and Acute Care CNS Neonatal (ACCNS-N) covers the neonatal patient population.

Take a look at Vivian's Clinical Nurse Career Guide for more information, including required education, responsibilities, pros and cons and more.