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Nurse Types / CVICU Nurse

A cardiovascular intensive care unit (CVICU) nurse cares for patients with critical heart and vascular conditions who need constant monitoring and expert medical support. With heart disease being the leading killer of both men and women, CVICU nurses are extremely important.

CVICU nurses may care for patients with complex problems, like congenital heart anomalies, cardiac infections, myocardial infarctions (heart attacks), or vascular diseases. Cardiovascular function impacts every area of the body. A good CVICU nurse must understand how cardiovascular problems affect other bodily systems, like the kidney, brain, and lungs.

The CVICU is an excellent fit for nurses who are strong critical thinkers with a deep understanding of cardiac rhythms, pathophysiology, and advanced medical interventions.

This article will explain exactly what a CVICU nurse does and how to get started in this field, including:

• What is a CVICU nurse?
• What do CVICU nurses do?
• Where do CVICU nurses work?
• What are specific types of CVICU nurses?
• How do you become a CVICU nurse in 3 steps?
• What are additional requirements of CVICU nurses? 
• What are the salary and career outlooks for CVICU nurses?
• FAQs

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What is a CVICU nurse?

A CVICU nurse provides advanced medical care to patients with complex cardiovascular problems. Many of these patients have recently undergone cardiac surgery for conditions like atrial fibrillation, abdominal aortic aneurysm, or heart valve replacements. Others are suffering from conditions like shock, respiratory insufficiency, or heart failure.

Qualities of a successful CVICU nurse

CVICU nursing is a type of critical care nursing. A great CVICU nurse must be organized, meticulous, and a strong critical thinker. Patients in the CVICU require advanced cardiac monitoring and intervention, so this type of nurse should be comfortable interpreting cardiac rhythms and responding appropriately.

Other skills required in this role include:

• A deep understanding of the heart, including pathophysiology, common disease processes, and cardiac rhythms
• Able to manage complex medications and therapies, like Continuous Renal Replacement Therapy (CRRT), Extracorporeal Membrane Oxygenation (ECMO)Strong resuscitation skills
• Attention to detail and ability to assess, interpret, and intervene according to minute shifts in general patient condition
• Ability to communicate well with an health team
• A love of supporting and teaching patients and their families about cardiovascular issues and recovery

What do CVICU nurses do?

CVICU nurses provide advanced care for critically ill patients with cardiovascular problems. 

Patients may include:

• Babies with congenital heart defects
• Adolescents with pericarditis (an infection of the lining around the heart)
• Adults with complex medical histories that include heart failure along with comorbidities like diabetes or cancer

A day in the life of a CVICU nurse

Most CVICU nurses work with just one or two patients at a time. A typical shift may begin with receiving a report from another nurse, including:

• Patient’s medical and surgical history
• Last set of vital signs and pain management plan
• Current medications and interventions
• Scheduled interventions with surgical, rehabilitative therapy, or imaging teams
• Dietary and daily care needs
• Relevant psychosocial or family issues

Next, the CVICU provides a thorough head-to-toe assessment of the patient, including:

• Intake and output
• Pain level and vital signs
• Skin assessment
• Heart and lung sounds
• Cardiac rhythm

The CVICU nurse then administers medications and monitors therapies throughout the shift. The nurse may also need to prepare the patient for a procedure or test. The nurse ensures that the patient’s daily care needs are met, including appropriate diet, bathing, and patient education.

Throughout the shift, the CVICU must communicate and coordinate with other members of the healthcare team. This might mean ensuring pain medication is administered prior to a scheduled procedure or knowing when to call the physician about a subtle change in heart rhythm. 

The CVICU nurse must be ready to call the rapid response team and jump into action if a patient’s heart stops beating. They must also be prepared to support patients and families with complex diagnoses or poor outcomes.

Common conditions treated by CVICU nurses

The cardiovascular system is a complex system that impacts every part of the body. CVICU nurses work with patients with a wide variety of cardiac and vascular problems, including:

• Coronary artery bypass grafting
• Heart and lung transplant  
• Heart failure  
• Ventricular Assist Device implantation and management 
• Cardiogenic Shock  
• Intra-Aortic Balloon Pump (IABP) procedures  
• Heart valve replacement  
• Transcutaneous Aortic Valve Implantation (TAVI)  
• Surgical intervention for atrial fibrillation  
• Thrombolytic therapy related to vascular emergencies

According to one study, the most common admission diagnoses to the CVICU are acute coronary syndrome (31.8%) and heart failure (18.6%). 

Some patients with cardiovascular issues can be managed on a general med-surg floor. 

Patients in the CVICU are usually admitted because of advanced issues like respiratory insufficiency, shock, unstable arrhythmias, and cardiac arrest.  

Where do CVICU nurses work?

Nearly all CVICU nurses work in hospital intensive care units due to the complex monitoring and support these patients require. 

Some nurses may work in step-down units, specialized telemetry units, or in remote teleICU facilities where they provide an additional set of eyes or expertise for patients offsite. Others may work in post-operative anesthesia units, cardiac cath labs, electrophysiology units, or interventional cardiology units. 

The CVICU is a high-technology workplace. Cardiovascular intensive care often requires advanced technology for intervention and monitoring. Some examples include:

• Intra-aortic balloon pumps
• Continuous renal replacement therapy
• Artificial ventilation
• Intravenous and central lines
• Conscious sedation

What are specific types of CVICU nurses?

CVICU nurses are already very specialized healthcare professionals. Some CVICU nurses may further specialize in a subset of cardiovascular care, like post-operative care, pediatric or neonatal cardiovascular care, or cardiothoracic intensive care.

Closely Related Fields

Nurses who work in the CVICU are a type of critical care nurse. Other critical care nurses include Intensive Care Unit (ICU) nurses and Pediatric Intensive Care Unit (PICU) nurses. Nurses who enjoy working with critical patients in a fast-paced environment might also consider emergency nursing.

How do you become a CVICU nurse in 3 steps?

Given the specialized nature of CVICU nursing, it takes extra training and experience to work as a CVICU nurse. Here’s how to get started.

Step 1 – Become a registered nurse

The first step to becoming a CVICU nurse is to obtain your Bachelor of Science in Nursing (BSN) and pass the NCLEX exam.

Earn a BSN degree

BSN-prepared nurses are in high demand, and most employers are looking to hire nurses with a bachelor’s degree rather than an associates. A BSN may also help you negotiate for a better salary and more responsibilities.

You may be eligible for an accelerated BSN program if you have a bachelor’s degree in another field. Others may start with a traditional four-year degree or RN-to-BSN bridge program.

Pass the NCLEX-RN exam

The NCLEX is a national exam that every registered nurse must pass in order to demonstrate a minimum level of skill and knowledge to practice safely.

There are two versions of the NCLEX for both practical and registered nurses. Nurses who aspire to critical care nursing should sit for the NCLEX-RN. 

Passing the NCLEX exam enables you to apply for a nursing license in the state where you would like to practice. Once you have your license, it’s time to find your first CVICU job. Our career resources can help you find and prepare for your next nursing position.

Step 2 – Accumulate experience

Helpful skills and experience

CVICU nurses should have a good understanding of cardiovascular issues. One way to prepare for this type of position is to take continuing education units on topics related to cardiac pathophysiology, interpreting cardiac rhythms, post-operative care, and advanced cardiovascular interventions.

Changing specialty to a CVICU nurse

Many nurses start their careers on the med-surg floor, which is excellent preparation for CVICU nursing. A year or two on a med-surg floor will help you learn the skills to care for patients with both medical and surgical needs in a less-acute setting.

Other nurses switch specialties from areas like emergency nursing, telemetry nursing, or other areas of critical care nursing. These positions provide excellent background in cardiac rhythms, critical nursing skills, and advanced medical technology.

Some hospitals also offer fellowship programs for nurses looking to switch to the CVICU. Check out the Incredible Health job board for CVICU positions near you.

Step 3 – Obtain certifications

All CVICU nurses should maintain active Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS) certifications.

As you gain experience and confidence in the CVICU, you may be interested in obtaining specialized certifications to demonstrate your knowledge and skill. These certifications may qualify you for more advanced positions or a better salary. 

Most advanced certifications require at least 2-5 years of experience working with critically ill cardiac patients. Available certifications include:

• Critical Care Registered Nurse (CCRN)
• Cardiac Medicine Certification (CMC)
• Cardiac Surgery Certification (CSC)
• Cardiac Vascular Nursing Certification (RN-BC)
• Certified Cardiac Rehabilitation Professional (CCRP)

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What are additional requirements of CVICU nurses? 

Nurses working in the CVICU thrive in a high-stress and fast-paced environment. They know how to manage their time, prioritize tasks, and provide exceptional, advanced-level nursing care.

This work can be difficult, however. CVICU nurses must also understand how to protect their mental health from the emotional labor involved in CVICU nursing. 

What are the salary and career outlooks for CVICU nurses?

Critical care nurses can earn up to $90,855, well above the average annual salary of $82,750. Due to an increasing need for nurses and critical care nurses in general, the career outlook for CVICU nursing is optimistic.

Wondering how much nurses make in your state? Learn more about the average salary for nurses by state as well as the highest-paying cities for nurses. 

Find out how much you could earn with our free salary estimator. Prospective CVICU nurses should also consider other benefits, like sign-on bonuses and paid volunteer days.

Job satisfaction

The CVICU can be a gratifying place to work. It provides the opportunity to care for patients using advanced technology and a great deal of skill.

One recent study found that 94-96% of registered nurses are satisfied with their jobs.

Next steps 

If you’re looking for a fast-paced, high-reward career in critical care nursing, the CVICU might be right for you. 

Nurses in this field are in demand, and there is much room for growth within the field. You can grow your career as a CVICU nurse with additional certifications or by taking on a managerial role in the unit. 

Another option is to pursue an advanced degree as a cardiac nurse practitioner. Teaching and research are also great options for those looking for a change of pace.

If you’d like to speak to other nurses to learn about CVICU nursing (or any aspect of nursing!), join the conversation over in our question-and-answer portal.

Take the first step in your next career as a CVICU nurse. Create a profile with Incredible Health today to find your next job opportunity!

FAQs

Nurse Types / Registered Nurse / Doctor vs. Nurse

Both nurses and doctors wear stethoscopes, dress in scrubs, carry initials after their names, and work hard at the frontline of healthcare. They perform many of the same tasks, but there are differences as well. The level of responsibility, scope of practice, and type of education help determine if you’re talking about a doctor or a nurse.

Before choosing a career path, it is important to unravel the details about these two types of heroes. 

Read on to discover:

• What is a doctor?
• What is a nurse?
• What are the similarities between doctors and nurses?
• What are the differences between doctors and nurses?
• What is the salary outlook for doctors and nurses?
• What is the job outlook for doctors and nurses?
• What should you consider when choosing between the two roles?

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What is a doctor?

A doctor is a highly trained medical professional who has a license to diagnose and treat a patient’s condition. 

Types of doctors 

While there are many types of doctors. These are a few of the most common: 

• Family physicians are doctors who specialize in preventative care for people of all ages. They treat those with chronic illnesses and minor injuries. They perform annual physical exams and are the first doctor one might see for health concerns before going to a specialist. 

• An Anesthesiologist is a type of doctor who is licensed to administer anesthesia. These doctors are present in the operating room and administer general anesthesia to patients during surgery. They monitor them closely to ensure the patient is responding well to the medicine.

• Emergency Medicine doctors receive patients with injuries, poisoning, breathing problems, stroke symptoms, and chest pain. They examine the patient and stabilize them as soon as possible. Then they either admit them to the hospital for further treatment/testing or discharge them with instructions on what to do next. 

What is a nurse?

A nurse is a healthcare professional licensed by their state to provide medical care. They train to have a broad skillset to cover a variety of caregiver tasks and specialties. 

Types of nurses

There are many types of nurses. These are a few related to the doctors mentioned above.  

• Nurse Practitioners (NP) are trained to do many things a doctor can do like diagnose a patient’s condition and formulate a treatment plan. Some states allow NPs to prescribe medications. 

• A Certified Registered Nurse Anesthetist (CRNA) has advanced their career to provide patients help with general anesthesia for surgery, monitor them closely during the procedure, and help them recover from it afterwards. They are also equipped to handle epidurals, nerve blocks, and spinal injections to help with a patient’s pain. 

• An emergency room (ER) nurse is one of the first professionals to take care of the patient when they arrive at the hospital. They take care of treatment ordered by the doctor necessary to ensure the patient’s safety and well-being. They often help educate the patient on the treatment plan the physician ordered for them before they are discharged or sent to another part of the hospital.

What are the similarities between doctors and nurses?

Doctors and nurses perform well under pressure and have the ability to make quick, life-saving decisions. They are also able to exhibit soft skills like:

• Critical thinking
• Strong written and verbal communication skills
• Problem-solving
• Leadership
• Attention to detail
• Teamwork

Nurses and physicians strive to help, heal, and serve others. They stay up to date on the latest medical terms, technology, and research. Both are inspiring professions and are in the business of changing lives for the better. 

What are the differences between doctors and nurses?

There are many differences between doctors and nurses. Some include:

Nurses are trained to care for a variety of patient needs which allows them to work in family medicine one day and mental health the next. If a doctor wants to change their specialty, they must go through a rigorous process of residency all over again to gain expertise in the new area. 

Choosing between becoming a nurse versus a doctor may amount to how much time you are willing to commit to your career. Doctors need to be available frequently, throughout the day and night for some patients. Nurses usually work 8- to 12-hour shifts and can be relieved of their duties.

What is the salary outlook for doctors and nurses?

Salaries for doctors and nurses can depend on:

• Type of license
• Specialty 
• Location
• Experience 

On average a doctor makes an annual salary of $208,000 or greater. The highest paying salary for a doctor is an anesthesiologist that averages $331,190 per year.

A registered nurse makes an average salary of $82,750. Check out each state to find which location works for your budget. 

What is the job outlook for doctors and nurses?

Demand for doctors and RNs continues to rise, while the need for RNs is slightly higher. The nursing profession continues to grow because of an aging population requiring ongoing healthcare services. Patients are increasingly looking for a more holistic approach to medicine which advanced practitioners tend to offer. 

The need for advanced nurse practitioners is rising as the industry demand for nurses increases compared to the demand for doctors.

The estimated employment growth of physicians and surgeons will rise 3%, and nurses will rise 6% between 2021 and 2031.

What should you consider when choosing between the two roles?

You want to determine the amount of time you want to invest in your education. It will normally take more than 10 years to become a doctor. You can begin nursing within 12-18 months, though most choose to get their Bachelor of Science in Nursing (BSN) which is 4 years.

The types of responsibilities and amount of time nurses spend with patients differ greatly from a physician. Nurses often have more time to spend tending to the patient.

Think about what kind of role you want to have in the healthcare to help you decide between these two careers. 

Education

To become a doctor a person must:

• Earn a 4-year pre-med bachelor’s degree
• Pass the Medical College Admission Test (MCAT)
• Complete 4 years of medical school
• Pass one or more U.S. medical licensing exams
• Choose a specialty and complete 3 to 7 years of residency
• Pass a board certification exam 

Doctors have the option of entering a fellowship program for 1 or more years after they complete their residency.

To become a nurse a person must:

• Be admitted to a nursing program
• Graduate from an accredited nursing program after 12 months to 4 years
• Pass the National Council Licensure Examination (NCLEX) 

Optional advanced nursing licenses, like a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP), can add on several more years of education. 

Responsibilities

A doctor’s responsibilities can include:

• Performing a physical exam
• Collecting patient history
• Ordering tests
• Prescribing medication

Depending on the patient’s condition, they may order diagnostic tests, such as X-rays and blood work before diagnosing the patient. Interpreting lab and radiology results is an important responsibility. 

After a diagnosis is made, the physician may prescribe medications and treatment, such as surgical intervention. Referring patients to a specialist, like an oncologist, is another added responsibility. 

Responsibilities of a nurse can include: 

• Head-to-toe nursing assessment of the patient
• Monitoring symptoms, and vital signs, and documenting findings in the patient’s medical record 
• Keeping the doctor up to date with important changes in the patient
• Helping patients complete daily living activities like toileting, walking, and bathing

Nurses also administer medications and perform diagnostic tests like blood draws ordered by a physician. They also carry out duties such as wound care and prepping patients for examinations. 

Next steps

Both of these careers are the heartbeat of healthcare. Although very different, nurses and doctors come together for the patient’s best interest. If you choose one of these paths, it can provide you with the ability and knowledge to change many lives.

You can visit the Questions & Advice section to see real nurse talk for more information about subjects like this and so much more!

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Nurse Types / Registered Nurse / Paramedic vs. Nurse

Choosing a healthcare career requires you to closely examine all your options. Among your choices is becoming a paramedic or a nurse. Both provide emergency care yet work in very different environments. You may be better suited to one than the other.

If you feel torn between the two, taking a closer look at the job responsibilities, work environments, and education required for each of these healthcare careers can help you decide.

In this article you’ll discover:

• What is a paramedic?
• What is a nurse?
• What are the similarities between paramedics and nurses?
• What are the differences between paramedics and nurses?
• What are the salary and job outlooks for paramedics and nurses?
• What should you consider when choosing between the two roles?

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What is a paramedic?

Paramedics provide advanced emergency care to patients. If you’ve ever had to call for an ambulance, it’s been a paramedic who has responded. 

It’s their job to attend to any immediate medical needs and get you stabilized before transporting you to a hospital (if necessary). Sometimes paramedics decide a trip to the emergency room isn’t needed and you can follow up with your regular doctor later.

During true emergencies, paramedics can administer drugs and perform some procedures like setting broken bones and administering intravenous fluids (IVs).

Types of paramedics

There are three types of paramedics. You can base the path you choose on your overall career goals and interests.

• Emergency Medical Technician (EMT) Paramedics are what most people think of when they picture a paramedic. Working as part of a rapid-response unit, they often arrive in ambulances and deal with all kinds of emergencies. From car accidents to heart attacks, they often are the first medical responders on the scene.

• Firefighter Paramedics work with firefighting units. They are both trained firefighters and EMTs. Firefighter paramedics respond to the same scenes where firefighters are called to assist, including house fires and vehicle accidents.

• Flight Paramedics care for patients who must be air-lifted from accident scenes or other remote locations where an ambulance can’t move easily. They are skilled enough to provide high-quality medical care until they can get to a hospital or trauma care facility. Flight paramedics often are assisted by flight nurses.

What is a nurse?

Nurses are another type of healthcare professional. They assist doctors, surgeons, and other healthcare workers treat patients for a variety of medical issues. Most nurses can administer medications, check vitals, perform bedside care, and assist patients with basic hygiene. The level of care nurses can provide depends on their nursing licensure.

Types of nurses

There are several types of nurses. You can choose which kind of nurse you’d like to be based on your personal career goals and level of education.

• Licensed Practical Nurses (LPNs) are entry-level and work under the direct supervision of an RN or doctor. If you choose to become an LPN, you’ll need to earn your Associate Degree in Nursing (ADN) and pass the NCLEX-PN exam to earn your nursing license.

• Registered Nurses (RNs) are more advanced than LPNs. They can administer diagnostic tests, create care plans for their patients, and assist during medical or surgical procedures. Some RNs also serve in supervisory roles. To become an RN, you’ll need to earn either an ADN or a Bachelor of Science in Nursing (BSN) and then pass your NCLEX-RN exam.

• Advanced Practice Registered Nurses (APRNs) are RNs who have completed advanced training in one of four specialty fields: certified nurse midwife, clinical nurse specialist, nurse anesthetist, and nurse practitioner. APRNs can prescribe medications and treat patients without supervision from a doctor.

What are the similarities between paramedics and nurses?

Both nurses and paramedics help people who need medical care. Paramedics and nurses can assess and treat life-threatening issues. They stabilize patients until they can receive the life-saving medical treatment needed at a hospital, trauma center, or other medical facility. 

Nurses and paramedics must act quickly because every second counts when a patient is experiencing a medical emergency.

What are the differences between paramedics and nurses?

There are more differences between nurses and paramedics than similarities. Some of the most obvious contrasts include:

• Nurses work in hospitals and other healthcare facilities. Paramedics treat patients on-site where emergencies happen.

• Paramedics have more medical training than LPNs, even though they only attend 1,200 to 1,800 hours of training versus the 12 to 18 months it takes to become an LPN.

• Paramedics are tasked with stabilizing patients and delivering emergency care before the patient gets to the hospital. Nurses must perform bedside care and a variety of other duties once patients get to a hospital or other healthcare facility.

What are the salary and job outlooks for paramedics and nurses?

According to the U.S. Bureau of Labor Statistics (BLS), the median pay for EMTs is $17.76 per hour. LPNs make an average of $23.11 per hour, with RNs making $39.78 on average.

EMTs continue to be in high demand, with a projected growth of 11% between now and 2030. Each year, the BLS expects 20,700 openings for new EMTs and paramedics. While also in demand, nursing professionals can only expect a growth of 6% between 2021 and 2031.

What should you consider when choosing between the two roles?

Nurses and paramedics perform life-saving duties. When deciding between the two healthcare careers, you may want to consider the following factors:

• Education. Paramedics complete 1,200 to 1,800 hours of training while LPNs are in school for 12 to 18 LPNs. RNs and APRNs must earn a BSN or higher, which requires several years of nursing school.
• Salary. EMTs earn about $5 less per hour than LPNs and nearly $20 less per hour than RNs.
• Stress levels. Both work in high-stress jobs. However, as first-responders, paramedics are under a lot of pressure to quickly stabilize patients so additional treatment can be administered at a hospital or other facility.
• Work environment. Nurses work in the safety and security of hospitals and other medical facilities. Paramedics do most of their work on the scene of accidents, injuries, and other medical emergencies.

Next steps

If you’re struggling to decide between becoming a paramedic or a nurse, you can talk it over with other nursing professionals who faced a similar situation. If you choose to become a paramedic and change your mind later, you can always go back to school to become an LPN, RN, or APRN.

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Nurse Types / Clinical Nurse Specialist

Clinical Nurse Specialists (CNS) are leaders in the nursing profession and healthcare. CNS professionals are widely accepted as nursing experts. They have advanced training and education in assessment, pharmacology, and physiology. Clinical nurse specialists are integral to many organizations because they promote effective, safe, low-cost, evidence-based healthcare services.

A nurse that wants to be recognized as an expert in their field, a CNS position may be the best option. 

For over 60 years, roles for CNSs have grown. Most states now offer fully accredited specialty education programs in advanced clinical practice. 

This article will cover everything you want to know about the CNS role:

• What is a clinical nurse specialist?
• What do clinical nurse specialists do?
• Where do clinical nurse specialists work?
• What are specific types of clinical nurse specialists?
• How do you become a clinical nurse specialist in 3 steps?
• What are the additional requirements of clinical nurse specialists?
• What are the salary and career outlooks for clinical nurse specialists?

What is a clinical nurse specialist?

A clinical nurse specialist is an advanced practice registered nurse (APRN) who has graduated from a Master’s or Doctorate program and is certified in their area of expertise. They have advanced training and education in assessment, pharmacology, and physiology. 

The National CNS Competency Task Force recommends these additional core competencies:

• Direct Care
• Consultation
• Systems Leadership
• Coaching
• Research
• Ethical Decision-Making, Moral Agency, and Advocacy
• Collaboration

In addition to providing direct care for prevention or intervention, the CNS’s scope of practice includes diagnosing and treating illnesses and injuries within their specialty. The expert’s specialty may be defined by:

• Patient population (e.g., geriatrics, pediatrics, women’s health)
• Practice setting (e.g., critical care, emergency room)
• Medical subspecialty or disease process (e.g., diabetes, infectious disease, oncology)
• Problem (e.g., wound care, pain management)
• Type of care (e.g., palliative care, rehabilitation)

A CNS specialty certification prepares professionals to work in different settings and roles. 

Qualities of a successful clinical nurse specialist

CNSs love learning and sharing what they learn. Additional qualities of a successful CNS include:

• Empathy
• Ability to communicate effectively
• Leadership qualities (able to motivate others and affect change)

They must also be passionate about improving the nursing profession, patient care, and the healthcare system. 

What do clinical nurse specialists do?

CNSs help organizations. Fundamentally, CNS practice seeks to improve conditions through mentoring and systemic changes that empower nurses. It aims to design evidence-based models to ease patient distress and promote ethical decision-making.

CNSs care for patients. Like other APRNs, they diagnose, develop care plans, treat, and provide ongoing care management for complex patients. In many states, the CNS can prescribe medications and other therapies. 

CNSs support nurses. They provide expertise and support to bedside nurses and steer change throughout organizations. They also promote best practices and evidence-based care to achieve optimal outcomes. 

CNSs use their advanced education and expertise to serve patients and healthcare organizations in a variety of ways, including:

• Advocating for cost-effective and quality patient outcomes 
• Serving as patient advocates
• Helping facilities achieve Magnet status 
• Assisting with staff retention and mentoring 
• Raising the standards for patient care 
• Increasing compliance with state and federal healthcare guidelines

Many CNSs serve in supervisory or leadership positions. They create or work with teams to develop policies and procedures. 

Others may work in academia or research. CNSs can assist with translating research findings, developing proposals, overseeing study design, or devising new evidence-based standards and protocols.

Graduate training prepares them to help design, implement, assess, and evaluate healthcare interventions that improve care delivery and outcomes. 

A day in the life of a clinical nurse specialist

A day in the life may start at a hospital or an outpatient clinic.

In the acute setting, the CNS will make rounds, perform assessments, and consult with nurses on complex patient care needs. CNSs use their advanced training to participate in initiatives such as preventing infections, reducing the length of stay, and avoiding hospital readmissions.

In an outpatient setting, the CNS may perform primary care assessments, well-child check-ups, or school physicals in the ambulatory setting. They may also counsel patients on disease management and treatment options. 

Common conditions treated by a clinical nurse specialist

CNSs treat clients with acute and chronic issues. Some common conditions a CNS manages include:

• Pregnancy/prenatal care
• Diabetic care
• Wound care
• Psychiatric or mental health care
• Neurological problems
• Cardiovascular disease

Depending on their specialty, you can see a CNS for many of the same conditions you might see a nurse practitioner for.

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Where do clinical nurse specialists work?

According to data from the National Association for Clinical Nurse Specialists (NACNS), most CNSs work in acute care settings, including hospitals (31.96%) and academic health centers (29.17%). Other places that a CNS may work include:

• Nursing schools (professors or administration)
• Outpatient clinics
• Public health agencies
• Private practice
• Veterans’ facilities/organizations
• Nursing homes or long-term care hospitals
• Professional organizations
• Medical suppliers (medical devices or pharmaceutical companies)
• Insurance companies

CNSs may also start their own businesses or work as consultants in many industries. 

What are specific types of clinical nurse specialists?

Most CNSs work in adult health or gerontology (75.85%). 

Other specialists are certified in:

• Pediatrics
• Adult psychiatric and mental health
• Child/adolescent psych and mental health
• Family health
• Women’s health
• Neonatal care

State practice requirements vary, but in most states, a CNS must be certified in their specialty. 

Closely-related fields

Other fields that are closely related include:

• Nurse Practitioner– Nurse practitioner (NP) training is similar, but there is a greater emphasis on direct patient care and less on systems leadership. 
• Clinical Nurse Leader– Clinical nurse leaders (CNLs) are not advanced practice nurses, but their specialization requires at least a master’s degree and focuses on leadership and organizational change.

How do you become a clinical nurse specialist in 3 steps?

If this specialty sounds like it’s for you, here are the 3 steps to becoming a CNS.

Step 1 – Become a registered nurse

To become a CNS, you must start as a registered nurse (RN). Educational programs, state licensing boards, and employers will not recognize a nurse without an active RN license.

Complete necessary education 

An RN who wants to be a CNS must earn a Bachelor of Science in Nursing (BSN) degree. The BSN degree typically takes four years to complete. 

Already-practicing RNs with an Associate Degree in Nursing (ADN) must choose a traditional BSN, Accelerated BSN (ABSN), or an RN-to-BSN degree program to earn the next required degree before applying to a CNS program.

To become a CNS, you must also earn your Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) before practicing. There are bridge programs such as the BSN to MSN and BSN to DNP to help speed up the process.

Although an MSN is the current minimum degree, the National Association of Clinical Nurse Specialists (NACNS) endorses a shift to the DNP by 2030.

Pass the NCLEX exam

After earning your degree in nursing, it is time to pass the NCLEX exam. This board exam assesses a nurse’s minimum competency for entry-level work as a clinical nurse. 

Step 2 – Accumulate experience

Experience improves nursing skills and helps nurses explore their passions and preferences. Most schools require at least 1–2 years of RN experience to enter their CNS programs.

Helpful skills and experience

Nurses known as the go-to nurse on their unit will make great CNSs. The CNS path is great for experienced or knowledgeable nurses who enjoy staying up-to-date on research and evidence-based practice. 

Clinical specialization is also a great option for nurses with experience in management and leadership. Those roles require similar skills and competencies nurses will need for a career as a CNS. If you have been successful in leadership positions and enjoyed the work, this job may be for you. 

Changing specialty to a clinical nurse specialist nurse

If you’re wondering if this rewarding career is for you, here are a few considerations for changing specialties to become a CNS. 

CNS positions are often part of management or leadership. That means the hours often differ from inpatient settings. They usually work normal business hours. On-call shifts, holidays, and weekends may not be required. 

It also means that the role has greater autonomy. Nurses comfortable working closely with their supervisors will notice that the CNS role is very different. The CNS may answer to upper-level administration and may not have day-to-day contact with their bosses. 

If you’re transitioning from a bedside nurse to a CNS, you will find that you spend more time looking up procedures and less time with patients. You’ll likely have more meetings and less time at the bedside. 

As a CNS, you have a bigger impact by supporting teams of nurses caring for patients rather than caring for patients yourself. 

Step 3 – Obtain certifications

To become certified as a CNS, you must complete an MSN or DNP program in clinical nursing and pass a national exam for CNS certification. 

Specialty CNS certifications are currently available through three nursing organizations. These include:

• American Nurses Credentialing Center (ANCC):
  • Adult-Gerontology Clinical Nurse Specialist Certification (AGCNS-BC)
• American Association of Critical-Care Nurses (AACN):
  • Adult-Gerontology Clinical Nursing Specialist (ACCNS-AG)
  • Pediatric Clinical Nurse Specialist (ACCNS-P)
  • Neonatal Clinical Nurse Specialist (CCNS-N)
  • Adult Acute/Critical Care Clinical Nurse Specialist (CCNS-Adult)
  • Pediatric Acute/Critical Care Clinical Nurse Specialist (CCNS-Pediatric)
  • Neonatal Acute/Critical Care Clinical Nurse Specialist (CCNS-Neonatal)
• Pediatric Nursing Certification Board (PNCB):
  • Pediatric Primary Care Mental Health Specialist (PMHS)

Some certifications, such as the Home Health Clinical Nurse Specialist (HHCNS-BC), have been replaced by newer practice certifications. 

What are the additional requirements of clinical nurse specialists? 

The main requirement for CNSs is continuing education. These courses allow nurses to stay current on nursing practice standards. The number of credits or hours required will depend on the certification and state boards. 

[ MORE: Earn your CEUs online, 100% free with Incredible Health. ]

What are the salary and career outlooks for clinical nurse specialists?

CNS salaries currently range from $51,000 to $166,500, but most fall between $82,500 (25th percentile) to $145,500 (75th percentile).

CNS salary is attractive, and so is the job outlook. According to the Bureau of Labor Statistics, master’s prepared APRNs are expected to see growth averaging 40% from 2021 to 2031.

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Job satisfaction

In addition to an excellent salary and job growth, CNSs can expect other aspects to contribute to increased job satisfaction. They have greater autonomy, the ability to provide high-quality care, and a voice in administrative decisions. 

Next steps 

When you achieve a CNS certification, the learning and growing don’t stop there! Clinical specialists have options for advancing their careers.

They may share their work with others by submitting articles to peer-reviewed books or journals. Or they may become leaders in their field by mentoring new CNSs. 

CNSs often seek specialty credentials to add to their certifications. Here are a few credentials offered to advance practice nurse specialists.

• Oncology Nursing Certification Corporation
  • Advanced Oncology Certified Clinical Nurse Specialist (AOCNS)
• Competency and Credentialing Institute
  • Clinical Nurse Specialist Perioperative Certification (CNS-CP)
• Hospice and Palliative Credentialing Center
  • Advanced Certified Hospice and Palliative Nurse (ACHPN)

A clinical nurse specialist wears many hats. Their roles and responsibilities offer many possibilities. If you are interested in this specialty, let us help you!

FAQs

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