North Carolina Board of Nursing

Nursing Practice

Clinical Nurse Specialists

General Information


Completion of a Master’s or higher degree in nursing or Post-Master’s certificate in nursing, with clinical specialization and preparation for expanded role functioning in areas such as mental health, neonatology, gerontology, cardiology, oncology or community.

What they do

The Clinical Nurse Specialist has the unique APRN role to integrate care across the continuum and through three spheres of influence: patient, nurse, system. The three spheres overlap and are interrelated, but each sphere possesses a distinctive focus. In each of the spheres of influence, the primary goal of the CNS is continuous improvement of client outcomes and nursing care.

Key elements of CNS practice are to manage complex client health issues through direct care, consultation, research, education and administrative roles. CNS’s may provide preventive care, client and family education and counseling, psychotherapy, and/or supervision and mentoring of physical and mental health needs over time. The CNS is responsible and accountable for treatment of health/illness states, disease management, health promotion, and prevention of illness and risk behaviors among individuals, families, groups, and communities. While historically the role began in hospitals, increasingly CNS’s now practice in most healthcare settings.

Who regulates

National CNS certification is required if one wishes to be recognized as a CNS by the NCBON. Recognition as a CNS by the NCBON is required to practice as a CNS in the state.