Who Regulates?
Clinical Nurse Specialists (CNSs) in North Carolina are regulated by the North Carolina Board of Nursing (NCBON). They must practice according to the NC rules for CNSs, and maintain competencies aligned with their educational preparation and national certification to ensure safe and effective care.
Laws and Rules
CNS practice is governed by 21 NCAC 36 .0228, which outlines requirements such as obtaining national certification prior to licensure.
Practice
CNSs integrate the three spheres of influence—patient/client, nursing personnel, and organizational/system—into their role. They focus on optimizing patient outcomes, advancing nursing practice, and improving health system performance through evidence-based leadership, education, and collaboration.
Prescriptive Authority
In North Carolina, CNSs do not have prescriptive authority. They cannot prescribe medications or obtain DEA registration. Their role emphasizes assessment, diagnosis, and non-pharmacologic interventions, along with pharmacologic monitoring rather than prescribing.
Clinical Services Provided
CNSs provide a wide range of services within their scope of practice, including:
- Comprehensive health assessments
- Diagnosis and non-pharmacologic interventions for acute and chronic conditions
- Pharmacologic monitoring
- Wellness promotion
- Interdisciplinary collaboration
- Outcome evaluation
- Evidence-based leadership
- Integration of education
- Consultation, management, and research
Refresher Course
The refresher course is an individually planned and self-directed course of study containing required components for the Clinical Nurse Specialist (CNS) who has not been engaged in Clinical Nurse Specialist practice in greater than two (2) years.