Clinical Nurse Specialist
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General Information


Completion of a Master’s or higher in nursing with clinical specialization and preparation for an expanded role with national certification in adult/gerontology, pediatrics, or neonatal clinical nursing.

What they do

The Clinical Nurse Specialist has the unique Advanced Practice Registered Nurse 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 Clinical Nurse Specialist is continuous improvement of client outcomes and nursing care.

Key elements of Clinical Nurse Specialist practice are to manage complex client health issues through direct care, consultation, research, education and administrative roles. Clinical Nurse Specialists 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 Clinical Nurse Specialist 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 Clinical Nurse Specialists now practice in most healthcare settings.

Who regulates

National Clinical Nurse Specialist Certification is required if one wishes to be recognized as a Clinical Nurse Specialist by the North Carolina Board of Nursing. Recognition as a Clinical Nurse Specialist by the North Carolina Board of Nursing is required to practice as a Clinical Nurse Specialist in the state.

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.

Application Processes

Last Changed 22-Mar-2023

North Carolina Board of Nursing

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Contact Information

(919) 782-3211
(919) 781-9461
8 a.m.-5 p.m., Mon-Fri
North Carolina Board of Nursing