CNS vs. CNL

Specialties CNS

Published

Specializes in Neonatal ICU.

I know that this may be addressed in another thread, but if someone could either answer my question, or direct me to an answer, I would appreciate it.

I know that a CNL is more of a generalist than a CNS, but what does this really mean? I know that in CNL training, in obtaining your MSN, you still have clinical rotations, and become an "expert" in a field.... but currently I work as an RN in a level III NICU, and would preferably stay with babies, or at the least, pediatrics. I feel that the program offered close to me that offers training to become a CNL is better for me due to the length, and online options, but I am unsure if the degree itself would be better as CNS or a CNL?

SOOOOO

My main question is: What in the world is the real difference between a CNS and a CNL?

Thanks!

Amanda

Up Vote Up Vote ×

Go to www.aacn.nche.edu/cnl/CNLgeneric.ppt.

or the AACN website.

Generally a CNL is a RN with a Master degree. perform the same role as a bedside nurse but with more emphasis on evidence based practice in the care of patient.

CNS is a Specialist.

Up Vote Up Vote ×
Go to www.aacn.nche.edu/cnl/CNLgeneric.ppt.

or the AACN website.

Generally a CNL is a RN with a Master degree. perform the same role as a bedside nurse but with more emphasis on evidence based practice in the care of patient.

CNS is a Specialist.

I'm currently in a CNL program, and there's a little more to it than that. In addition to performing bedside duties, a CNL is responsible for an entire group of patients (a single unit, floor, etc). They look at nursing on the unit from a systems level and determine what changes can be made to improve patient outcomes, using evidence-based criteria for doing so. That may not be how the role is actually implemented everywhere, but that's how it was designed, and that's what we're being taught to do (or rather they're starting to get us thinking about things from a systems-level; I'm still in the pre-licensure component of my program. I just started my first med-surg rotation last week- I'm so excited!).

Up Vote Up Vote ×
Specializes in Nephrology, Cardiology, ER, ICU.

My own take on this is that a CNS can also be an advanced practice nurse while a CNL can not.

However, have you considered NNP?

Up Vote Up Vote ×

CNSs are advanced practice nurses who are experts in a specific clinical specialty (e.g., I'm a child psych CNS). CNLs are Master's-prepared generalists who are not advanced practice nurses.

Up Vote Up Vote ×

Interesting question. I have a master's degree in nursing and I have worked in serveral areas. Does that make me a CNL? I guess I would want to know if the CNL is some sort of designation or certification. What kind of testing is required. Also I am interested in becoming a CNS but not sure in what area and don't know how long you need to have worked in a particular to become a CNS.

Up Vote Up Vote ×
Specializes in Nephrology, Cardiology, ER, ICU.

In order to take the CNS exam you have to complete a CNS program. I had an MSN in management and leadership, then did a post-MSN certificate for adult health CNS, then did another post-MSN certificate for peds CNS.

Up Vote Up Vote ×
Interesting question. I have a master's degree in nursing and I have worked in serveral areas. Does that make me a CNL? I guess I would want to know if the CNL is some sort of designation or certification. What kind of testing is required. Also I am interested in becoming a CNS but not sure in what area and don't know how long you need to have worked in a particular to become a CNS.

There is an exam and national certification for CNLs, but I don't know what the specific requirements are to be eligible. As trauma noted, in order to be eligible for certification as a CNS, you have to have completed an MSN program (or post-Master's certificate) that specifically prepared you as a CNS in your particular specialty.

Up Vote Up Vote ×

As Elkpark mentioned, there is a national certification examination for CNLs. This exam is administered by the American Association of Colleges of Nursing (AACN).

To be eligible to sit for the CNL Certification exam, you need to have graduated from a CNL program -- or be teaching in an existing CNL program.

Up Vote Up Vote ×
I know that this may be addressed in another thread, but if someone could either answer my question, or direct me to an answer, I would appreciate it.

I know that a CNL is more of a generalist than a CNS, but what does this really mean? I know that in CNL training, in obtaining your MSN, you still have clinical rotations, and become an "expert" in a field.... but currently I work as an RN in a level III NICU, and would preferably stay with babies, or at the least, pediatrics. I feel that the program offered close to me that offers training to become a CNL is better for me due to the length, and online options, but I am unsure if the degree itself would be better as CNS or a CNL?

SOOOOO

My main question is: What in the world is the real difference between a CNS and a CNL?

Thanks!

Amanda[/quote

I am in my last semester of the CNL program. Here is a comparison table from the AACN to explain the difference.

[TABLE]

[TR]

[TD=width: 39%, bgcolor: #ffffff]Clinical Nurse (CNL)

[/TD]

[TD=width: 30%, bgcolor: #ffffff, colspan: 2]Shared Role Characteristics

[/TD]

[TD=width: 30%, bgcolor: #ffffff]Clinical Nurse Specialist (CNS)

[/TD]

[/TR]

[TR]

[TD=width: 54%, bgcolor: #ffffff, colspan: 2]The Clinical Nurse Leader (CNL) is prepared at the master's degree level as a generalist.

In addition to the competencies delineated in the AACN (1998)

Essentials of Baccalaureate Education for Professional Nursing Practice1, the CNL is prepared with the competencies outlined in the AACN (2003) Working Paper on the Role of the Clinical Nurse Leader2.

[/TD]

[TD=width: 46%, bgcolor: #ffffff, colspan: 2]The Clinical Nurse Specialist (CNS) is an advanced practice nurse prepared in a clinical specialty at the master's, post-master's or doctoral level as a specialist.

The CNS, as an Advanced Practice Nurse (APN), is prepared with the AACN (1996)

Essentials of Master's Education for Advanced Practice Nursing3, including the Graduate Nursing and APN Clinical Core. In addition, the CNS is prepared in a specialty curriculum which includes those clinical and didactic learning experiences identified and defined by the specialty nursing organization for the particular area of advanced clinical practice.

[/TD]

[/TR]

[TR]

[TD=width: 39%, bgcolor: #ffffff]The CNL functions as a generalist providing and managing care at the point of care to patients, individuals, families, and communities.

[/TD]

[TD=width: 30%, bgcolor: #ffffff, colspan: 2]Both the CNL and CNS provide care in all types of health care settings, including acute, outpatient, home, school and community.

[/TD]

[TD=width: 30%, bgcolor: #ffffff]The CNS functions as an expert clinician in a particular specialty or subspecialty of nursing practice.,,456

[/TD]

[/TR]

[TR]

[TD=width: 39%, bgcolor: #ffffff]The CNL is responsible for the management and coordination of comprehensive client care, for individuals and clinical cohorts.

7

[/TD]

[TD=width: 30%, bgcolor: #ffffff, colspan: 2]The CNL and CNS develop a comprehensive and holistic view of patients.

[/TD]

[TD=width: 30%, bgcolor: #ffffff]The CNS is responsible for designing, implementing, and evaluating patient-specific and population-based programs of care.

8,9

[/TD]

[/TR]

[TR]

[TD=width: 39%, bgcolor: #ffffff]The CNL functions primarily within clinical microsystems which are small

[/TD]

[TD=width: 30%, bgcolor: #ffffff, colspan: 2]Both the CNL and CNS manage care

[/TD]

[TD=width: 30%, bgcolor: #ffffff]The CNS functions at both microsystem and system levels, within three spheres of

[/TD]

[/TR]

[/TABLE]

Up Vote Up Vote ×

[TABLE]

[TR]

[TD=width: 39%, bgcolor: #ffffff]

functional front-line units such as a hospital unit, outpatient clinic or home health agency.10

[/TD]

[TD=width: 30%, bgcolor: #ffffff]

that is responsive to the health care needs of individuals and families.

[/TD]

[TD=width: 30%, bgcolor: #ffffff]

influence: client, personnel and organizational systems. 11

The CNS(even if unit-based) exerts influence on behalf of their specialty population at the system level.

[/TD]

[/TR]

[TR]

[TD=width: 39%, bgcolor: #ffffff]

The CNL assesses individuals and families to anticipate risks, design and implement plans of care, provide oversight of the care delivery and outcomes for a specified group of patients.

[/TD]

[TD=width: 30%, bgcolor: #ffffff]

The CNL and CNS provide highly skilled clinical patient care. The CNL and CNS serve as advocates for individual clients, families and communities in the health care system.

[/TD]

[TD=width: 30%, bgcolor: #ffffff]

The CNS manifests a high level of expertise in the assessment, diagnosis, and treatment of the complex responses of individuals, families or special populations to actual or potential health problems, prevention of illness and injury, maintenance of wellness, and provision of comfort.12

[/TD]

[/TR]

[TR]

[TD=width: 39%, bgcolor: #ffffff]

The CNL implements principles of "mass customization" 13 to ensure consistency of clinical care within populations. The CNL also uses strategies for risk anticipation and risk assessment to design, implement and evaluate plans of care for a cohort of patients.

[/TD]

[TD=width: 30%, bgcolor: #ffffff]

The CNL and CNS use clinical knowledge and skill and a variety of information technologies, including clinical databases, to anticipate risk, perform risk assessments and other surveillance strategies to customize interventions and ensure achievement of health related outcomes. The CNL and CNS design and provide health promotion and risk reduction services for patients.

[/TD]

[TD=width: 30%, bgcolor: #ffffff]

As a consultant the CNS provides expert knowledge and skill in a specialized area of practice to other nurses and the multidisciplinary health care team, particularly for complex or critically ill patients.14

[/TD]

[/TR]

[TR]

[TD=width: 39%, bgcolor: #ffffff]

The CNL is responsible for the delegation and oversight of care delivery by other staff on a daily

[/TD]

[TD=width: 30%, bgcolor: #ffffff]

The CNL and CNS mentor nursing staff and other care

[/TD]

[TD=width: 30%, bgcolor: #ffffff]

The CNS serves as a mentor to other nursing professionals to advance the practice of nurses and nursing.

[/TD]

[/TR]

[/TABLE]

Up Vote Up Vote ×

For the rest of the comparison table please visit: http://www.aacn.nche.edu/cnl/CNLCNSComparisonTable.pdf

Up Vote Up Vote ×
+ Add a Comment