CNL

[PatMac10,RN]

I'm doing some research on the Clinical Nurse Leader (CNL) role. I've read the White paper on the difference between the CNL and the CNS (although the difference still is very clear to me). I understand that CNL is NOT an APRN role and that CNS is.

However CNS, at this time, do not have diagnostic prescriptive authority in my state (NC). Therefore the line between CNS and CNL is further blurred. I understand (in theory) the microsytem and macrosystem levels that each type of nurse works at.

My searches for answers on here haven't yielded much in the way of clear answers. I understand this certification is still new.

I was all for being a FNP up until about about 4 months ago. I'm not sure if I want the responsibility of being a provider yet.

I'm 23 and have been a nurse for just over 3 years and I've learned so much and still have so much to learn. Also, I'm not sure if being an NP, at least at this point in my life, fits the goals I have for myself. I like working less than 5 days a week. Having a job that I can leave work at work. Etc...

I enjoy working the floor (although I Have my days) and I'm interested in the CNL role as an intermediary role that could both allow me to teach in the future or pursue advanced practice. Are any of you certified as Clinical Nurse Leaders (CNLs)? Or do you know of anyone going through a CNL program?

What are your opinions on this new certification. I have wonder what place, if any, will the role fill. In theory, In theory, I can understand the potential benefits of such a role, but is it truly applicable to most health systems? In some ways it seems like a graduate prepared floor nurse or charge nurse.

[llg, PhD, RN]

Here's another angle.

I've been watching this from this sidelines for years. I agree that the CNL degree was created by academia who wanted to secure funding for students wanting to enter nursing at the MSN level. That's why they are generalists, not specialists. When the programs were created, the new CNL grads were beginner-level nurses with MSN's who would hopefully, be able to advance quickly in their careers once they got some clinical practice experience.

I don't think educators should be in the business of creating practice roles with only token input from practice facility experts. What they all failed to see is that academia's emphasis on the DNP role led to an elimination of many (most?) MSN programs. Young nurses today who wish to get an MSN have far fewer choices than in the past -- with most schools only offering programs producing the limited official "advanced practice roles" + degrees in Nursing Administration (geared for upper level administrators) + degrees in Nursing Education (geared for academic teaching, not staff eduction) + a few CNL degrees.

None of those options is a good fit for the nurse who wants a career working in a hospital in roles such as: staff development educator, patient educator, infection control specialist, diabetes educator, program coordinator (e.g. diabetes, cardiac rehab, rehab, etc.), quality assurance specialist, case managers, discharge planners, etc. Hospitals have many, many positions who fall into this "miscellaneous" category. In the olden days, a person could get an MSN in "adult med/surg" of "pediatric nursing," "leadership," etc. and take a variety of courses that taught the kinds of skills such roles require -- such as basic management, project management, adult education principles, along side some clinical courses related to the population of interest. In today's landscape ... there are few programs left that are preparing people for these types of roles.

The CNL curriculum is the best one available for these types of roles -- but the people in academia who run these programs have not realized that. They see their programs as preparing graduates for a specific role that THEY designed that very few hospitals have adopted. However, hospitals are aggressively looking for qualified nurses with MSN's who can fill the types of roles I mentioned above. My own hospital (a children's hospital) struggles to find anyone who has the appropriate credentials for such a job. We would love to hire someone with a CNL education and sufficient experience -- but unfortunately, the degree is not readily available in my region and there are few totally online options for CNL programs for our existing RN's to take.

So to me, the CNL education has good potential that has been unrealized because the academic leaders fail to see where/how the value of that focus can be used by employers. The educators should focus on producing graduates that possess certain skills -- and let the employers decide how to best use the people with that knowledge and those skills. But with the creation of this CNL role, they have limited their view to a narrowly described job role that the practice world has not fully bought into. Free it up and let the role expand. Invite practicing RN's to get a MSN with a CNL focus without limiting their view as to what types of roles they might take after graduation. Loosen up the curriculum a bit so that the CNL grads are prepared for the many types of roles that employers need to fill with those types of skills.

Everyone would win.

llg (former CNS back in the days before CNS's tried to be like NP's and be mid-level providers. Currently, a Nursing Professional Development Specialist in a children's hospital)