Real Difference between Clinical Nurse Leader and Nurse Practitioner

[trina9230]

Hi -

Could someone that work in a hospital setting explain to me the "real" difference between a CNL and a NP? I've read all the descriptions on various school program sites but they seem very academic and don't speak to what the main differences are...I will be pursuing a higher level degree next fall and would like to know which avenue to choose. If you have pay difference that would help as well.

Thanks in advance

[Moogie]

NP is an advanced practice role that, in most states, allows some sort of prescriptive authority. Other advanced practice roles are CRNA (Certified Registered Nurse Anesthetist) CNM (Certified Nurse Midwife) and CNS (Clinical Nurse Specialist, a role that is becoming blurred with the NP in many areas.) An advanced practice nurse can work in the hospital but also in independent practice (in some states) and in group practices (with physicians, PAs and other advanced practice nurses.)

A Clinical Nurse Leader is a new role; it is being utilized in the VA system but not so much in other systems because of budgetary concerns and the newness of the role. My understanding is that CNL programs prepare one to be an expert clinician within an acute care setting. A CNL coordinates care, does discharge planning, looks at community and institutional trends to better understand what might be going on with a hospitalized patient.

The University of Iowa College of Nursing has a nice description on its website. The U of I has recently dropped its entry-level CNL and has changed it to a post-baccalaureate program. I think this is in response to confusion among employers about what to do with a master's prepared CNL who has no experience (as well as the graduates who end up taking bedside jobs so they can get experience and truly become clinical nurse LEADERS.)

http://www.nursing.uiowa.edu/academic_programs/graduate/mnhp/index.htm

[trina9230]

Thanks, I've pretty much read the same material and don't think I've ever ran into a CNS so I'll probably continue on with the NP Masters program...they are really pushing the CNS program at my school but I wanted to do more research before I made a final decision.

Thanks sooo much for the information.

[traumaRUs, MSN, APRN]

I'm an adult CNS as well as a peds CNS - like Moogie said - the lines are blurring between CNS and NP. I live in IL where CNS has the same prescriptive authority as NP. I work in a large nephrology practice with 2 FNPs, 1 PA and me and we all do the same exact job.

[Jules A, MSN]

Ummm NPs actually take care of patients CNLs...paper.

[RNMeg]

On my unit, the CNLs basically equate to charge nurses. They occasionally take patients and work the floor, but they usually work in a charge nurse role. They're not really paper-pushers, though..they do rounds, start IVs, handle staffing, coordinate admissions and discharges (bed control), act as clinical support for those of us doing direct care, that sort of thing.

[Jules A, MSN]

On my unit, the CNLs basically equate to charge nurses. They occasionally take patients and work the floor, but they usually work in a charge nurse role. They're not really paper-pushers, though..they do rounds, start IVs, handle staffing, coordinate admissions and discharges (bed control), act as clinical support for those of us doing direct care, that sort of thing.

That sounds refreshing. At my place they make up seminars we have to attend DURING our shift and sign off on to show their projects as part of our magnet thing. I'm pretty sure they couldn't even insert a foley let alone start an IV.

[trina9230]

Thanks for the information...was the academic training piece similar to the NP program...I've found some year long programs for the NP track...some of them (reputable schools such as Vandi and Emory) offered most of it online.

[Moogie]

Thanks, I've pretty much read the same material and don't think I've ever ran into a CNS so I'll probably continue on with the NP Masters program...they are really pushing the CNS program at my school but I wanted to do more research before I made a final decision.

Thanks sooo much for the information.

Trinia, did you mean CNS (Clinical Nurse Specialist) or CNL (Clinical Nurse Leader)? The CNS is an advanced practice role that is, unfortunately, not very appreciated in some institutions. In my area, the CNS is often the first nurse to be laid off when the budget is tight and some schools are dropping their CNS tracks because of lack of employment for clinical nurse specialists in their area. One of my friends was doing a combined NE/CNS track but the CNS part got dropped because of difficulty finding preceptors. There just weren't many CNSs employed in hospitals in her area, either.

If you're torn between the CNS and NP roles, you might be wise to stick with NP.

The CNL is a relatively new position and, while some of the responsibilities seem to be similar to the CNS, it's not an advanced practice specialty. The information I posted about U of Iowa's program is a good summary of the role of the CNL.

In all honesty, sometimes schools push a certain track because they don't have many applicants for that track and they want to increase their numbers. Do some digging before you jump.

[adventure780, BSN, MSN, RN, APN]

Thanks for this information, I too am in caught between CNL and NP