What "CNL" means to the field

ukstudent · Mar 13, 2008

To me it means nothing. You are meant to be a clinical leader without actual clinical knowledge!!! That's an oxymoron just there. You will be paying graduate level price. ie advance practice price for an education that will NOT be considered advance practice. You would still have to go back and spend more in order to get to an advance practice level.

imenid37 · Mar 13, 2008

You cannot be a leader in the clinical setting, without clinical experience and leadership qualities. You get neither in a program like this. You get an education and an MSN degree. You are a new grad w/ an MSN. It will save you time if you want to advance your career because you already have the degree. I do not think the other staff will see you as a leader by virtue of your degree. You need to earn that kind of respect which comes with years of experience. CNL should be a degree reserved for those who have attained expertise at the bedside and want to step up their career. It is silly to make it entry level. I know that it can be hard to get a loan for a second BS degree and I am not slamming any persons, but rather a nursing education community which creates this kind of program. My alma mater Uof MD has such a program. This is just another example of how the many in the nursing education community are out of touch w/ what reality is at the bedside.

MIA-RN · Mar 13, 2008

I am actually looking into the CNL program where I am and I think it sounds like a good idea. It gives you a master's level education and there is a 420 hour 'immersion experience' at the end of the courses. You also have to have practiced as a registered nurse for three years before qualifiying for entry to the program, so its not a 'new grad' type of degree.

I think it prepares a person to become a leader on the unit both clinically and in a management sense. I definitely DO NOT want to be a nurse practitioner, and this degree would allow me the master's education without having to become an NP.

It is a rather new degree; according to where I plan to attend there are less than 100 schools offering the degree nationally.

The risk is what if degree doesn't give the outcomes it intends, of course. Meaning maybe the leadership jobs won't call for the master's level education, or maybe it won't develop into opportunities other than hospital positions as its forecasted to over the next years.

But there is risk involved with everything new.

Like I said I am considering it too, but not so sure yet. My main concern is that I want to leave bedside within the next 8 - 10 years and that degree, although the most interesting one to me at the moment, is really meant for someone who will have a longer bedside career than I intend.

Anyway, those are my thoughts on the CNL degree.

nrsjo · Mar 13, 2008

I work with folks who have their CNL degree. To me, you have to be really, really careful about what YOUR facility is going to use this level of education for. What I have seen, is that you are an MSN working at the bedside, with no leadership or decision making power. You are not treated as someone who is supposed to be facilitating patient outcomes and mentoring people. Nor are you treating as a management person. So............what's the point? Maybe others are having a better experience in other parts of the country with it.

MIA-RN · Mar 13, 2008

nrsjo--you have a very valid point. For me, the univeristy teaching hospital where i work is also where I will go to school...so its a good crossover into leadership there. But you are correct that it might not be as good a fit elsewhere.

elkpark · Mar 13, 2008

nrsjo--you have a very valid point. For me, the univeristy teaching hospital where i work is also where I will go to school...so its a good crossover into leadership there. But you are correct that it might not be as good a fit elsewhere.

And is the hospital affiliated with the uni actually using CNLs, in the role for which they are told they're being prepared?

I've heard no interest in this role from anybody in nursing other than the schools that are offering the program. From what I've read of the role (and I freely admit I'm no expert), it sounds like they are being prepared to do what most good, experienced bedside nurses used to be able to do. I feel kinda bad for the students who are basically being used a "guinea pigs" to run this idea up a flagpole and see if anyone salutes. Maybe it'll work out great and it's the Next Big Thing -- but that's certainly not clear at this point. It's not like there was some great cry from the larger nursing community that we need Master's-prepared bedside nurses ...

Frankly (and I freely admit I'm widely known for being cynical), I believe that this got started because so many second-career people want to go into nursing, but they already have BA/BS degrees and can't get financial aid for an additional baccalaureate degree; so they want to go into MSN programs (so they're eligible for federal financial aid) but not an advanced practice program (like so many of the direct-entry programs already out there); but there's no sensible justification for Master's programs to prepare basic bedside nurses to do the same things ADN and BSN graduates do; so someone dreamed up this "CNL" idea to justify preparing bedside RNs at the Master's level.

I'm glad that there are some CNL programs that actually require you to have some RN experience, because all the ones I've heard of so far are direct-entry programs -- so, they're turning out supposed "clinical leaders" who have no clinical experience. That may sound reasonable in academia, but not to most of us out in the real world ...

MIA-RN · Mar 13, 2008

elkpark--thank you. That is great food for thought in terms of whether I will actually find a job where I work if i do get the CNL.

The description of the degree where I am looking to attend says that CNL grads are employed as patient care facilitators, case managers, and resource nurses. I don't know if those roles traditionally require Master's education, or if there is a trend towards requiring a Master's for those roles.

Sure is good to think about though...

And I agree that the requirement of several years practice as an RN are vital and Im glad the program I'm looking into requires it. I have a friend who is an NP and never worked bedside as an RN... She is amazing and absolutely wonderful at what she does...but she might be the exception and not the rule.

elkpark · Mar 13, 2008

elkpark--thank you. That is great food for thought in terms of whether I will actually find a job where I work if i do get the CNL.
The description of the degree where I am looking to attend says that CNL grads are employed as patient care facilitators, case managers, and resource nurses. I don't know if those roles traditionally require Master's education, or if there is a trend towards requiring a Master's for those roles.Sure is good to think about though...
And I agree that the requirement of several years practice as an RN are vital and Im glad the program I'm looking into requires it. I have a friend who is an NP and never worked bedside as an RN... She is amazing and absolutely wonderful at what she does...but she might be the exception and not the rule.

Those roles have been around for a long time, and have not required Master's-prepared people (as I said, the CNL descriptions I have read sound like what any seasoned, experienced RN has always been able to do, with a little extra (forgive me! :rolleyes: ) fluff thrown in to justify the graduate degree ...) If there is a trend toward requiring MSNs for those roles, that would be news to me; people with MSNs are going to expect to get paid more than the regular "working stiffs," and I find it hard to imagine hospitals embracing the idea of paying MSN-prepared people more to do the same job that undergrad-prepared (ADN or BSN) RNs are doing perfectly well now.

nrsjo · Mar 14, 2008

Elkpark, I agree- this is a position that a seasoned, experienced RN could fulfill. It is exactly that experience which makes someone a good role model, charge nurse, preceptor, etc. An MSN is supposed to enhance that that and help you build on existing knowledge, not be a substitute for it.

As for programs which take 2nd degree students and give them an MSN which slaps on the "leader" title, I wish them well. The point was made earlier, that respect is earned, and even a well seasoned RN coming into the role finds that out. An MSN with no clinical experience is going to have a rough time.

llg, PhD, RN · Mar 14, 2008

In addition to what elkpark said ...

I think the role also got started in the schools because schools get money in the creation of new programs in the form of grant money and research dollars to create and evaluate a new approach.

Also, faculty members get grant money for their research into the new roles -- and get to publish articles on the new programs. Those publications get them promotion and tenure.

Neither the grant dollars nor the publications come if all you are doing is preparing great nurses in the traditional programs. The fame, glory, and money comes in creating something new -- with a new title.

merellis2009 · Mar 14, 2008

As a CNL graduate myself I thought I could help answer some of your questions and concerns and dispel some of the rumors/myths about CNL programs.

1. CNL's function in the generalist role. We are not CNS's. We are not advanced practice nurses (unless you attend Vanderbilt which has a longer program and allows their students to become advanced practice.)

2. When you graduate with a MSN and after you earn your CNL certification, you are beginning as a regular RN like any other brand new RN at the bedside. However long you remain in that staff nurse role is dependant upon you, your employer, how quickly and comfortably you build your skill set, and your employer's understanding of the role itself. If your employer doesnt have a clue about the CNL role and they are not supportive, then chances are you will not be moving onto that role. However, if you are lucky enough to find a great place that supports the CNL vision, then your chances of course would be much better.

3. I must say that I have to disagree. I don't think just any seasoned RN could function as a CNL because of the nature of certain required graduate level courses that CNL students must take. Graduate level biostatistics, graduate level epidemiology, graduate level research courses, and graduate level management courses are all integral to the function of the CNL. Without that framework, even a seasoned RN could find himself/herself floundering in the role.

4. No one is saying that the MSN is a substitute for "doing your time" as a staff RN and having others recognize you and respect you over time. The CNL students that I know don't look at it that way at all. We're out there just like the rest of the "new nurses" trying to get into our own groove and provide the best care for our patients possible for right now. Then some of us (not all of us) plan on moving forward with our chosen paths and moving into the role. As for me, I am considering becoming a CNM/FNP and utilizing the 2-3 roles together.

5. Mia, you were concerned about how valuable your MSN degree and CNL certification would be if the role were to turn sour. Well, if that were to occur, then at the very worst, you'd still have your MSN degree. No one would be able to take that from you.

If anyone really wants to know about the CNL just google "AACN white papers clinical nurse leader" and read the actual description. It can tell you quite a bit!