Clinical nurse specialists are often educators as well as clinical experts.
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Clinical nurse specialists are often educators as well as clinical experts.

Nursing is a career with considerable variety, and licensed practical nurses and clinical nurse specialists work at different places on the nursing spectrum. LPNs and CNSs have dramatically different educational preparation, work responsibilities, salaries and opportunities. However, nursing careers span a continuum that can begin with an LPN license and finish with an advanced degree. So, for some people, the LPN can be seen as the first step toward becoming a CNS.

Workplace Settings

LPNs are bedside nurses. They provide direct care such as bed baths, help patients walk or eat, change dressings, give some medications and perform other basic tasks. LPNs – also known as licensed vocational nurses or LVNs in Texas and California – must work under the supervision of a registered nurse or doctor. In addition to hospital care, LPNs may work in doctors’ offices, clinics and long-term care facilities. The clinical nurse specialist generally works in a relatively large hospital or multi-hospital health care system. More than 70 percent of CNSs work in inpatient hospitals, according to the National Association of Clinical Nurse Specialists. However, the CNS can also be found in home health care, long-term care and public health.

Clinical Expertise

A CNS is a clinical expert who functions at a high level that in some ways is similar to a physician. For example, a CNS is authorized to prescribe medications in some states. Many CNSs specialize in a particular patient population, such as pediatrics or women’s health. A CNS may also specialize in a workplace setting, such as the emergency room; a particular disease, such as diabetes; or a type of problem, such as pain management. The final area of specialization for a CNS is a particular kind of clinical care, such as psychiatric nursing. A CNS is often an expert consultant in her area of specialty. She may develop specialized assessment tools, create pain management strategies for surgical patients or work in a hospital for quality improvement.


LPNs attend community colleges or technical-vocational schools where they earn a degree that makes them eligible to take a national licensing exam. An LPN can earn a degree in one year of full-time attendance. The CNS must have a master’s degree, and some may attain the level of a doctorate in nursing. If a CNS were able to attend school full-time from entry to nursing school until graduation, her education would probably take six or seven years. However, many RNs continue their schooling part-time after becoming licensed, and it may take 10 years or more to become a CNS.


Salaries for LPNs and CNSs reflect the differences in their respective educations, scope of practice and responsibilities. The average annual salary for an LPN in 2011 was $42,040, according to the Bureau of Labor statistics. Although the BLS does not track CNS salaries separately from RN salaries, Code Blue Careers reports that CNS salaries in the North Carolina region ranged from $59,000 to $95,000 in 2012. ScrubsMag reported that CNS salaries in December 2010 averaged $76,000 annually.

2016 Salary Information for Licensed Practical and Licensed Vocational Nurses

Licensed practical and licensed vocational nurses earned a median annual salary of $44,090 in 2016, according to the U.S. Bureau of Labor Statistics. On the low end, licensed practical and licensed vocational nurses earned a 25th percentile salary of $37,040, meaning 75 percent earned more than this amount. The 75th percentile salary is $51,220, meaning 25 percent earn more. In 2016, 724,500 people were employed in the U.S. as licensed practical and licensed vocational nurses.

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