The healthcare industry contains an almost endless supply of career options, and registered nurses might enjoy the broadest selection of all. At the highest level, advanced-practice registered nurses practice at doctor-like levels of care. Like doctors, they can choose to specialize in areas of practice such as neonatal or perinatal care. Getting there requires nursing experience and a graduate degree, and many clinical nurse specialists also choose to become certified in their field.
Clinical nurse specialists are among the most highly trained of all nurses, so it's not a career you'll get into quickly. First, you have to be a registered nurse, which requires two to four years of schooling and an associate or bachelor's degree. If you start off with two years' training, you'll need to upgrade to a bachelor's degree before you can get into a CNS program. They're highly competitive, and having a background in critical-care nursing, obstetrics and neonatal or perinatal nursing would be a definite advantage. Choose a master's degree or doctoral degree program that offers a concentration in neonatal or perinatal care.
Once you graduate from your program, you'll need to be licensed by your state's board of nursing before you can practice. Some states administer an examination as part of the process, or require you to have a national certification. The American Association of Colleges of Nursing, National Certification Corporation and American Nurses Credentialing Center all offer certifications for clinical nurse specialists in pediatric or neonatal care. You'd have to document your experience in the field and your education, and then pass a certification exam. Many of those certifications are changing at the end of 2014, to align with the new consensus model for advanced practice nurses.
Each of the 50 states has its own board of nursing, which leads to a lot of variance in licensing. Every board sets its own licensing requirements, and a nurse's professional duties -- called a code of practice -- vary widely between states. In 2008, the National Council of State Boards of Nursing and dozens of nurses' organizations arrived at a plan, called the "consensus model," to standardize certifications and remove some of the restrictions on how advanced practice nurses are permitted to provide care. By 2015, when this plan comes into force, every state that supports the consensus model will have identical requirements for clinical nurse specialists, nurse practitioners, nurse-midwives and nurse anesthetists.
During the changeover period, there will be some overlap between certifications. For example, the American Association of Colleges of Nursing will offer its existing CCNS credential for critical-care nursing until the end of 2014. The new ACCNS credential becomes available in the summer of 2013. Clinical nurse specialists holding the earlier certification will be able to maintain it, but if they allow their certification to lapse they must qualify under the new standards. The main difference between the two is that credentials meeting the new standard are designed to span the entire spectrum from wellness to acute care, while the old ones focused primarily on one or the other.
- Explore Health Careers: Clinical Nurse Specialist
- University of Illinois at Chicago: Master of Science (MS) in Nursing Perinatal Clinical Nurse Specialist Concentration
- University of Washington School of Nursing: Neonatal Clinical Nurse Specialist Graduate Certificate Program
- American Association of Colleges of Nursing: CCNS — Certification for Adult, Neonatal and Pediatric Acute and Critical Care Clinical Nurse Specialists
- American Association of Colleges of Nursing: ACCNS — Certification for Adult-Gerontology, Pediatric and Neonatal Clinical Nurse Specialists
- American Association of Colleges of Nursing: Frequently Asked Questions About the APRN Consensus Model for Clinical Nurse Specialists
Fred Decker is a trained chef and certified food-safety trainer. Decker wrote for the Saint John, New Brunswick Telegraph-Journal, and has been published in Canada's Hospitality and Foodservice magazine. He's held positions selling computers, insurance and mutual funds, and was educated at Memorial University of Newfoundland and the Northern Alberta Institute of Technology.