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Distinguishing the Clinical Nurse Specialist From Other Graduate Nursing Roles

Mohr, Lynn, D., PhD, APRN, PCNS-BC, CPN; Coke, Lola, A., PhD, APRN, ACNS-BC, FAHA, FPCN, FAAN

doi: 10.1097/NUR.0000000000000373
Feature Article

Purpose: Today’s healthcare environment poses diverse and complex patient care challenges and requires a highly qualified and experienced nursing workforce. To mitigate these challenges are graduate nursing roles, each with a different set of competencies and expertise. With the availability of many different graduate nursing roles, both patients and healthcare professionals can be confused in understanding the benefit of each role. To gain the maximum benefit from each role, it is important that healthcare providers and administrators are able to distinguish the uniqueness of each role to best use the role and develop strategies for effective collaboration and interprofessional interaction. The purpose of this article was to define the role, educational preparation, role differences, and practice competencies for the clinical nurse specialist (CNS), nurse practitioner, clinical nurse leader, and nurse educator/staff development educator roles. A second purpose was to provide role clarity and demonstrate the unique value the CNS brings to the healthcare environment.

Description: Using evidence and reviewing role competencies established by varying organizations, each role is presented with similarities and differences among the roles discussed. In addition, collaboration among the identified roles was reviewed, and recommendations were provided for the new and practicing CNSs.

Outcomes: Although there are some similarities among the graduate nursing roles such as in educational, licensing, and certification requirements, each role must be understood to gain the full role scope and benefit and glean the anticipated outcomes.

Conclusions: Healthcare providers must be aware of the differences in graduate nursing roles, especially in comparing the CNS with other roles to avoid confusion that may lead to roles being underused with a limited job scope. The CNS provides a unique set of services at all system outcome levels and is an essential part of the healthcare team especially in the acute care setting.

Author Affiliations: Assistant Professor (Dr Mohr), Women Children and Family Nursing, and Associate Professor (Dr Coke), Adult Health and Gerontological Nursing, Rush University College of Nursing, Chicago, Illinois.

The authors report no conflicts of interest.

Correspondence: Lynn D. Mohr, PhD, APRN, PCNS-BC, CPN, Women Children and Family Nursing, Rush University College of Nursing, 600 S Paulina St, Chicago, IL 60612-3244 (

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