The Clinical Nurse Leader (CNL) is an advanced patient care generalist and healthcare specialist with advanced education and knowledge in general medicine. The CNL is the single-point clinical leader for providing patient care designed, implemented, and evaluated as evidence-based, safe, and directed toward optimal patient outcomes.
In this role, the Clinical Nurse Leader differs from other advanced nursing positions by providing:
- Clinical Leadership – vs. Administrative Leadership provided by unit-level clinical Managers or Directors,
- Generalized Clinical Knowledge – vs. Specialized Clinical expertise provided by a Clinical Nurse Specialist (CNS), and
- Generalized Patient Care Coordination – vs. Specialized Patient Care provided by a Nurse Practitioner (NP).
The Clinical Nurse Leader is the single, central individual who coordinates and integrates the contributions of an interdisciplinary care team that may include:
- Physicians,
- Nurse Practitioner (NP),
- Clinical Nurse Specialist (CNS),
- Pharmacists,
- Social Workers, and
- Other relevant healthcare specialists.
This team collaborates under CNL clinical leadership to plan and implement the most effective patient care plan. Each team member contributes from within their area of expertise.
The Clinical Nurse Leader is responsible for bringing focus to many aspects of patient care, including:
- Quality improvement,
- Efficient work processes,
- Treatment innovations,
- Medical error reduction,
- Improved Patient Safety,
- Cost containment and waste reduction,
- Application of Evidence-Based Practices , and
- Use of core measurements to improve patient outcomes,
The Clinical Nurse Leader and the Clinical Nurse Specialist (CNS) often work closely to develop and implement innovative clinical care programs based on the latest research and Evidence-Based Practices. They also work closely to plan and coordinate care for patients with complex care needs.
History
The Clinical Nurse Leader role is relatively new, created in 2007. The CNL role emerged from an effort begun in 1999 by the American Association of Colleges of Nursing (AACN) to address a looming crisis in delivering quality healthcare. This crisis was due to a confluence of concerns, including:
- The National Academy of Sciences, Institute of Medicine (IOM) landmark report titled "To Err is Human: Building A Safer Health System" found that preventable medical errors accounted for between 44,000 and 98,000 deaths and costs of between $17 billion and $29 billion each year,
- Reports from multiple healthcare organizations of decreasing patient care quality indicators,
- Five consecutive years of declining nursing baccalaureate enrollment, and
- Looming storage of nurses.
The effort determined that the existing patient care model needed to improve its focus on the quality of patient care. In the current model, each care team member, physicians, nursing and administrative staff, and nursing leadership focused on individual responsibilities. It became apparent that the model lacked a single, identifiable individual responsible for integrating and focusing the efforts of each team member on producing a quality outcome for the patient.
This effort resulted in developing the role of Clinical Nurse Leader, the educational model for CNL master’s degree and post-graduate certificate programs, and national certification.
Practice Specialties
The Clinical Nurse Leader provides clinical leadership across all patient age groups, genders, and disease or illness types. However, the CNL works in clinical units where they have extensive prior patient care experience.
Core Competencies
The Clinical Nurse Leader must be well-grounded in patient care and have a broad view across the continuum of care within and outside the hospital or healthcare systems. The CNL must demonstrate high emotional intelligence and leadership strength to bring quality patient care to the forefront.
Practice Settings
The Clinical Nurse Leader usually works in acute care units within Hospitals, Specialty Clinics, or Long-Term Care Facilities.
Education
The ability to practice as a Clinical Nurse Leader requires a graduate-level nursing education. There are several degrees or certificate types:
- Master of Science in Nursing (MSN), Master of Science, Nursing Major (MS-NM), or Master of Nursing (MN) – This has been the most commonly offered degree type and is the minimum degree required for Clinical Nurse Leader education. These degree programs are offered widely by public and private schools. The master’s degree in nursing focuses on advanced nursing theory and care practice. Read more...
- Doctor of Nursing Practice (DNP) – In addition to studying advanced nursing theory and care practice, the DNP emphasizes using research results to improve the CNL‘s nursing practice. DNP programs also emphasize the application of Evidence-Based Practice to improve the quality of patient care. Read more...
- Post-Master's Certificate – Eligibility is limited to individuals with a graduate-level or doctoral-level nursing degree. For example, someone holding an MSN as a Nurse Practitioner (NP) would be eligible to enroll in a Clinical Nurse Leader certificate program. Read more...
Prospective students should verify that the Certified Nurse Leader program they select is accredited. Proper accreditation ensures that graduates are eligible to sit for the certification exams required to become licensed to practice.
Use the Clinical Nurse Leader Search Tool to identify programs for this and other degree combinations from our survey of more than 710 schools.
Accelerated Degree Programs
Accelerated Degree Programs generally cost less and can be completed more quickly than enrolling in consecutive BSN and MSN or doctoral programs. Use the Accelerated Degree Program Search Tool to identify programs for this and other degree combinations from our survey of more than 710 schools.
Dual Degree Programs
Dual Degree Programs award two degrees in separate but related areas of study. Students enrich their nursing education with study in another academic department. These programs award a Clinical Nurse Leader degree with an additional non-nursing degree, such as:
- Master of Science in Nursing (MSN) – CNL, may be paired with a:
- Master of Business Administration (MBA).
Graduates from Dual Degree Programs are eligible to sit for the appropriate national certification exams and become licensed as required.
Use this Dual Degree Program Search Tool to identify Dual Degree Programs from our survey of more than 710 schools.
Tandem Degree Programs
Tandem Degree Programs award two degrees in the course of Clinical Nurse Leader study. These programs save the student time and expense by eliminating duplicate coursework. Some schools offer CNL Tandem Degree combinations, such as:
- Bachelor’s of Science in Nursing (BSN), followed by a:
Graduates from Tandem Degree Programs are eligible to sit for the appropriate national certification exams and become licensed as required.
Use this Tandem Degree Program Search Tool to identify these and other Tandem Degree programs from our survey of more than 710 schools.
Top Degree and Certificate Offerings
This table displays a count of the top Clinical Nurse Leader degree and certificate types offered by more than 710 graduate nursing programs. This count includes degrees awarded singly, as the higher degree in a Tandem Degree Program, or as part of a Dual Degree Program offering.
Certification
Graduates from a Clinical Nurse Leader degree or post-master’s certificate program are eligible to sit for the Clinical Nurse Leader (CNL) exam. The CNL exam is administered by the American Association of Colleges of Nursing (AACN) . Individuals who pass the exam receive the Clinical Nurse Leader (CNL) credential.
Additional certifications are available for a Clinical Nurse Leader to develop expertise in related areas of nursing and healthcare. Review this site’s survey of more than 300 nursing and healthcare certifications.
License to Practice
Clinical Nurse Leaders are not required to obtain a state license by the state where they work as a CNL. However, this is no exemption for Registered Nurses (RNs) to become licensed as an RN in their practice state.
States participating in the Nurse Licensure Compact have multistate RN license agreements. This Compact ease the transfer of nursing licenses and the ability to practice among participating states. Participation in this Compact varies by state. Check with your state’s Board of Nursing for more detailed information.
Since Clinical Nurse Leaders are not Advanced Practice Registered Nurses (APRNs), they are not subject to APRN Scope of Practice rules.
Professional Associations
The primary professional association for Clinical Nurse Leaders is the Clinical Nurse Leader Association (CNLA). The CNLA provides resources and representation for Clinical Nurse Leaders nationwide.
Clinical Nurse Leaders can benefit from membership in other professional associations in their clinical specialization or that promote nursing leadership skills. Other associations of interest at the state and local levels enable members to organize with their neighboring peers to address more localized issues. These associations may be chapters of national or international associations or organized independently.
This site includes a survey of more than 1,800 international, national, regional, state, and local nursing and related healthcare professional associations. These associations provide professional development resources and representation in numerous nursing and affiliated healthcare specialties.