How To Become a Clinical Nurse Leader (CNL)

What Does a Clinical Nurse Leader Do?

CNL and seated nurse

If you like the idea of blazing new trails, a career as a Clinical Nurse Leader (CNL) could be for you. This relatively new nursing role was developed by the American Association of Colleges of Nursing (AACN) to improve patient safety and health outcomes and boost the quality and cost-efficiency of American health care. A CNL is an advanced practice nurse – a nurse with a master’s or doctoral degree in clinical practice – who supervises other RNs and hospital staff in a specific area of acute care.

Unlike many nursing professional roles you’ve heard or read about, the title “clinical nurse leader” refers to a hospital position rather than a particular credential. This is a leadership role involving both management skill and clinical strategy. A CNL provides care directly, but also formulates and coordinates plans of care for patients with complex conditions. Clinical nurse leaders serve as safety checkpoints, because they are equipped to understand and evaluate the whole arc of a patient’s care. Patient safety is the chief reason why this position exists.

CNLs need deep experience in nursing practice, as well as hospital systems training. Graduate training provides advanced clinical knowledge needed to support and lead fellow RNs – many of whom are specialists themselves – and also the organizational expertise to supervise plans of care that have many distinct components.

The duties and competencies of the CNL role were laid out by AACN in a 2007 white paper. While the role is still relatively new, early evidence demonstrates that patients under a CNL’s care are safer, spend less time in the hospital, and are less likely to return with the same condition. Nurses working under a CNL report higher job satisfaction.

Duties of a CNL include:

  • Develop and implement best practices for care delivery
  • Assess patient and population health
  • Formulate plans of care that are supported by research and data
  • Supervise and educate nurses and technicians as they deliver care
  • Work with outside clinicians and community resources to meet patients’ health needs
  • Deliver complex care directly to patients
  • Evaluate and report patient outcomes, costs of care and other quality measures
  • Identify and correct areas of waste and inefficiency
  • Share research outcomes and best practices
  • Strive to eliminate racial, ethnic and language disparities in care and patient outcomes
  • When appropriate, use distance technology to deliver patient care and monitor health status
  • Collect and analyze data to support future care decisions

You can become a CNL in most areas of hospital care, working within a population specialty (infants or children, for example) and a specific clinical area, such as oncology or nephrology. If you have a passion for safe healthcare practice, a talent for detail, and the ability to synthesize information from many different sources, this role may be an excellent professional fit for you.

Workplace Details

The CNL role is designed to be flexible and appropriate for all types of clinical settings. At present, most CNLs work in hospitals, including intensive care units and general medical surgical units. Other common employers include doctors’ offices, urgent care centers and home health agencies. The Veterans Health Administration is currently the largest employer of CNLs.

CNLs are also well suited to work in government and regulatory agencies, community health agencies, and higher education. The AACN predicts that more CNLs will enter these fields in coming years, as the role becomes better known.

Like most nurse leaders, CNLs generally work full time. In hospital settings, where patients need 24-7 care, they take on rotating shifts that cover days, nights and holidays. Those working in doctors’ offices and home health can also expect some evening and weekend hours to accommodate patients’ schedules.

CNL Salary and Job Outlook

State
Average Wage
California
$101750
Texas
$70390
New York
$80830
Florida
$64630
Pennsylvania
$68770

Hover over any state to explore local income and job growth data.

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ALABAMA
Median Salary: 
$55,500
Bottom 10% (Entry Level): $41,600
Top 10% (Lots of Experience): $76,000

2014-2024 Job Growth: 17%
Projected Annual Job Openings: 1,870

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Birmingham$43,240$57,670$77,370
Huntsville$41,840$56,800$75,450

ALASKA
Median Salary: 
$88,100
Bottom 10% (Entry Level): $65,200
Top 10% (Lots of Experience): $116,900

2014-2024 Job Growth: 10%
Projected Annual Job Openings: 190

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Anchorage$65,100$88,940$117,550
Fairbanks$69,190$98,120$119,580

ARIZONA
Median Salary: 
$71,500
Bottom 10% (Entry Level): $52,400
Top 10% (Lots of Experience): $96,100

2014-2024 Job Growth: 22%
Projected Annual Job Openings: 3,500

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Phoenix$52,850$73,400$97,630
Tuscon$52,510$67,590$82,510

ARKANSAS
Median Salary: 
$55,700
Bottom 10% (Entry Level): $40,100
Top 10% (Lots of Experience): $76,700

2014-2024 Job Growth: 15%
Projected Annual Job Openings: 870

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Little Rock$42,070$60,690$84,170
Fort Smith$39,910$52,140$63,430

CALIFORNIA
Median Salary: 
$100,400
Bottom 10% (Entry Level): $64,400
Top 10% (Lots of Experience): $147,100

2014-2024 Job Growth: 17%
Projected Annual Job Openings: 10,470

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Los Angeles$63,400$95,940$129,340
San Francisco Bay$83,120$132,970$167,920
San Diego$57,610$85,470$126,550
Sacramento$67,060$116,690$155,890

COLORADO
Median Salary: 
$68,500
Bottom 10% (Entry Level): $51,200
Top 10% (Lots of Experience): $95,100

2014-2024 Job Growth: 33%
Projected Annual Job Openings: 2,350

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Denver$51,510$70,580$97,080
Colorado Springs$51,430$63,590$88,590

CONNECTICUT
Median Salary: 
$76,500
Bottom 10% (Entry Level): $55,300
Top 10% (Lots of Experience): $100,700

2014-2024 Job Growth: 6%
Projected Annual Job Openings: 990

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Hartford$55,130$76,020$97,630
Bridgeport$56,590$75,830$103,110
New Haven$57,470$78,720$105,440

DELAWARE
Median Salary: 
$71,100
Bottom 10% (Entry Level): $53,800
Top 10% (Lots of Experience): $93,300

2014-2024 Job Growth: 17%
Projected Annual Job Openings: 420

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Wilmington$54,470$72,460$93,860
Dover$52,740$64,500$84,490

DISTRICT OF COLUMBIA
Median Salary: 
$79,600
Bottom 10% (Entry Level): $55,300
Top 10% (Lots of Experience): $103,800

2014-2024 Job Growth: 11%
Projected Annual Job Openings: 380

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Washington DC$53,890$76,030$101,360

FLORIDA
Median Salary: 
$62,100
Bottom 10% (Entry Level): $46,100
Top 10% (Lots of Experience): $82,900

2014-2024 Job Growth: 25%
Projected Annual Job Openings: 8,110

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Miami$50,250$65,560$91,660
Orlando$43,490$61,570$79,250
Tampa$49,770$62,990$84,660
Jacksonville$48,910$61,610$79,810

GEORGIA
Median Salary: 
$63,100
Bottom 10% (Entry Level): $44,200
Top 10% (Lots of Experience): $80,900

2014-2024 Job Growth: 20%
Projected Annual Job Openings: 2,980

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Atlanta$47,500$67,010$82,160
Augusta$46,880$65,910$88,340

HAWAII
Median Salary: 
$92,300
Bottom 10% (Entry Level): $63,400
Top 10% (Lots of Experience): $119,400

2014-2024 Job Growth: 13%
Projected Annual Job Openings: 400

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Honolulu$63,930$93,970$120,600

IDAHO
Median Salary: 
$61,000
Bottom 10% (Entry Level): $44,600
Top 10% (Lots of Experience): $78,400

Job Growth Data Not Available

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Boise$46,390$61,760$78,900

ILLINOIS
Median Salary: 
$67,100
Bottom 10% (Entry Level): $45,600
Top 10% (Lots of Experience): $99,600

2014-2024 Job Growth: 11%
Projected Annual Job Openings: 3,970

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Chicago$51,580$73,220$103,790
Rockford$43,920$59,400$87,180

INDIANA
Median Salary: 
$57,900
Bottom 10% (Entry Level): $41,900
Top 10% (Lots of Experience): $78,600

2014-2024 Job Growth: 19%
Projected Annual Job Openings: 2,510

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Indianapolis$43,290$61,450$81,840
South Bend$43,460$58,310$76,100
Fort Wayne$40,640$53,490$73,350

IOWA
Median Salary: 
$53,900
Bottom 10% (Entry Level): $40,700
Top 10% (Lots of Experience): $73,800

2014-2024 Job Growth: 16%
Projected Annual Job Openings: 1,280

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Des Moines$41,010$56,420$75,160
Cedar Rapids$39,730$50,730$74,600

KANSAS
Median Salary: 
$56,300
Bottom 10% (Entry Level): $41,700
Top 10% (Lots of Experience): $76,600

2014-2024 Job Growth: 8%
Projected Annual Job Openings: 760

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Wichita$41,060$51,440$72,980
Kansas City$44,940$63,260$81,370

KENTUCKY
Median Salary: 
$58,000
Bottom 10% (Entry Level): $42,600
Top 10% (Lots of Experience): $77,000

2014-2024 Job Growth: 36%
Projected Annual Job Openings: 2,670

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Louisville$44,330$61,510$78,730
Lexington$44,220$59,870$76,890

LOUISIANA
Median Salary: 
$59,800
Bottom 10% (Entry Level): $42,900
Top 10% (Lots of Experience): $83,300

2014-2024 Job Growth: 16%
Projected Annual Job Openings: 1,910

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
New Orleans$49,930$66,140$99,220
Baton Rouge$42,650$56,830$78,160
Lafayette$40,670$55,480$80,510

MAINE
Median Salary: 
$62,800
Bottom 10% (Entry Level): $46,400
Top 10% (Lots of Experience): $85,900

2014-2024 Job Growth: 11%
Projected Annual Job Openings: 510

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Portland$49,850$64,470$91,370
Lewiston$45,100$63,890$78,040

MARYLAND
Median Salary: 
$72,100
Bottom 10% (Entry Level): $53,400
Top 10% (Lots of Experience): $97,500

2014-2024 Job Growth: 20%
Projected Annual Job Openings: 3,250

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Baltimore$53,920$72,460$98,440
Frederick$55,480$75,920$98,980

MASSACHUSETTS
Median Salary: 
$83,900
Bottom 10% (Entry Level): $55,200
Top 10% (Lots of Experience): $135,000

2014-2024 Job Growth: 7%
Projected Annual Job Openings: 2,490

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Boston$60,060$92,190$145,530
Worcester$52,460$82,700$142,480
Springfield$47,590$72,530$101,550

MICHIGAN
Median Salary: 
$65,800
Bottom 10% (Entry Level): $50,600
Top 10% (Lots of Experience): $89,400

2014-2024 Job Growth: 12%
Projected Annual Job Openings: 3,370

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Detroit$52,500$69,600$105,020
Grand Rapids$48,130$60,180$76,730

MINNESOTA
Median Salary: 
$72,100
Bottom 10% (Entry Level): $49,400
Top 10% (Lots of Experience): $98,400

2014-2024 Job Growth: 12%
Projected Annual Job Openings: 2,010

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Minneapolis - St. Paul$53,730$77,400$100,460
Rochester$41,210$59,810$94,640

MISSISSIPPI
Median Salary: 
$55,600
Bottom 10% (Entry Level): $40,200
Top 10% (Lots of Experience): $77,500

2014-2024 Job Growth: 14%
Projected Annual Job Openings: 1,070

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Jackson$42,150$60,990$88,630
Gulfport$42,590$57,050$76,120

MISSOURI
Median Salary: 
$57,800
Bottom 10% (Entry Level): $41,200
Top 10% (Lots of Experience): $80,100

2014-2024 Job Growth: 14%
Projected Annual Job Openings: 2,530

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
St. Louis$42,050$59,020$83,960
Kansas City$44,940$63,260$81,370

MONTANA
Median Salary: 
$60,700
Bottom 10% (Entry Level): $47,300
Top 10% (Lots of Experience): $81,200

2014-2024 Job Growth: 22%
Projected Annual Job Openings: 450

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Billings$51,200$62,670$88,330
Missoula$50,750$62,420$87,110

NEBRASKA
Median Salary: 
$58,000
Bottom 10% (Entry Level): $42,800
Top 10% (Lots of Experience): $77,600

2014-2024 Job Growth: 14%
Projected Annual Job Openings: 840

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Omaha$43,460$59,630$80,340
Lincoln$42,500$56,230$75,400

NEVADA
Median Salary: 
$81,400
Bottom 10% (Entry Level): $58,800
Top 10% (Lots of Experience): $104,200

2014-2024 Job Growth: 19%
Projected Annual Job Openings: 860

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Las Vegas$62,700$84,080$108,390
Reno$55,940$75,620$98,560

NEW HAMPSHIRE
Median Salary: 
$65,400
Bottom 10% (Entry Level): $47,100
Top 10% (Lots of Experience): $93,000

2014-2024 Job Growth: 15%
Projected Annual Job Openings: 490

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Manchester$46,320$67,900$94,190
Nashua$46,310$63,890$91,400

NEW JERSEY
Median Salary: 
$79,200
Bottom 10% (Entry Level): $57,200
Top 10% (Lots of Experience): $102,900

2014-2024 Job Growth: 13%
Projected Annual Job Openings: 3,000

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Newark$58,110$81,250$104,130
Trenton$52,450$71,710$93,130

NEW MEXICO
Median Salary: 
$64,700
Bottom 10% (Entry Level): $50,800
Top 10% (Lots of Experience): $87,100

2014-2024 Job Growth: 17%
Projected Annual Job Openings: 660

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Albuquerque$52,550$66,430$88,630
Las Cruces$27,720$60,700$92,420

NEW YORK
Median Salary: 
$78,000
Bottom 10% (Entry Level): $52,300
Top 10% (Lots of Experience): $111,100

2014-2024 Job Growth: 17%
Projected Annual Job Openings: 7,450

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
New York City$62,140$86,520$116,630
Buffalo$50,970$70,090$93,740
Rochester$46,960$60,760$77,900
Albany$44,640$61,640$79,960

NORTH CAROLINA
Median Salary: 
$58,900
Bottom 10% (Entry Level): $43,300
Top 10% (Lots of Experience): $79,700

2014-2024 Job Growth: 22%
Projected Annual Job Openings: 4,190

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Charlotte$44,010$59,750$78,850
Raleigh$44,970$60,090$79,230
Greensboro$43,130$61,120$86,440
Winston - Salem$43,770$58,270$77,490

NORTH DAKOTA
Median Salary: 
$57,900
Bottom 10% (Entry Level): $43,400
Top 10% (Lots of Experience): $75,700

2014-2024 Job Growth: 24%
Projected Annual Job Openings: 400

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Fargo$43,820$58,380$76,530
Bismarck$43,580$57,070$73,580

OHIO
Median Salary: 
$61,300
Bottom 10% (Entry Level): $47,200
Top 10% (Lots of Experience): $80,100

2014-2024 Job Growth: 14%
Projected Annual Job Openings: 4,830

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Cleveland$52,280$65,220$80,050
Columbus$46,330$61,330$90,830
Cincinnati$47,490$62,580$81,990
Dayton$48,440$59,850$78,710

OKLAHOMA
Median Salary: 
$58,400
Bottom 10% (Entry Level): $42,700
Top 10% (Lots of Experience): $77,000

2014-2024 Job Growth: 14%
Projected Annual Job Openings: 1,160

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Oklahoma City$43,130$60,220$78,470
Tulsa$43,630$58,820$76,640

OREGON
Median Salary: 
$85,200
Bottom 10% (Entry Level): $61,000
Top 10% (Lots of Experience): $109,000

2014-2024 Job Growth: 15%
Projected Annual Job Openings: 1,280

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Portland$58,970$86,940$112,620
Salem$63,450$80,010$103,720

PENNSYLVANIA
Median Salary: 
$65,700
Bottom 10% (Entry Level): $47,200
Top 10% (Lots of Experience): $93,700

2014-2024 Job Growth: 14%
Projected Annual Job Openings: 4,890

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Philadelphia$53,320$76,110$100,010
Pittsburgh$47,760$61,520$80,320
Harrisburg$51,160$64,360$92,930
Allentown$51,170$63,980$86,160

RHODE ISLAND
Median Salary: 
$76,300
Bottom 10% (Entry Level): $55,400
Top 10% (Lots of Experience): $98,000

2014-2024 Job Growth: 12%
Projected Annual Job Openings: 450

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Providence$55,000$76,050$99,370

SOUTH CAROLINA
Median Salary: 
$59,300
Bottom 10% (Entry Level): $42,200
Top 10% (Lots of Experience): $80,100

2014-2024 Job Growth: 15%
Projected Annual Job Openings: 1,600

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Greenville$42,380$57,960$77,620
Columbia$33,930$57,080$78,000
Charleston$49,680$65,020$92,470

SOUTH DAKOTA
Median Salary: 
$53,400
Bottom 10% (Entry Level): $41,000
Top 10% (Lots of Experience): $74,700

2014-2024 Job Growth: 12%
Projected Annual Job Openings: 420

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Rapid City$42,750$57,830$75,800

TENNESSEE
Median Salary: 
$56,800
Bottom 10% (Entry Level): $41,800
Top 10% (Lots of Experience): $76,300

2014-2024 Job Growth: 25%
Projected Annual Job Openings: 2,440

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Nashville$41,930$58,810$78,640
Memphis$46,000$60,500$78,810
Knoxville$40,920$54,240$70,650
Chattanooga$41,680$56,130$74,340

TEXAS
Median Salary: 
$68,600
Bottom 10% (Entry Level): $50,100
Top 10% (Lots of Experience): $95,000

2014-2024 Job Growth: 31%
Projected Annual Job Openings: 10,820

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Dallas - Ft. Worth$52,170$71,920$96,640
Houston$55,040$76,670$98,900
San Antonio$45,920$65,450$89,960
Austin$51,570$66,340$86,640

UTAH
Median Salary: 
$59,700
Bottom 10% (Entry Level): $44,200
Top 10% (Lots of Experience): $79,200

2014-2024 Job Growth: 33%
Projected Annual Job Openings: 1,150

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Salt Lake City$46,020$61,730$81,490
Ogden$42,940$57,090$76,880

VERMONT
Median Salary: 
$62,800
Bottom 10% (Entry Level): $47,900
Top 10% (Lots of Experience): $91,000

2014-2024 Job Growth: 11%
Projected Annual Job Openings: 230

VIRGINIA
Median Salary: 
$63,600
Bottom 10% (Entry Level): $43,400
Top 10% (Lots of Experience): $90,900

2014-2024 Job Growth: 14%
Projected Annual Job Openings: 2,380

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Virginia Beach$43,130$61,350$79,450
Richmond$44,170$64,510$85,180

WASHINGTON
Median Salary: 
$77,000
Bottom 10% (Entry Level): $52,900
Top 10% (Lots of Experience): $110,000

2014-2024 Job Growth: 20%
Projected Annual Job Openings: 2,470

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Seattle$55,410$80,960$113,850
Spokane$50,630$73,400$104,950

WEST VIRGINIA
Median Salary: 
$56,700
Bottom 10% (Entry Level): $40,500
Top 10% (Lots of Experience): $78,400

2014-2024 Job Growth: 8%
Projected Annual Job Openings: 590

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Huntington$39,560$55,600$76,120
Charleston$41,380$55,920$75,860

WISCONSIN
Median Salary: 
$65,100
Bottom 10% (Entry Level): $49,900
Top 10% (Lots of Experience): $90,000

2014-2024 Job Growth: 10%
Projected Annual Job Openings: 1,860

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Milwaukee$51,600$67,980$91,900
Madison$54,670$73,910$100,370

WYOMING
Median Salary: 
$60,800
Bottom 10% (Entry Level): $44,000
Top 10% (Lots of Experience): $81,000

2014-2024 Job Growth: 20%
Projected Annual Job Openings: 210

SALARY BY METRO AREA:

CityEntry LevelMedianLots of Experience
Cheyenne$47,920$64,100$88,730
Casper$40,880$57,560$77,510

According to the US Bureau of Labor statistics, the median annual wage for all registered nurses is $67,490. Reported salaries range from $46,360 (10th percentile) to $101,630 (90th percentile).

Average CNL salaries should hover within the higher part of this RN range, though; for example, Payscale.com reports a median salary of $74,030 for CNLs. Glassdoor.com has the average CNL salary at $88,833. The University of San Francisco’s School of Nursing and Health Professions, meanwhile, suggests that a typical CNL salary is roughly $84,000. The role is still relatively new, but so far, their salaries appear to be on par with those of other nurse leaders.

As with all registered nurses, CNL salary varies by location, with New York and Los Angeles paying the best (but also having a high cost of living). Salaries are generally best in government hospitals, including VA facilities. In unionized hospitals, nursing salaries are closely tied to years of professional experience.

According to the Bureau of Labor Statistics, employment of registered nurses in general is expected to grow by 16 percent between 2014 and 2024, considerably faster than average. The CNL role has been embraced by the United States Veterans Health Administration, which has committed to having three CNLs at every facility by 2016. The fact that relatively few nurses are trained and credentialed should also help job prospects for the next few years.

One of the best ways to improve job prospects is to enter the CNL role with a solid foundation of clinical experience. Because this is a leadership role, employers generally favor candidates who have been on the front lines.

Nurse.com maintains a comprehensive job board for nurses in all specialties, including CNLs. VA Careers is another good bet for job prospects. Hospitals who are partnered with a CNL training program may also be looking to hire CNLs.

Compare Salaries by City

New York City NY Median Pay

$86520 Per Year

$41.59 Per Hour

Los Angeles CA Median Pay

$95940 Per Year

$46.12 Per Hour

Steps to Become a Clinical Nurse Leader

1

Earn a bachelor's degree and become a registered nurse.

To obtain certification as a CNL, candidates must be registered nurses and must hold a master’s degree from an approved training program. Preparation generally requires four years of study at the bachelor’s level.

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2

Get licensed as an RN.

After earning your bachelor’s degree you must be licensed and certified as an RN in your state. This usually requires graduation from an accredited training program and passage of the National Council Licensure Examination for Registered Nurses (NCLEX–RN).

3

Enroll in a CNL master's program.

CNL programs cover very specific criteria and competencies laid out by the AACN. In this way, they’re generally more rigorous than a standard master’s of science in nursing (MSN) program, though they typically require about two years to complete. Coursework and training emphasize care delivery systems, leadership, healthcare technology and finance. Candidates also complete advanced clinical courses like assessment, pathophysiology and pharmacology.

The AACN maintains an online list of accredited educational programs that are approved to prepare students for CNL certification. Special programs are available to help RNs with an associate degree “bridge” to the master’s level, and some universities offer special programs for students who hold a bachelor’s degree in a non-nursing field.

All CNL education programs involve supervised practical and clinical experience. Hospitals interested in implementing the CNL role often partner with universities and serve as clinical training sites.

4

Get clinical nursing experience.

Because CNL is a leadership role, most employers prefer candidates with several years of clinical experience in nursing.

5

Obtain a CNL credential.

Clinical Nurse Leader (CNL) certification is administered by the Commission on Nursing Certification. To obtain the credential, candidates must hold a degree from an approved CNL master’s- or doctoral-level training program and pass a knowledge exam.

6

Consider opportunities for advancement.

Nursing is a very flexible profession, especially for those with post-bachelor’s education. The advanced generalist training of clinical nurse leaders prepares them to work in all healthcare settings as well as non-clinical fields like health insurance, case management and government and community agencies. CNLs with doctoral degrees are qualified to teach and conduct research at the university level.

Explore Degree Paths

In terms of practical preparation, there are different routes you might take. Nursing experience is a given, as is depth in a specialty area. Some new nurses enter their profession with a plan to practice in a particular area; others develop their interests after they gain experience. Either way, you’ll want to be confident about your clinical interests before applying to graduate school.

Graduate training requires a bachelor’s degree in nursing (BSN) and licensure as an RN, so it’s fair to say that the BSN-RN offers the shortest path toward a role in hospital leadership. If earning a BSN is not possible for you right away, don’t let that discourage you: many good nursing schools offer “ladder” or “bridge” programs designed to let working nurses complete professional degrees, so if you begin practice as a CNA or LPN, you can locate programs that let you “bridge the gap” in curricula, and work your way to a BSN. Most common are RN-to-BSN programs: RNs with an associate degree (AD-RNs) can earn their BSN over a course of part- or full-time study. You’ll also find CNA-to-LPN programs, and LPN-to-BSN programs.

There is no downside to building your practical experience before pursuing advanced training. Many graduate degree programs look for applicants who have a deeper experience of practice, as well as those with diverse backgrounds and a record of volunteerism and community service. Becoming a leader — being qualified to lead other highly qualified people — is a journey, not a destination, and the majority of educators understand that.

Whatever degree path you follow, make sure that the undergraduate program(s) you enroll in are nationally accredited: their accreditation status is key to your future work and study prospects. Your state’s Nursing Commission or Nursing Board should provide a list of state-approved educational programs and their accreditation status. Look for nursing programs that are CCNE (Collegiate Council of Nursing Education) or ACEN (Accreditation Commission for Education in Nursing; formerly NLNAC) accredited. You should also check the websites administered by the graduate programs that interest you, and find out if there is any specific accreditation they require from incoming students’ BSN programs.

BACHELOR'S DEGREE IN NURSING

4 years

The bachelor’s degree in nursing (BSN) and associate’s degree in nursing (ADN) have much in common, in terms of foundational nursing preparation; the major difference lies in the supporting curriculum for a BSN, and sometimes the depth of the science curriculum. A BSN is a traditional four-year university degree, so you will take writing courses as well as electives in social science, history, and the arts. You must complete a BSN in order to pursue graduate education in nursing.

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BSN students usually begin taking nursing courses after their first year. Your major coursework may include such classes as:

Human anatomy and physiology (with laboratory)

Students learn about the human body’s internal structure and the biological control of homeostasis.

Nursing practice (2+ semesters, with clinical practicum)

An extended course that combines theory and practice. Students develop primary nursing skills over several semesters. Topics include both clinical techniques and effective communication, with attention to issues of cultural and religious sensitivity.

Caring for adults with acute/chronic illness (with clinical practicum)

Clinical skills, patient assessment, and decision-making surrounding care of adults with chronic or acute conditions.

Childbearing and family health

A nursing course that addresses whole-family care, including reproductive health of adults and the care of mothers and newborns.

Have you already earned a bachelor’s or higher degree in a different field? Are you a strong student? If so, you may have alternatives to enrolling in a traditional BSN program. An accelerated BSN (ABSN) degree option would allow you to earn your professional degree after a shorter period of study. If you are academically well-prepared, you should consider an accelerated BSN/MSN program: these are highly selective programs, but students who qualify can earn a master’s in nursing and advanced practice certification in 1.5-2 years.

GRADUATE SCHOOL

2 years, MSN, full-time; 2.5-3 years, DNP, full-time

If a position as a clinical nurse leader is your professional objective, you should search for graduate degree programs that have:

  • a proven record of training clinical leaders, and
  • a curriculum that includes classes in leadership strategies and healthcare systems analysis, in addition to the training that qualifies you for an advanced practice credential

You should leave graduate school with your degree (MSN or DNP); your advanced practice certification in an acute care specialty; and coursework that has prepared you for supervisory roles in a hospital setting.

Bachelor’s-prepared nurses have two training options preparatory to advanced practice certification: they can earn a master’s degree (MSN) or a doctorate in nursing practice (DNP). Master’s-prepared nurses can complete a DNP in about 16 months, full-time. Most graduate programs offer part- and full-time study options, though for certain specialties (like emergency nurse practitioner) part-time study may not be feasible.

Why select master’s over a doctoral training, or vice versa? Think carefully about your personal goals for the next few years, and your ideas about the direction you’d like your career to take in the long run. Master’s programs focus on the essentials of advanced clinical practice. DNP programs offer the same clinical rigor and provide additional leadership and scientific training. Both master’s and doctoral programs may give students an option to pursue subspecialty interests, such as pediatric oncology or adult cardiology; this will differ on a school-by-school basis. While master’s programs seldom require students to complete research projects, this is a requirement for earning a doctorate. The bottom line: if you envision yourself in an executive role in healthcare, or if you are interested in research or university teaching, then a DNP (or a Ph.D.) is probably on your horizon. Regardless, you may prefer to practice as an APRN for a period of time before choosing a doctoral program.

When you’re ready to start shopping for a graduate school, you’ll discover that advanced practice training programs can differ quite a lot in terms of the features they offer their students – study-abroad options, immersion in rural practice, subspecialty areas; the more you do your homework, the more ideas you’ll develop about the kind of nursing you’d like to practice. But every graduate program is a balance between studies that are central to advanced nursing practice, and specialty-specific topics. Your coursework will very likely include classes like:

Advanced health assessment/diagnostic reasoning

Students refine their skills in patient assessment through supervised clinical practice and classroom discussion. This course may be tailored to an advanced-practice specialty – for instance, adult-gerontology acute care.

Leadership for health professions

Students learn and practice leadership skills that operate on a personal scale, including positive communication techniques and organizational strategy; on a larger scale, students analyze and discuss topics in health policy and ethics.

Evidence-based decision-making

How can we establish that a particular medical treatment is effective? Students learn statistical methods and research approaches that allow medical scientists to ask and answer questions about the value of different treatments.

Quality and safety in healthcare systems

Students study principles of optimal systems design with a focus on patient-centered care; the objective is to prepare students to enter the workforce and measurably improve the safety and efficiency of hospital care.

Keys to Success as a CNL

Necessary Skills and Qualities

Previous nursing experience

The CNL is an advanced role that requires prior nursing experience. Candidates need sufficient knowledge and clinical judgment to assess patients, create plans of care, supervise other practitioners and deliver direct patient care when necessary.

Critical thinking and problem solving skills

By definition, CNLs are excellent critical thinkers and problem solvers. They must be able to envision care delivery as a complex system. The adjustments they make to that system are designed to improve quality and efficiency. Also, when a plan of care isn’t working, the CNL must be able to recognize the problem and make appropriate adjustments.

Leadership

Leadership skills are essential. CNLs must be confident in providing direct supervision to a diverse team of professionals. In hospitals, this usually involves working closely with the unit nurse manager and supervising the work of nurses and technicians.

Ability to work well with others

CNLs must work collaboratively with people who are not under their direct supervision, including physicians, social workers, therapists, housekeeping staff, transport staff and many others, in addition to patients and their families.

Interest in industry developments

The CNL role emphasizes evidence-based practice. These professionals must have the background to understand, evaluate and implement new research findings. They also need to be comfortable testing new systems and interventions and sharing their findings.

Knowledge of the latest technology

Technology is part of every CNL’s daily experience. These professionals use information systems to gather and organize data and support decision-making. Some also use telemedicine (distance technology) to deliver care and monitor their patient populations.

Appreciation for social justice

Recognizing and eliminating racial, ethnic, economic and language barriers to health is fundamental to a CNL’s work.

Ability to follow safety protocol

The job also involves some potential health hazards. Like all healthcare professionals, CNLs are at increased risk for infectious disease. Following safety rules around immunizations, infection control and protective clothing is essential to minimize these risks.

Certification Maintenance and Professional Development

  • All advanced practitioners must renew their certification at regular intervals in order to retain advanced credentials. Renewal cycles and requirements depend on your certification, and your credentialing organization; you should check with your credentialing body if you have questions about recertification.
  • Continuing education opportunities help advanced practice nurses stay current with new research in their field and prepare for recertification. You can find these opportunities offered as traditional classes or online courses. Credentialing bodies and nursing professional organizations usually publish an online calendar of CE opportunities; university nursing programs are also a good place to look for CE calendars. You should bookmark pages operated by the American Association of Nurse Practitioners (AANP); the National Association of Nurse Practitioners in Women’s Health (NPWH); the Pediatric Nursing Certification Board (PNCB); and other organizations that serve your community of advanced practice nurses.
  • If you’re a master’s-prepared nurse working in acute care, you may want to earn a post-graduate certificate in a related specialty to broaden your scope of practice; or maybe you want to earn a doctoral degree to open up job opportunities in executive leadership. Post-graduate certification can take 1-2 semesters of full-time study, depending on the preparation afforded by your previous training, while a DNP usually requires three semesters of full-time study for a master’s-prepared nurse.
  • Healthcare systems rely increasingly on IT specialists with backgrounds in clinical practice; nurse informaticists are uniquely qualified to improve systems of clinical documentation, patient records and hospital ordering. If you are engaged in process improvement within the hospital setting, you may want to consider post-graduate certification in medical informatics. Post-graduate study programs are offered in traditional and online formats by universities around the U.S, and the American Nurses Credentialing Center (ANCC) offers certification in informatics.
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