- Clinical Nurse Specialist -
Advanced Registered Nursing Practice in Canada

The clinical nurse specialist (CNS) is a registered nurse with advanced education and expertise in a nursing speciality. It is an advanced nursing practice role but within the nursing scope of practice for registered nursing.

Advanced nursing practice requires knowledge and competencies that are beyond those expected of the nurse providing direct care to clients.

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See Nursing Careers for a definition of "direct care" and other nursing job classifications.

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The role of the CNS is quite diverse and can vary greatly depending on the needs of the community and the employer. A masters degree is usually required along with expertise in a particular clinical area such as:

pediatrics adult nursing rehabilitation

gerontology critical care cardiology palliative care

oncology mental health community and home care

The role is a diverse one and involves client care as well as leadership to staff on clinical matters and liaison with other departments or services. The CNS may also be involved in quality improvement projects and research.

A CNS is regulated by the provincial regulatory nursing organization and practices under the established legal definition of registered nursing.

Additionally there would be no special nursing scope of practice for the CNS. The registered nurse in this role cannot perform skills or carry out restricted or controlled acts specified in nursing laws that are outside the registered nursing scope of practice.

The role is a clinical one, not an administrative one. The expertise and advanced nursing practice that the CNS brings to the clinical area is in the depth and breadth of the nursing knowledge base in their specialty.

The clinical nurse specialist can be expected to be proficient in observing, conceptualizing, diagnosing, and analyzing complex clinical or non-clinical problems related to health and would be expected to have a knowledge base that encompasses the range of theory necessary to understand specific client problems and determine possible nursing treatment options.

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Read about the difference between a clinical nurse specialist and a nurse practitioner

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