Clinical Nurse Specialists Are In Demand

By Nancy Giguere, Star Tribune Sales and Marketing

Last update: December 28, 2005 - 8:30 AM

Like nurse midwives, nurse anesthetists and nurse practitioners, clinical nurse specialists (CNS) are advanced practice nurses. And although they are less well known, the demand for their training and skills is increasing.

Their practice focuses on a population like pediatric patients, a setting like critical care, a disease like diabetes, a special type of care like rehabilitation, or a particular problem such as pain management.

“A CNS is a master’s-level nurse who works in three spheres of influence: direct care, staff development and organizational change,” says Patty Finch Guthrie, a geriatric CNS who is also director of clinical practice, innovation and research at North Memorial Medical Center.

Complex Patients

Direct care usually involves working with “complex patients” and their families. For example, the clinical team caring for an elderly patient with a broken hip, heart disease, arthritis and diabetes might ask a geriatric CNS to do an assessment. This would determine if additional nursing interventions are needed.

After assessing the patient, the CNS would determine a nursing plan of care with the staff nurse. The plan would include referrals to the appropriate clinicians. In this case, these might include a dietitian, a social worker, a pharmacist and another CNS who specializes in diabetes.

Staff Development

Clinical nurse specialists also focus on meeting the educational needs of the nursing staff. “For instance, we realized that nurses on the orthopedic unit had difficulty distinguishing between delirium and dementia in older patients,” Finch Guthrie says.

So she provided the staff nurses with information about medications that can cause delirium in older people. She also introduced a new assessment tool and worked with nurses to develop a care protocol appropriate for older patients.

Many clinical nurse specialists also teach continuing education classes for the nursing staff. For example, Finch Guthrie has taught classes on nutrition for elders and the assessment of elderly patients.

Organizational Change

Finally, clinical nurse specialists work to bring about organizational changes that lead to better patient outcomes. “We set a goal for the orthopedic unit of reducing delirium by 50 percent in elderly patients,” Finch Guthrie says. “Our team included a geriatrician and a geriatric nurse practitioner, a geriatric CNS, a psychiatric CNS, a social worker, and the pharmacy, nursing, therapy and dietary staffs. We created a new protocol, which was eventually adopted throughout the hospital.”

According to the National Association of Clinical Nurse Specialists, research shows that CNS practice leads to positive outcomes. These include reduced medical complications in hospitalized patients, improved pain management practices and increased patient satisfaction with nursing practices.

A Strong Demand

In the 1990s, healthcare systems downsized and laid off clinical nurse specialists, who went into other areas of nursing. A decade later, these same organizations are implementing evidence-based practices, and clinical nurse specialists are once again in demand.

But now they’re hard to find. “Every day, I see ads, receive e-mails and get calls from recruiters who are trying to fill CNS positions all over the country,” Finch Guthrie says. She believes the demand will remain strong for the foreseeable future.

According to Salary.com, the current median annual salary for clinical nurse specialists is $72,315.

Nancy Giguere is a freelance writer from St. Paul and has written about healthcare since 1995.

Recent Jobs : Career management stories

As Economy Shrinks, Fast Food Grows - December 28, 2005

As Economy Shrinks, Fast Food Grows - As the economy continues to shrivel, fast food restaurants are still booming. But the careers aren’t just behind the counter or on the line. There are management jobs and careers at corporate offices. The fast food industry might be something appealing to you. More