Clinical Nurse Specialists

The details of a clinical nurse specialist's job depend on the setting in which he or she is employed (e.g., hospital, nursing home, community clinic, mental health facility, home health care, industrial setting, or other). Clinical nurse specialists must be able to work as part of an interdisciplinary health care team, which can include doctors, psychologists, physical therapists, and social workers. Areas of specialty include:

• population (e.g., geriatrics, women’s health, pediatrics)
• setting (e.g., critical care, emergency room)
• disease or medical subspecialty (e.g., cardiac, diabetes, oncology)
• type of care (e.g., psychiatric, rehabilitation)
• type of health problem (e.g., wounds, pain, stress)

The clinical nurse specialist is expected to be able to see the "big picture" in a way that the staff nurse who is focused on delivering direct care cannot. Patients and their families need an expert guide and advocate to make the most constructive use of today's immensely complex health care delivery system. Clinical nurse specialists plan, direct, or coordinate the daily patient care activities in a clinical practice. In addition, they ensure that other health care providers follow recognized clinical policies, protocols, regulations, and standards in the delivery of patient care.

In addition to ensuring that the patient receives the most appropriate state-of-the-art nursing care while in the hospital, the clinical nurse specialist has an important role as an educator and consultant. Educating patients and their families is the most obvious part of the teaching role but far from the only part. The clinical nurse specialist is also involved in the professional development of the other members of the nursing staff and the nursing students by teaching them about new concepts and techniques in nursing.

Clinical nurse specialists may be involved in the planning and development of nursing school courses or continuing education programs either in the hospital or academic setting. They may be called on to provide an expert nursing perspective for students in other disciplines, such as social work or medical ethics. Clinical nurse specialists are frequently called on to provide health care education for the community at large or for specific sectors of the community, such as manufacturers of medical equipment.