Clinical Nurse Leader (CNL) Career Overview

What Is a Clinical Nurse Leader?

In the late 1990s, the Committee on Quality Health Care in America reported between 44,000 and 98,000 Americans were dying every year because of medical errors. In response, the American Association of Colleges of Nursing (AACN) decided to add a new nursing specialty to the mix: clinical nurse leaders.

Their role was to prevent errors, facilitate hospital operations, and generally make patient care better and safer. Clinical nurse leaders (CNLs) hold advanced degrees and specialize in general medicine versus a specific medical specialty. While other nursing leaders may spend their time on the administrative needs of their unit, CNLs have a patient-facing role and serve as resource nurses to the team.

According to the AACN, clinical nurse leaders spend their efforts on:

• Care coordination
• Care transitions
• Communication
• Measuring outcomes
• Promoting best practices
• Quality improvement
• Risk assessment
• Team leadership

While clinical nurse leaders must earn a Master of Science in Nursing, they are not considered advanced practice nurses or nurse practitioners. Instead, they use their knowledge to improve patient care on a broader scale.

Where Do Clinical Nurse Leaders Work?

Clinical nurse leaders work wherever nurses do. They help with nursing tasks, but don’t get assignments the same way staff nurses do. Instead, they work with the whole unit, helping staff care for all the patients.

Clinical nurse leaders can find work in:

• Hospices
• Hospitals
• Nursing homes
• Outpatient clinics
• Private medical offices
• Rehabilitation facilities

In a hospital or long-term healthcare facility, CNLs work on the unit. While they may have an office, they will spend a lot of their days out on the unit with the nursing staff, assisting with tasks and troubleshooting issues.

In outpatient clinics, clinical nurse leaders may still help out with patients, but will focus more on how well the clinic is running. Is the waiting room getting too full? Are appointments taking longer than expected? A CNL can help a clinic adjust some of its day-to-day practices to ensure efficient routines.

What Does a Clinical Nurse Leader Do?

Resource nurses are always a valuable part of any nursing team, and clinical nurse leaders provide the support of a resource nurse and more. CNLs work with nursing staff and patients to streamline care, help with heavy assignments, and assist in other nursing tasks.

For the hospital, a CNL helps their bottom line by improving patient outcomes, providing leadership on their unit, mentoring nurses, and suggesting change where it’s needed. One major goal of a CNL is to improve communication between team members. CNLs can serve as indispensable liaisons between members of the health team, making sure no patient falls through the cracks.

All these roles come together to equal better patient care, happier staff, and more efficient systems. Some tasks a CNL may perform throughout the day include:

• Auditing patient care plans
• Collaborating with physicians, social workers, case managers, and other care providers to discuss patient care
• Completing risk assessments for patient safety
• Developing and maintaining risk-lowering plans for diverse populations
• Educating patients and families
• Evaluating treatment results and suggesting solutions as necessary
• Implementing safety standards on the unit
• Overseeing patient care by other staff
• Performing direct patient care
• Promoting cost-effective and efficient care
• Serving as a resource for nurses to ask questions
• Staying current on research and sharing applicable results with management

The clinical nurse leader role encompasses many other nursing roles. In doing so, they not only offer support for the staff on their unit, but they can see how the unit runs as a bigger picture and develop techniques to help it run smoother.

How Do I Become a Clinical Nurse Leader?

Clinical nurse leadership roles require an advanced degree. But the first step is graduating from an accredited nursing program with a Bachelor of Science in Nursing (BSN). After getting their degrees, graduates can work as graduate nurses (GNs). Many facilities hire nurses as GNs to train them. After they pass the NCLEX-RN, the state licensing exam, GNs become registered nurses (RNs) and can legally practice on their own.

After some experience, aspiring clinical nurse leaders can return to school and earn a Master of Science in Nursing (MSN). They can graduate with their MSN in two years, but it can take more time to complete if they work full-time. After earning their MSN, nurses can apply to clinical nurse leadership positions.

To demonstrate further authority in their field, clinical nurse leaders may choose to obtain a CNL Certification from the Commission on Nurse Certification. To be eligible for this certification, CNLs must:

• Be graduates of an accredited CNL master’s or post-master’s program OR
• Be students in their last term of an accredited CNL master’s or post-master’s program
• Have a current RN license

How Much Does a Clinical Nurse Leader Make Per Year?

Because clinical nurse leaders hold a management role, they can make more than bedside nurses. According to the U.S. Bureau of Labor Statistics (BLS), the average salary for clinical nurse leaders is $134,440. However, this amount can vary depending on the work setting and the cost of living in the area. The low-end average is $67,900, and the high-end is $216,750. Depending on the type of facility, an employer may be able to offer higher or lower compensation:

• Hospitals; state, local, and private: $128,740
• Government: $125,590
• Outpatient Care Centers: $129,500
• Offices of Physicians: $134,330
• Nursing Care Facilities (Skilled Nursing Facilities): $106,520
• Home Health Care Services: $109,300

Salaries also vary depending on which state a clinical nurse leader works in. The West Coast generally pays nurses the best, but they also have a higher cost of living.

The top-paying cities for clinical nurse leaders include:

• Trenton, NJ: $193,730
• San Francisco-Oakland-Hayward, CA: $186,560
• New York-Newark, Jersey City, NY-NJ-PA: $179,330
• San Jose-Sunnyvale-Santa Clara, CA: $176,640
• Napa, CA: $172,730
• Boston-Cambridge-Nashua, MA-NH: $165,940
• Danbury, CT: $165,910
• Vallejo-Fairfield, CA: $164,990
• California-Lexington Park, MD: $163,250
• Portland-Vancouver-Hillsboro, OR-WA: $161,070

Clinical nurse leaders can also earn more when they become certified in their specialty, depending on the facility. In general, the more experience and proof of expertise, the more a clinical nurse leader will be able to earn.

Are Clinical Nurse Leaders in High Demand?

The BLS predicts that nursing leadership jobs will jump 28% by 2032, which is much higher than average. Unfortunately, medical errors still occur, and patient care can still improve. As patient and hospital advocates, clinical nurse leaders have their work cut out for them. As older nurses are looking to retire, CNLs may also see a surge in job availability in the coming years.

Additional Resources for Clinical Nurse Leaders

To learn more about becoming a clinical nurse leader, these additional resources may help:

• Clinical Nurse Leader Association
• American Association of Colleges of Nursing
• Nursing Management Magazine
• Nurse Leader Magazine