Become a Clinical Nurse Leader in 3 Steps

Nurse Types / Clinical Nurse Leader

Working as a nurse can be a gratifying career. For many nurses, their love of the profession translates into the next logical step: becoming a clinical nurse leader. 

The potential to affect the profession, care for patients, and support other nurses at the leadership level is a great goal to aspire to.

But what does it take to be a clinical nurse leader? Understanding what path to take doesn’t have to be overwhelming. We’ve prepared this guide to help you become a clinical nurse leader in 3 steps. We’ll cover these topics:

• What is a clinical nurse leader?
• What do clinical nurse leaders do?
• Where do clinical nurse leaders work?
• What are closely related fields?
• How do you become a clinical nurse leader in 3 steps?
• What are additional requirements of clinical nurse leaders?
• What are the salary and career outlooks of clinical nurse leaders?

What is a clinical nurse leader?

The American Association of Colleges of Nursing (AACN) established the role of clinical nurse leader (CNL) in 2004. 

It describes a clinical nurse leader as a master’s level nurse who is responsible for coordinating and providing care for a group of patients. This advanced, evidence-based care is designed to improve the quality of patient care outcomes.

This specially trained nurse works together with the entire healthcare team to ensure patients are getting the right care. They are also a resource for the rest of the nursing team.

It’s important to note that a clinical nurse leader is not a manager or supervisor of other nurses. Instead, they lead by guiding the clinical care of their patient cohort.

Qualities of a successful clinical nurse leader

Are you wondering if you have qualities that would make you a good clinical nurse leader? To be a successful, you need to:

• Have great critical thinking skills
• Believe in a high safety standard
• Possess excellent communication skills
• Be open to change
• Own your decisions
• Be able to motivate others
• Have excellent interpersonal skills

What do clinical nurse leaders do?

A clinical nurse leader holds a high level of responsibility in their role. They use the skills discussed above to meet these demands. As a clinical nurse leader, you can expect to:

• Make decisions about changing care plans if needed
• Work with the rest of the healthcare team to coordinate care for a group of patients
• Focus on assessing and reducing risk for patients
• Use evidence-based practice and new technology with patients’ treatment goals
• Mentor other nurses in best practices and patient care
• Maintain safety standards for patients and a healthy workplace
• Develop and maintain quality improvement initiatives

A day in the life of a clinical nurse leader

As you can imagine, this level of responsibility and skill makes for a busy workday! To envision what a day in the life of a clinical nurse leader looks like, consider the following potential routine:

• Begin shift by reviewing each patient’s chart for changes during the previous shift
• Meet with the nurses assigned to the patients in the CNL’s group, to discuss the plan of care and improvements to treatment
• Round on patients to assess their care needs and personal goals
• Educate patients and families when necessary
• Assist bedside nurses with patient care as needed
• Collaborate with the healthcare team to meet patients’ needs, ensuring PT, OT, and other services where appropriate
• Answer questions from nursing staff about resources for patients

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Common conditions treated by clinical nurse leaders

Being a clinical nurse leader covers a broad scope of patients and conditions. A clinical nurse leader can expect to see many common conditions. They may treat:

• Renal disease
• Cardiac disease
• Cancer
• Orthopedic cases
• Diabetes
• Behavioral and mental health problems
• Alzheimer’s disease/dementia
• Post-surgical cases
• Traumatic injuries

Where do clinical nurse leaders work?

The AACN specifies that the clinical nurse leader should be prepared to practice in any healthcare setting. This means you can expect to see clinical nurse leaders working in:

• Hospitals
• Skilled nursing facilities
• Outpatient clinics
• Cancer centers
• Mental health facilities

What are closely related fields? 

The leadership skills and responsibility associated with a clinical nurse leader are seen in some closely related nursing fields as well. In all of these specialties, the common denominator is being prepared at the Master of Science in Nursing (MSN) level at a minimum:

• Clinical nurse manager
• Director of nursing
• Chief nursing officer
• Healthcare administrator
• Clinical nurse educator

The AACN also notes that the initiatives that drive the Doctor of Nursing Practice (DNP) degree, although separate from the CNL, are closely related and complementary.

How do you become a clinical nurse leader in 3 steps?

What is the best career path to achieve the goal of becoming a clinical nurse leader? By following the 3 steps discussed below, it’s a goal that’s easily within your reach.

Step 1 – Become a registered nurse

If you aren’t already a registered nurse, this is the first step to take. Reaching the level of clinical nurse leader requires that you are able to work as a licensed provider in a nursing role.

Earn an MSN 

It’s advisable to begin with a Bachelor of Science in Nursing (BSN) degree if you’re just starting out as a registered nurse. The AACN notes that ideally, 80% of nurses should be BSN-prepared. This step will also move you closer to a role as a clinical nurse leader since they must advance to an MSN degree level.

In addition to enrolling in a BSN program at the beginning of your college career, you can also take these approaches:

• RN to BSN– if you already have an Associate Degree in Nursing (ADN), you can use credits earned to advance to the BSN level more quickly.
• ABSN– an Accelerated Bachelor of Science in Nursing (ABSN) allows you to use credits to earn a BSN more quickly if you already have a bachelor’s degree in another field.

Clinical nurse leaders must hold a master’s degree in nursing, so you’ll need to be sure to choose an eligible CNL program to complete your degree pathway. There are a couple of ways to do this: 

• BSN-MSN program if you’ve completed your BSN
• RN-MSN program if you’re an ADN nurse

Pass the NCLEX exam

Earning a BSN prepares you to sit for the NCLEX exam, which is required by all state boards of nursing to earn your license as a registered nurse. This rigorous exam known as “nursing boards” proves you have the knowledge needed to enter safe nursing practice.

Step 2 – Accumulate experience

Clinical nurse leaders must be confident in their skills and knowledge, and part of that comes with accumulating experience in the nursing field. You may also want to explore different nursing specialties to learn what area you would like to focus on as a clinical nurse leader.

Helpful skills and experience

Because a clinical nurse leader must have an overview of best nursing practices to effectively do their job, there are a few areas that it’s helpful to have skills and experience in that include:

• Participating in quality initiatives in patient care
• Evaluating patient outcomes
• Analyzing trends in labs and vital signs
• Understanding evidence-based practice
• Mentoring other nurses
• Communicating with all members of the healthcare team
• Researching in any field

Changing specialty to a clinical nurse leader nurse 

If you’re in a nursing specialty and hope to change to a clinical nurse leader, it’s important to think about where you’d like to work. 

You can continue as a clinical nurse leader in your area of expertise, but your role will not be focused on a narrow scope of highly specialized tasks. Instead, it will be a more general application of broad skills to support your population of patients. 

If you’re coming from a role like med-surg, your experience will involve treating a range of both acute and chronic disorders. You should easily be able to apply your knowledge of the related processes, assessment skills, and communication skills to a role as a CNL. 

Each specialty will bring its own unique insights into working as a CNL. For example, critical care nurses know how to work under pressure and react quickly to negative trends in their patients. Pediatric nurses understand communication with children and parents. These are all skills you can bring with you to a CNL position.

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Step 3 – Obtain certifications

Certification is at the core of clinical nurse leadership and is required to hold the title. To be eligible to sit for the CNL Certification exam, you must:

• Pass the NCLEX-RN
• Be a graduate of an accredited CNL master’s or post-master’s program OR
• Be a student in the last term of a CNL master’s or post-master’s program

In addition, students enrolled in a CNL program must complete 300 clinical hours in practice as a CNL, and a total of 400 clinical hours in the program (which can include those in practice as a CNL). 

What are additional requirements of a clinical nurse leader? 

The initial CNL certification earned is valid for 5 years. Before the certificate expires, it must be renewed. A nurse does not have to hold the job title of clinical nurse leader or retest to renew the CNL certification, but the following criteria must be met:

• List employment during the 5 year certification period, covering 2,000 hours of professional practice
• List 50 contact hours earned during the 5 year certification period, including any CEUs earned toward renewing an RN license
• Meet the AACN Standards of Conduct
• Provide a current RN license number, state, and expiration date

What are the salary and career outlooks for clinical nurse leaders? 

Nursing in general is projected to continue to have job growth in the next decade, and master’s level nurses like CNLs are no exception. Through 2026, nurses in master’s degree prepared occupations similar to CNLs can expect an average of 26,000 annual job openings. 

Clinical nurse leaders have a robust salary outlook, with a national annual income of $102,715.

When considering your potential salary range as a clinical nurse leader, it’s important to look at the highest paying states and cities for nurses as well. These areas may offer higher than average pay as a CNL.

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Job satisfaction

Earning a master’s degree in a CNL program and earning your certification is no small feat. Does all this hard work translate into high job satisfaction? 

If you’re working as a nurse, a great way to find out is to seek out clinical nurse leaders within your organization and discuss your aspirations in the field. Advice from seasoned nurses can provide great insights into real world experiences in their roles. 

Next steps

Nurses who have successfully earned their clinical nurse leader certification and are working in the role may decide to further advance their leadership skills to a more specialized area such as a Doctor of Nursing Practice. 

Your understanding of the big picture when it comes to coordinating patient care may make a great stepping stone to a role in nursing administration, such as Chief Nursing Officer.

No matter what direction clinical nurse leadership takes you in, it’s sure to give you the ability to impact the quality of care your patients receive. For nurses with a passion for leadership and making a difference, being a clinical nurse leader is a worthwhile pursuit.

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