What is a Clinical Nurse Leader?

A few weeks ago, a MidleveU reader asked me “What exactly is a Clinical Nurse Leader?”.  While I had some idea, I wasn’t confident in my perception of the Clinical Nurse Leader (CNL) role.  What exactly do CNL programs teach?  What kinds of jobs do CNL program graduates fill?  I just wasn’t quite sure.

I poked around the internet, trying to find answers to these questions and ended up reading a few articles filled with nursing jargon, no closer to clarifying my perception and getting an answer to this reader’s question.  So, I decided to go straight to a CNL expert for answers.  Dr. Jane Gannon, CNL Track Coordinator at University of Florida College of Nursing, graciously agreed to answer a few questions about the Clinical Nurse Leader role and education.  Here’s what she had to say:

For what types of careers does the Clinical Nurse Leader degree prepare students?  What types of jobs does a Clinical Nurse Leader degree translate to in “real life”?

Dr. Gannon clarifies that students in CNL programs earn an MSN degree.  The Clinical Nurse Leader track is an MSN program, so upon successful graduation, CNL students are prepared to sit for the CNL certification exam and seek employment as a Clinical Nurse Leader.  The CNL role is an advanced practice generalist role unlike the nurse practitioner and clinical nurse specialist roles which are specialty focused.  NP’s and CNS’s generally work mainly in their specific specialty area.  A Clinical Nurse Leader can work in any setting because the CNL role competencies are needed in every health care setting.  The competencies of a CNL include leadership, care environment management and outcome management.

According to the University of Florida School of Nursing website, a Clinical Nurse Leader’s role is to promote the best possible patient care in all settings.  CNL’s typically oversee and direct care for a group of patients.  a Clinical Nurse Leader program prepares students to work as outcomes managers, patient advocates, educators, team managers, risk anticipators and a resource for both patients and healthcare providers.

In what major ways does the Clinical Nurse Leader curriculum differ from a nurse practitioner (ex. FNP) program?

Generally, NP and CNL programs have some courses in common and others that focus on the role competencies of each.  Dr. Gannon says that at University of Florida, both CNL and NP students take nearly all of the same core courses that are required for their respective advanced practice role.  These include courses in ethics, advanced health assessment, pathophysiology, research theory and utilization, policy and finance and health promotion.

Where the NP and CNL programs differ are in the clinical and role courses.  CNL students have courses focused on leadership, outcome management and management of the care environment.  There are six CNL specific courses at U of F.  The last of these courses is a role immersion course, or residency.  Unlike NP students, CNL students’ only clinical course is this full time residency activity consisting of 480 hours over the course of 12 weeks.  Nurse practitioner students generally have three specialty courses focused on their role competencies and three clinical courses that accompany them.  They then have a practicum experience in their last semester of study.  The total number of clinical hours differs depending on the NP role.

The Clinical Nurse Leader curriculum focuses on ensuring that students have the skills to carry out the CNL role.  Their leadership and role courses focus on communication skills, leadership theories, self-awareness, conflict management, negotiation and other skills that will make them effective leaders on a unit of care.  Management of the care environment courses focus on assessing a unit of care, using data effectively for unit based decision making, especially as it impacts resource utilization, cost efficiency and effectiveness and safety.  Skill in control chart construction and interpretation and quality improvement methods are developed as are use of tools like work flow charts and Pareto charts.  Finally, the clinical outcome management course focuses on both individual and aggregate care outcomes and strategies to track and improve clinical outcomes using evidence based practice.  These courses are unique to the Clinical Nurse Leader curriculum.

Are Clinical Nurse Leader program graduates eligible to take the national Nurse Practitioner certification exam after graduation and practice as Nurse Practitioners (ex. treating patients, writing prescriptions) if they choose?  If not, are CNL program graduates required to take a national certification exam before working in a CNL role?

CNL program graduates take the CNC exam administered by the Commission on Nurse Certification (CNC), an autonomous arm of the American Association of Colleges of Nursing (AACN) and governed by the CNC Board of Commissioners.  The CNC Board of Commissioners and staff are responsible for the policies and administration of the CNL Certification Program.

Clinical Nurse Leader graduates are not eligible to take the nurse practitioner certification exams nor can they practice as nurse practitioners.  The CNL role is not a specialty role; it is an advanced generalist role, so they do not write prescriptions.  CNL’s manage patient care delivery but do not treat patients using the advanced management processes encompassed by the NP role in terms of treatment plans.  They do have advanced health assessment skills and use these in unit based care delivery.

A big “Thank You” to Dr. Jane Gannon, CNL Track Coordinator at University of Florida School of Nursing for clearing up the difference between Nurse Practitioner and Clinical Nurse Leader programs as well as their “real life” roles.

Are you a Clinical Nurse Leader?  Tell us about your experience by commenting below!

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