References

ICN framework of competencies for the nurse specialist. 2009. https://tinyurl.com/vz2yagg (accessed 8 April 2020)

Affara FA, Styles MM A nursing regulation guidebook: from principle to power.Geneva: International Council of Nurses; 1992

American Nurses Association. Nursing: scope and standards of practice. 2015. https://tinyurl.com/vxzsbmg (accessed 8 April 2020)

Baldwin KM, Clark AP, Fulton J, Mayo A National validation of the NACNS clinical nurse specialist core competencies. J Nurs Scholarsh. 2009; 41:(2)193-201 https://doi.org/10.1111/j.1547-5069.2009.01271.x

Brook S, Rushforth H Why is the regulation of advanced practice essential?. Br J Nurs. 2011; 20:(16)996-1000 https://doi.org/10.12968/bjon.2011.20.16.996

Bryant-Lukosius D, DiCenso A, Browne G, Pinelli J Advanced practice nursing roles: development, implementation and evaluation. J Adv Nurs. 2004; 48:(5)519-529

Chiarella M, Thoms D, Lau C, McInnes E An overview of the competency movement in nursing and midwifery. Collegian. 2008; 15:(2)45-53 https://doi.org/10.1016/j.colegn.2008.02.001

Cooper MA, McDowell J, Raeside L The similarities and differences between advanced nurse practitioners and clinical nurse specialists. Br J Nurs. 2019; 28:(20)1308-1314 https://doi.org/10.12968/bjon.2019.28.20.1308

Daly WM, Carnwell R Nursing roles and levels of practice: a framework for differentiating between elementary, specialist and advancing nursing practice. Journal of Clinical Nursing. 2003; 12:(2)158-167 https://doi.org/10.1046/j.1365-2702.2003.00690.x

Department of Health. The NHS plan: a plan for investment, a plan for reform. CM 4818-1 (archived). 2000a. https://tinyurl.com/yxh8unob (accessed 8 April 2020)

Department of Health. Developing key roles for nurses and midwives a guide for managers. 2000b. https://tinyurl.com/utgppxy (accessed 8 April 2020)

Donald F, Kilpatrick K, Reid K, Carter N, Martin-Misener R, Bryant-Lukosius D A systematic review of the cost effectiveness of clinical nurse specialist and nurse practitioners: what is the quality of the evidence?. Nurs Res Pract. 2014; 2014 https://doi.org/10.1155/2014/896587

Dunn L A literature review of advanced clinical nursing practice in the United States of America. J Adv Nurs. 1997; 25:(4)814-819 https://doi.org/10.1046/j.1365-2648.1997.1997025814.x

The nature of clinical practice in advanced practice nursing: a qualitative study. 2003. https://tinyurl.com/ulydc3e (accessed 8 April 2020)

Elsom S, Happell B, Manias E The clinical nurse specialist and nurse practitioner roles: room for both or take your pick?. Aust J Adv Nurs. 2006/2007; 24:(2)56-59

Hamric AB, Spross JA, Hanson CM Advanced nursing practice: an integrative approach.St Louis (MO): Elsevier Saunders; 2005

Health Education England. Multi-professional framework for advanced clinical practice in England. 2017. https://tinyurl.com/yc9scy5w (accessed 8 April 2020)

Health Research Authority. Defining research table. 2017. https://tinyurl.com/r9j7n54 (accessed 8 April 2020)

The clinical nurse specialist: issues in practice. In: Humphris D (ed). Basingstoke: Macmillan Press; 1994

International Council of Nurses. ICN framework of competencies for the nurse specialist. 2009. https://tinyurl.com/vz2yagg (accessed 8 April 2020)

Jokiniemi K, Meretoja R, Pietila AM Constructing content validity of clinical nurse specialist core competencies: exploratory sequential mixed-method study Scandinavian Journal of Caring Sciences. 2018; 32:(4)1428-1436 https://doi.org/10.1111/scs.12588

Lopatina E, Donald F, DiCenso A Economic evaluation of nurse practitioner and clinical nurse specialist roles: A methodological review. Int J Nurs Stud. 2017; 72:71-82 https://doi.org/10.1016/j.ijnurstu.2017.04.012

Macmillan Cancer Support. Quality in nursing. Excellence in cancer care: the contribution of the clinical nurse specialist. 2010. https://tinyurl.com/yca4s9dj (accessed 8 April 2020)

Macmillan Cancer Support. Impact briefs. Cancer clinical nurse specialists. 2012. https://tinyurl.com/yx6t47gv (accessed 8 April 2020)

Mills C, Pritchard T A competency framework for nurses in specialist roles. Nursing Times. 2004; 100:(43)28-29

Mohr LD, Coke LA Distinguishing the clinical nurse specialist from other graduate nursing roles. Clin Nurse Spec. 2018; 32:(3)139-151 https://doi.org/10.1097/NUR.0000000000000373

NHS England. How to ensure the right people, with the right skills, are in the right place at the right time. A guide to nursing, midwifery and care staffing capacity and capability. 2013. https://tinyurl.com/hvlz859 (accessed 8 April 2020)

NHS England. Leading change, adding value. A framework for nursing, midwifery and care staff. 2016. https://tinyurl.com/h45wu74 (accessed 8 April 2020)

NHS England, NHS Improvement. The NHS long term plan. 2019. https://tinyurl.com/y6dzmk2o (accessed 8 April 2020)

Nursing and Midwifery Council. Standards of proficiency for specialist community public health nurses. 2017. https://tinyurl.com/tulpc72 (accessed 8 April 2020)

Nursing and Midwifery Council. Realising professionalism: standards for education and training. Part 3: Standards for pre-registration nursing programmes. 2018a. https://tinyurl.com/y9t2nmjb (accessed 8 April 2020)

Nursing and Midwifery Council. The code. Professional standards of practice and behaviour for nurses, midwives and nursing associates. 2018b. https://tinyurl.com/gozgmtm

Nursing and Midwifery Council. Reviewing our post-registration standards. 2020. https://tinyurl.com/sr37fkq (accessed 8 April 2020)

Redekopp MA Clinical nurse specialist role confusion: the need for identity. Clin Nurse Spec. 1997; 11:(2)87-91 https://doi.org/10.1097/00002800-199703000-00017

Roberts J, Floyd S, Thompson S The clinical nurse specialist in New Zealand: how is the role defined?. Nurs Prax N Z. 2011; 27:(2)24-35

Specialist nurses make a difference.London: RCN; 2009

Royal College of Nursing. Advanced level nursing practice section 1: the registered nurse working at an advanced level of practice. 2018. https://tinyurl.com/y68m4y2a (accessed 8 April 2020)

Sanchez K, Winnie K, Haas-Rowland N Establishing the clinical nurse specialist identity by transforming structures, processes and outcomes Clin Nurse Spec. 2019; 33:(3)117-122 https://doi.org/10.1097/NUR.0000000000000438

The scope of professional practice.London: UKCC; 1992

A higher level practice. Report of the consultation on the UKCC'S proposals for a revised regulatory framework for post-registration clinical practice.London: UKCC; 1999

Vidall C, Barlow H, Crowe M, Harrison I, Young A Clinical nurse specialists: essential resource for an effective NHS. Br J Nurs. 2011; 20:(17)S23-S27 https://doi.org/10.12968/bjon.2011.20.Sup10.S23

Wickham S What are the roles of clinical nurses and midwife specialists?. Br J Nurs. 2013; 22:(15)867-875 https://doi.org/10.12968/bjon.2013.22.15.867

Young L Specialist nurses: changing lives, saving money. Primary Health Care. 2010; 20:(3)7-8 https://doi.org/10.7748/phc.20.3.7.s9

The scope and variance of clinical nurse specialist job descriptions

11 June 2020
Volume 29 · Issue 11

Abstract

Specialist nurses have been part of the nursing workforce for decades but articulating the scope of such roles, educational requirements, professional expertise and levels of pay is still widely debated within the workplace. This article reports on a study that examined a sample of clinical nurse specialist (CNS) job descriptions from across the UK. One hundred job descriptions were sourced, originating from various healthcare settings, and audited to explore their scope and content. In conclusion, the job descriptions showed a high level of agreement of the scope domains of a CNS role but were less consistent when considering the experience and educational requirements of CNSs.

Clinical nurse specialist (CNS) roles in the UK have been in existence and debated for decades (Humphris, 1994; Mills and Pritchard, 2004; Vidall et al, 2011; NHS England, 2013; 2016; Health Education England (HEE), 2017; Royal College of Nursing (RCN), 2018; NHS England and NHS Improvement, 2019; Nursing and Midwifery Council (NMC), 2020). Variations in the roles seem to remain widespread, accompanied by diverse clinical roles across healthcare settings, with differing titles, educational requirements and pay (Mills and Pritchard, 2004).

There are several definitions of the CNS (Affara and Styles, 1992; Affara, 2009; RCN, 2009). More than 10 years ago, the RCN (2009) suggested that CNSs and nurse practitioners should be educated to at least degree level. Furthermore, they should also possess specialist knowledge, skills, competencies and experience, with key role components including a clinical focus, consultancy, and involvement in education, research, liaison and administration. In practice, there is some consistency among CNS roles, with the majority of those in the roles acting as key workers, attending multiprofessional meetings and enhancing patient experiences. However, these roles can be specific to individual jobs and local service issues and provide a wide range of services. HEE and the RCN have set out frameworks defining CNS roles, specifying levels of advanced practice and educational levels (HEE, 2017; RCN, 2018). Yet, despite this, roles have not always been clearly defined (Affara, 2009; Mohr and Coke, 2018).

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content