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The scope and variance of clinical nurse specialist job descriptions

11 June 2020
Volume 29 · Issue 11


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).

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