A clinical nurse leader is a nurse in charge of coordinating and integrating patient care within a group of patients. It is a relatively new nursing role, and was created by the American Association of Colleges of Nursing as the result of investigations into methods of improving patient care and prepare student nurses for the future of the healthcare system. A clinical nurse leader is a registered nurse with a Master’s degree in the Science of Nursing. A CNL has also finished advanced nursing course work in a number of specialties, such as pharmacology, pathophysiology, and clinical assessment. A CNL has to have a grounding in many different strategies in order to be able to coordinate between them. In order to effectively carry out the analysis of patient care data, CNLs are also trained in statistics and data analysis, project design, and many other generalist skills.
A clinical nurse leader must constantly research the cutting edge of nursing practices, procedures, and technology, and find out what has been proven to work and what hasn’t. Using this knowledge the CNL must then bring the best of the new developments to his or her own facility. The CNL also must regularly study patients’ charts and progress, and evaluate which procedures are working and which are not. A CNL has the authority to make changes to patient care plans when necessary. The clinical nurse leader is also responsible for making sure that every patient’s health care plan is individualized to their particular needs. The CNL combines both extremes of the professional nursing world. These nurses are involved personally with each one of their patients on the one hand, and aware of the current state of the science and practice of nursing on the other.
He or she also serves as the contact point for a whole network of other professionals: doctors, social workers, pharmacists, and other nurses, and helps make sure that they are all working with the same information and to the same purposes. A CNL oversees patient medical teams. This kind of nurse is an advanced generalist, who combines the functions of traditional nurse, administrator, and professional researcher, and has a role in all health care settings, including nursing homes, hospitals, memory care centers, doctor’s offices, rehabilitation centers, and hospices.
Clinical nurse leaders are also responsible for reducing the occurrence of medical errors. Estimates of the number of American deaths due to medical errors place it at a minimum of 44,000 and maybe as much as 98,000 each year, to say nothing of suffering related to non-fatal errors. A major part of the clinical nurse leader’s purpose is to see both the big picture and the details of their practices, to make them run safely and more effectively. They are also supposed to provide greater accountability for patient healthcare outcomes. By taking charge of creating, evaluating, and coordinating patient care procedures, clinical nurse leaders also take responsibility for their patients.
The role of the CNL is actually just a formalization of a role that had developed organically. Executive nurses have testified before nursing task forces that this role had informally developed as a response to the needs of modern health care services, with the occupants of these roles trained for them on a personal, informal, and adhoc basis, and were recruited on the basis of previous job experience.
Although similar in some ways, a clinical nurse leader is not the same thing as an advanced practice registered nurse, a clinical nurse specialist, or a nurse practitioner. APRNs, CNSs, and NPs are all educated as specialists in a well-defined area of practice. A CNL, on the other hand, has a broader, more general education in different specialties. The CNL is more of a complementary role to these other nursing specialists. By working with each of these other types of nurses the clinical nurse leader ensures that patients benefit from specialist attention coordinated by the generalist perspective.
Clinical nurse leaders were never intended to replace nurses with baccalaureate degrees. The American Association of Colleges of Nursing is in no way recommending that baccalaureate nursing programs be phased out. Instead, it recognizes that while some circumstances call for post-graduate education in nursing, many other areas of the field are much better served by the graduates of traditional nursing programs. However, a clinical nurse leader requires so much extra education that it would be impossible to have the needs of the position filled simply by modifying the existing four year programs.
There are a number of different ways to work up to a CNL certificate. Originally a BSN was required first. Today, however, ADN graduates can become trained as CNLs as well. MSN graduates can as well. No matter which of these places the training begins from, all end up producing the same CNL Master’s degree. The CNL program takes an average of four semesters to complete. The training is provided with high technology practical instruction, where students are exposed to the latest in nursing technology. Because the CNL training is so complex and advanced, CNL schools tend to be very selective when it comes to their applicants.