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Clinical Nurse Leader
Frequently Asked Questions
What is the Clinical Nurse Leader?
The Clinical Nurse Leader or CNL is a new nursing role being developed by AACN in collaboration with an array of leaders from the practice environment. Two AACN task forces met to identify how to (1) improve the quality of patient care and (2) best prepare nurses with the competencies needed to thrive in the current and future health care system. The CNL role emerged following research and discussion with stakeholders as a way to engage highly skilled clinicians in outcomes-based practice and quality improvement strategies.
What does a CNL do?
The CNL oversees the care coordination of a distinct group of patients and provides direct patient care in complex situations. The CNL puts evidence-based practice into action to ensure that patients benefit from the latest care innovations. The CNL collects and evaluates patient outcomes, assesses cohort risk, and has the decision-making authority to change care plans when necessary. The CNL functions as part of an interdisciplinary team by communicating, planning, and implementing care directly with other health care professionals, including physicians, pharmacists, social workers, clinical nurse specialists and nurse practitioners. The CNL role is not administrative or managerial. The CNL is a leader in the health care delivery system in all settings in which health care is delivered, not just the acute care setting. Implementation of this role will vary across settings.
The CNL role is fully described in AACN's Working Paper on the Role of the Clinical Nurse Leader »
Is the CNL needed in the health care system?
The need for the CNL was confirmed through discussions between AACN and health care leaders. Nurse executives stated that this role has emerged in the practice setting and is being further developed on an ad hoc basis. Individuals in the role have been recruited opportunistically based on available clinicians with appropriate education and experience, personal characteristics, and self-selection. Stakeholders affirmed the need to produce these clinicians through education. In addition, reports released by the Institute of Medicine, Robert Wood Johnson Foundation and the American Hospital Association cited the need for change in health care delivery and education of health professionals to improve patient outcomes.
What is the educational preparation of a CNL?
The CNL is a generalist clinician, educated at the master's degree level. Graduate education is to enable the CNL to bring a high level of clinical competence and knowledge to the point of care and to serve as a resource for the nursing team. The master's degree in nursing will prepare graduates for a generalist role.
Will the CNL replace baccalaureate-prepared nurses and is AACN recommending that baccalaureate programs close?
No. The AACN Board of Directors has reaffirmed the organization's strong support for baccalaureate (BSN) nursing education. Though AACN recognizes that entry-level nurses will continue to be prepared at the diploma and associate degree (ADN) levels, the organization supports the four-year baccalaureate degree as the minimum credential for professional nursing practice.
How is a CNL different from a Clinical Nurse Specialist or other advanced practice nurse?
The CNL is prepared as a generalist rather than a specialist such as the clinical nurse specialist (CNS) or nurse practitioner. Advanced practice nurses (APNs) have specialized education in a defined practice area. The CNL and APN roles complement one another. AACN in consultation with a select group of CNSs has developed a document, The CNL-CNS Roles: Similarities, Differences and Complementarities. More information on differences between CNL and other programs (PDF)
(ADAPTED FROM AACN’S CNL Frequently Asked Questions)