What is a Clinical Nurse Leader?

A Clinical Nurse Leader is a new designation for a Master of Science in Nursing graduate – a Clinical Nurse Specialist – who specializes in maintaining the quality and safety of patient services.  The development of this specialty is the result of a campaign initiated by the American Association of Colleges of Nursing (AACN), which is the authoritative professional body for all types of nursing education in this country.

The history of this new specialization begins in 1999 with the release of a report by the Institute of Medicine on the significant shortfall in patient safety measures and patient safety training in the medical profession.  That report coupled with declining enrollments in baccalaureate nursing programs led the AACN to initiate a task force effort aimed at producing an analysis of what changes might be needed in nursing education.  The task force – actually, two task force efforts – developed a new educational model for a nurse, graduated beyond the baccalaureate level with a new license and newly defined scope of practice.

The evolving profession of Clinical Nurse Leader (CNL) is the result of those efforts.  Training for this role includes risk assessment, quality improvement techniques, centralized care coordination, the measurement of patient outcomes and a leadership or advocacy role in sustaining quality patient care.  Further, the CNL is a designated leader and teacher for RNs and other medical personnel working with patients about the perspective, the benchmarks and the precautions associated with quality patient care.

Five years ago the AACN launched an educational development program in conjunction with ninety graduate nursing programs to get the Clinical Nurse Leader profession underway.  The Association has been faced with a dual role of developing an educational platform for this new position and also working to convince medical facilities and health service providers that they need CNL personnel on staff.

Today a number of nursing schools have incorporated the CNL specialty into their curriculum, but the available programs represent just a fraction of the nursing programs in this country.  Some of the MSN programs offering the Clinical Nurse Leader specialization are available online.  While there is little debate about the need to improve the quality of patient care in this country, educating specialists in the field is proving to be an ongoing challenge.

Some schools have chosen to incorporate a Care and Outcomes concentration for their MSN advanced nurse programs and have made the concentration available to several of the specializations that are offered.  Others have incorporated elements of the program recommended by the AACN into their Nurse Educator, Nurse Administrator and Clinical Nurse Specialist Generalist programs.  The AACN has taken on an impressive role of advocacy on this program with the best of motivation.

Launching the CNL initiative was an effort to drive the further development of nursing education and at the same time, introduce an entirely new ombudsman role into the field.  It is likely that a quality control expert in the nursing ranks has been looked on with some degree of discomfort by health service providers; hopefully the profession will continue to grow.