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A clinical nurse leader, known also as a CNL®, is a master’s degree-educated nurse who is skilled in the practice of healthcare across the continuum of care within diverse healthcare settings. The American Association of Colleges of Nursing (AACN) developed the CNL in 2003 in response to a demand for general practice nurses who would apply their skills to improve healthcare delivery systems.
A CNL may work with various patient populations and simultaneously coordinate the activities of other nurses and allied health professionals in what is known as a clinical microsystem. A clinical microsystem comprises small teams of healthcare professionals working together to provide front-line patient care.
Though their titles are nearly identical, clinical nurse leaders (CNL) are distinct from clinical nurse specialists. A clinical nurse specialist (CNS) primarily focuses on patient care. A CNS’s duties typically include patient assessment and treatment, developing healthcare plans, and consulting with other healthcare team members, such as patient care managers and RNs, on proper care and related practices. Meanwhile, CNLs focus on how the larger healthcare institution in which patients receive care ultimately performs. In applying a systems-level perspective, CNLs assess patient care processes and outcomes by reviewing factors such as staffing, healthcare delivery models, and external factors. In essence, CNLs monitor and improve the systems that deliver patient care.
Those already working as advanced registered nurses may take an interest in becoming a CNL if they wish to apply assessment, management and leadership skills as a primary feature of their job duties. Particular focus areas a CNL may work in include care coordination, outcomes measurement and tracking, transitions of care, interprofessional communications and team leadership, risk assessment, implementation of best practices, and quality improvement.
A person may become a licensed CNL via more than one pathway. Registered nurses who already hold a bachelor of science in nursing (BSN) may enroll in a master of science in nursing (MSN) program with a CNL specialization. After successfully graduating from a CNL program, these nurses are eligible to sit for the CNL exam—those who pass become certified as CNLs.
To help RNs expand their careers, accredited clinical nurse leader programs offer a variety of benefits for aspiring CNLs. This guide provides an overview of different types of accredited CNL programs, requirements for admission, clinical supervision hours, and a sampling of accredited CNL programs.
What is a Clinical Nurse Leader Program?
The CNL degree is typically a graduate (MSN) or doctoral (DNP) nursing degree. To be admitted, CNL candidates must have, at minimum, an associate degree in nursing.
Types of CNL Degree Programs
There are three academic program pathways for nursing professionals to become CNLs. These are MSN, DNP and post-master’s certificate programs. Such programs are available in on-campus, online, and hybrid learning formats.
MSN Programs
A master of science degree in nursing (MSN) is the minimum advanced degree a nursing professional must complete to become eligible for CNL certification. Upon enrolling in an MSN program, nurses intent on becoming a CNL choose a CNL specialization track. MSN programs typically require two to three years to complete.
The Commission manages the national certification program for CNLs on Nurse Certification (CNC), an autonomous arm of the American Association of Colleges of Nursing. The CNC formally recognizes individuals who fulfill established professional standards and knowledge via the CNL certification.
DNP Programs
A doctorate of nursing practice (DNP) program prepares CNLs for advanced practice roles. Nurses wishing to establish careers in research, advanced clinical care, hospital operations and other tracks may benefit from the training and prestige associated with a DNP degree. The DNP is a terminal degree for nursing professionals. This means a nursing professional can attain no degree above and beyond the DNP. The CNL specialization is but one of some specializations that a DNP program may offer.
Regardless of specialization, many programs feature core coursework in advanced health assessment, pathophysiology, pharmacology, and evidence-based practices. Some programs feature a capstone or similar final project as part of their curriculum. These final projects allow students to demonstrate both their theoretical knowledge and tangible skills by applying their expertise to a real-world issue. DNP programs can generally be completed between two and six years.
Post-Master’s Certificate Programs
Though they may have intellectual curiosity, not all nursing professionals have the time to dedicate to pursuing a DNP degree. Thus, Such individuals may find post-master’s certificate programs a rewarding and less demanding alternative. Such programs provide nurses with another means of maintaining their existing skill set without the potentially onerous time commitment of an additional degree.
Within the nursing profession, a post-master’s certificate is generally accessible to those with an MSN, DNP, or nursing PhD. Such certificate programs will usually take one to two years to complete. In recognition of the diverse circumstances and backgrounds that nursing professionals come from, post-master’s certificate programs are often offered using different education delivery models, including in-person, hybrid and fully online options.
After completing the requisite academic training, a nurse can become certified as a CNL by passing the CNL examination. Students in their last term of a CNL education program are eligible to sit for this exam. CNL certification is available through the Association of American Colleges of Nursing (AACN). To be awarded certification, candidates must fulfill these criteria:
- RN licensure
- Graduation from a CNL master’s or post-master’s education program
- Successful completion of the CNL Certification Exam
- Candidates currently being disciplined by a state nursing board are ineligible to take the exam.
CNL Program & School Accreditation
Prospective applicants should be mindful of the two basic types of accreditation. These are programmatic and institutional.
The programmatic accreditation process assesses the rigor of an educational program within a larger college or university to ensure it meets rigorous criteria. The Commission on Collegiate Nursing Education (CCNE) vets baccalaureate, master’s, and doctoral nursing programs, whereas the Accreditation Commission for Education in Nursing (ACEN) regulates associate’s, bachelor’s, and doctoral degrees.
In contrast, institutional accreditation is the accreditation of an entire institution. The Council for Higher Education Accreditation (CHEA), a US Department of Education branch, approves seven regional institutional accrediting bodies. These regional institutional accrediting bodies are responsible for institutional accreditation within a particular geography of the United States.
When exploring online programs, it is important to check the state authorization or NC-SARA status. NC-SARA stands for National Council for State Authorization Reciprocity Agreements. NC-SARA is a private non-profit organization devoted to expanding students’ access to educational opportunities and ensuring effective regulation of distance learning programs.
Prospective students should also verify whether a program accepts students from their home state and meets licensing criteria in the states where a student intends to seek licensure after graduation. Prospective students can usually find this data on school websites or by contacting them directly.
Typical Admissions Requirements for CNL Degrees
As previously noted, to become a practicing CNL, one must complete, at minimum, a master’s degree and then pass a national certification exam. Though the specifics vary, all programs require a collection of application materials and completion of prerequisite coursework. Due to the ever-evolving nature of medical knowledge and school curricula, many programs limit how long ago a student’s prerequisite credit may have been completed and still be accepted for admission purposes.
Prerequisite courses:
- Anatomy and Physiology I and II
- Microbiology
- Nutrition
- Statistics
- Lifespan Development
- Chemistry
Application Requirements:
To gain entry into a CNL degree program, a person must complete various requirements. While application material requirements vary among programs, many feature a common set of core requirements. Admissions requirements for most CNL programs include:
- BSN from an accredited school
- Minimum GPA of 3.0
- Transcripts from all colleges/universities attended
- CV or resume
- Two professional letters of reference
- Personal essay
- Copy of current U.S. RN license
- Prerequisite coursework
Supervised Hour Requirements for CNL Degrees
CNLs must meet rigorous educational and clinical requirements to become eligible for certification. A critical element of accredited CNL degree programs is supervised clinical experience. Supervised clinical experience ensures that CNLs obtain vital hands-on experience. Such experience builds both necessary skill as well as confidence. AACN requires individuals seeking certification to have a minimum of 400 hours of supervised clinical experience.
Because state licensure requirements vary, a prospective CNL may need more than 400 hours of such experience to obtain licensure in some states. In addition, several degree programs offer a curriculum requiring students to complete more than this minimum 400 hours of clinical experience to graduate successfully.
Online MSN-CNL Programs
Sacred Heart University offers a 39-credit-hour online MSN program designed to be completed in two years. Applicants are not required to have a BSN to be admitted and can choose from one of six start dates. Students may choose one of three specializations; the CNL track is one such specialization. In addition, nurses may transfer up to nine credits of graduate work from a regionally accredited university that was completed within the prior six years.
The curriculum consists of nine courses that make up twenty-seven specialization credit hours. In these courses, students develop knowledge in pharmacology, advanced pathophysiology, communications, information management, and more. The specialization also includes 348 hours of role immersion to ensure students meet the requirements to take the AACN’s CNL Certification Exam successfully.
- Location: Fairfield, CT
- Duration: Two years
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
University of Massachusetts Amherst
The University of Massachusetts Amherst offers an online MSN with a CNL concentration. In 2023, RegisteredNurses.org ranked this program the second best among clinical nurse leader programs in the nation. This program trains graduates to provide comprehensive nursing to individuals, families, and groups. Successful graduates possess the skills necessary to lead intradisciplinary and interdisciplinary healthcare teams effectively and provide quality care across all clinical settings.
This program is designed to align with the knowledge and competencies articulated by the American Association of Colleges of Nursing (AACN) and is specifically relevant to the CNL role. This 32-credit program may be completed in two to three years.
- Location: Amherst, MA
- Duration: Two (full-time) to three (part-time) years
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
The Morningside University Nylen School of Nursing offers an MSN degree with a CNL track. This 38-credit program comprises 22 credits from master’s core classes and 16 CNL specialty course credits. Students also complete 500 clinical/practicum hours and one on-site residency. Prospective students should note that study plans can be temporary and are subject to change based on availability and enrollment.
Admission requirements include, but are not limited to, a bachelor’s degree from an accredited institution with a minimum cumulative GPA of 3.0, a valid RN license, a completed application, academic transcripts, letters of recommendation, a professional goal essay, a resume or curriculum vitae and the capacity to meet essential ability requirements as detailed on the university’s website.
- Location: Sioux City, IA
- Duration: Two (full-time) to three (part-time) years; tracks of study usually include one summer semester
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
Augusta University offers an MSN degree with a CNL concentration. This program is an accelerated graduate program and is designed for individuals with non-nursing bachelor’s degrees. The curriculum comprises 60 graduate credits and a 1,020 clinical/lab hour requirement.
Graduates of this program are eligible to take the NCLEX licensure examination for Registered Nurses (RN) and the CNL Certification exam offered by the American Association of Colleges of Nursing. The MSN-CNL program is taught on the Augusta and Athens campuses.
- Location: Augusta, GA
- Duration: Two years
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
The Montana State University College of Nursing offers a 42-credit master of nursing (MN) degree featuring distance delivery. All graduate courses are offered online with teleconference and video conferences used to supplement content.
Students are required to travel to Bozeman at the beginning of each autumn semester. The curriculum features a practice hour requirement of 405 hours, in which 315 of those hours are immersion hours within CNL practice. To graduate, students also complete a professional project. They complete this project in collaboration with a faculty chairperson and committee. Graduates are eligible to take the CNL certification examination and are urged to do so as soon as possible after graduation.
The College of Nursing accepts applications to the MN program on a rolling basis. Students accepted to the program may begin their coursework any semester. Applications are only accepted from students living in states near Montana. Precise details on admission requirements can be found on the school website.
- Location: Bozeman, MT
- Duration: Two years
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
Online DNP-CNL Programs
The Bradley University Department of Nursing seeks to shape future generations of nursing leaders. It offers a fully online MSN to DNP-Leadership program targeted to MSN credentialed nurses who graduated from an NLNAC-, ACEN- or CCNE-accredited program. Enrollment in this program also requires a current nursing license, a minimum cumulative GPA of 3.0, and an undergraduate statistics course completion.
The curriculum can typically be completed over nine semesters and features several leadership track courses as well as a DNP project (with a 300-hour clinical requirement).
- Location: Peoria, IL
- Duration: Three years
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
The University of Rochester offers two programs for nursing professionals seeking to secure a DNP. These programs are the post-BS to DNP program and the post-MS to DNP program. The post-BS to DNP program offers students the option to choose one of six specialty practice areas or to become a CNL. Students can expect to complete this program in five to six years, regardless of their chosen focus. The post-MS DNP program offers master’s degree credentialed nurses the option to complete a DNP. Part-time program students can expect to complete a DNP in three years.
The DNP program requires more than classroom-based coursework. All students must also complete at least 1,000 post-baccalaureate clinical hours to earn their DNP degree. In addition, as is typical of most such programs, students must also complete a DNP project to graduate. In this project, students design, implement, and evaluate an initiative for either improving clinical practice in their preferred setting or positively impacting health policy. Students complete these projects independently but do so while benefiting from their DNP committee’s guidance and collaborative support from practice partners and mentors.
- Location: Rochester, NY
- Duration: Three to six years, depending on existing training and pace of study
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
The University of Detroit Mercy offers a post-BSN to DNP program with a CNL major. This program provides students two options. Students may earn a master of science in nursing (MSN) with 41 credit hours and fulfillment of 300-400 hours of clinical training. Those who wish to secure a DNP with a CNL major continue their studies and complete an additional 31 credit hours over five semesters. These 31 credit hours consist of an executive leadership bridge to the DNP (6 credits) and a subsequent 25 credit hours and additional clinical hours of training.
This program trains nurses in advanced clinical knowledge, leadership skills, and systems knowledge to provide quality care and clinical leadership in all healthcare settings. Graduates may then fill roles in which they implement evidence and outcomes-based practices, develop and implement quality improvement strategies, and create and manage microsystems of care that effectively meet the diverse needs of various individuals and families. The program is based on recognition of the high demand for nurse leaders who can address contemporary challenges in an ever-evolving healthcare industry.
- Location: Detroit, MI
- Duration: Four years
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
Online CNL Graduate Certificate Programs
South Dakota State University offers an online 14-credit-hour post-graduate clinical nurse leader certificate program. The curriculum comprises three courses in microsystems approaches, health operations, and financial management, and a clinical immersion and capstone project. The program focuses on integrating the work of CNLs into various healthcare settings. The curriculum is designed to meet the national AACN requirements for certification as a clinical nurse leader.
Applicants must meet licensure, coursework, experience, and other requirements. Nurses with master’s degree-level training in nursing education, nurse administration, or clinical nurse specialist are eligible to apply.
- Location: Sioux Falls, SD
- Duration: One year
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
The University of Detroit Mercy offers an online 19-credit hour post-master’s clinical nurse leader certificate program. This program trains nurses in advanced generalist knowledge in leadership at the point of care, healthcare delivery systems, quality improvement, safety, evidence-based practice, and informatics. Among its requirements is a clinical immersion project designed in collaboration with a health system partner. Upon completing their certificate, graduates are well-equipped to function in various healthcare settings.
Upon matriculation, students devise an individualized program of study in consultation with the clinical nurse leader program coordinator/advisor. Admission generally requires demonstration of completion of coursework in advanced health assessment, advanced pathophysiology, and advanced pharmacology from an accredited master of science in nursing degree program. Students who lack this coursework background may still be admitted individually. Students need not be a resident of Michigan to enroll in the program.
- Location: Detroit, MI
- Duration: 12 to 18 months
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
Saint Xavier University, designated as a Center of Excellence (COE) in nursing education, offers a post-master’s clinical nurse leader certificate program. Each applicant is reviewed individually to determine which courses are necessary for the certificate. A student’s study plan is also crafted individually and incorporates a gap analysis to guide the formulation of an appropriate study plan.
Required core courses include epidemiology and population-based health care, advanced pharmacology, advanced pathophysiology, and advanced health assessment. Students also complete four practicum courses for 450 nursing practicum hours. Graduates of this program are eligible to take the CNL certification exam.
- Location: Chicago, IL
- Duration: Contact the program for an assessment
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
Bernd Geels
WriterBernd Geels is a Berlin, Germany-based freelance writer and artist. He holds an undergraduate degree in atmospheric science and two graduate degrees. He completed his most recent graduate degree in international environmental studies at the Monterey Institute of International Studies in 2011. He is interested in healthcare, climate change, marine conservation, indigenous science and refugee issues. You can reach him directly at [email protected].