Clinical nurse specialists and nurse practitioners are registered nurses (RNs) who fall within the category of advanced practice nurses. These are health care professionals that have a wider scope of nursing knowledge, education and skills than the average RN. Despite some differences, they both enjoy some of the highest salaries in the nursing field.
A clinical nursing specialist is trained as a clinician, meaning that they focus on a specialty—examples being acute care, community health, oncology and pediatrics—to assess, diagnose and treat diseases and injuries. This enables them to work in a wide range of medical environments, which include emergency and operating rooms.
A nurse practitioner is more focused on primary care, which means that they act as the initial point of contact in a medical facility and tend to more common health problems. Thus their assessment skills are not as focused as that of clinical nurse specialists. Like their advanced nursing counterparts, nurse practitioners adhere to specialty areas.
Clinical nurse specialists and nurse practitioners can be mostly found in hospitals and nursing clinics. Other major employers include physicians' offices and long-term care facilities. In places such as physicians' offices, they normally work the traditional 40-hour work week. However, in places that demand around-the-clock care, such as hospitals, they can work longer, irregular hours that may include night, weekend or holiday shifts.
RNs generally have an associate and/or bachelor's degree in nursing, plus obtain a license to practice nursing by passing the NCLEX-RN (National Council Licensure Examination-Registered Nursing). However, clinical nurse specialists and nurse practitioners are required to get a master's degree as well, and they can also choose to pursue a Ph.D. for positions in academia and advanced research. Organizations such as the American Nurses Association—through its American Nurses Credentialing Center subsidiary—offer credentialing in certain specialty areas.
According to salary.com, as of July 2010 the median annual salary for clinical nurse specialists was around $86,000, while that of nurse practitioners was around $87,000. By comparison, the median annual salary of RNs in general is around $65,000.
According to the U.S. Bureau of Labor Statistics, the job outlook for clinical nurse specialists and nurse practitioners—as part of the general RN population—is excellent. The agency expects a 22 percent boost in employment between 2008 and 2018, which is a much faster rate than the U.S. workforce in general.
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