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Adult-Gerontology and Pediatric Clinical Nurse Specialist

School DNP Application Deadline

November 1 (for early acceptance) and March 1

*Applications to the MU Graduate School are due at least 10 business days prior to the school's application deadline.

What does a Clinical Nurse Specialist do?

Clinical nurse specialists (CNSs) are licensed professional nurses with graduate preparation (master's, post-master's, or doctorate (e.g. DNP)) from a CNS program. CNSs are expert clinicians in a specialized area of nursing practice. The specialty may be identified in terms of population (e.g. pediatric or adult), setting (e.g. critical care unit, operating room, emergency department), disease or medical sub-specialty (e.g. diabetes, oncology, psychiatry), type of care (e.g. rehabilitation, end-of-life), or type of problem (e.g. pain, wound management, stress) (NACNS, 2004). A CNS may be unit-based or have agency-wide responsibilities for a patient population. CNSs are clinical experts in the diagnosis and treatment of illness, and delivery of evidence-based nursing interventions (ANA, 2004). Additionally, CNSs are experts in executing delegated medical regimes associated with the diagnosis and treatment of disease for a specialty population. The CNS has a unique APRN role to integrate care across the continuum and through three spheres of influence: direct patient/client care, nurses & nursing practice, and systems and organizations (APRN Joint Dialogue Group, 2008). Thus, in addition to direct patient/client care, key elements of CNS practice are to create environments through mentoring and system changes that empower nurses to develop caring, evidence-based practices. Accordingly, CNSs are often involved in developing staff education as well as safety and quality improvement activities.

Who should apply?

Individuals with a baccalaureate degree in nursing who want to:

  • Provide advanced practice nursing care to adults or children with complex health problems across the continuum of care
  • Become clinical experts in the diagnosis and treatment of illness and the delivery of evidence-based nursing interventions for a specialty population
  • Empower other nurses to advance their nursing practices and improve patient outcomes
  • Develop the knowledge, skills, and clinical expertise to effect system-wide changes to improve programs of care

Career opportunities

  • Clinical nurse specialist in acute care, critical care, rehabilitation, long-term care and community-based health care settings
  • Case manager in pediatric and adult inpatient and outpatient settings
  • Care coordinator of healthcare services for people in rehabilitation centers, long-term care facilities, residential care facilities, outpatient clinics, and home health agencies
  • Trauma coordinator for a trauma center
  • Transplant coordinator in a hospital or for a regional organ donor network
  • Director of a parish nursing program
  • Director of a hospice program
  • Director or staff development coordinator in acute care, long-term care, public health, and home health agencies
  • Consultant for hospitals, rehabilitation centers, long-term care facilities, home health agencies, schools, or day care centers
  • Research coordinator in a variety of healthcare settings
  • Quality improvement coordinator or Outcomes manager in a variety of healthcare settings
  • Clinical instructor in a School of Nursing

The curricula

The DNP curricula includes theoretical courses and clinical practica to provide the necessary knowledge and skills to function in the advanced practice nursing role of clinical nurse specialist. The DNP curriculum is based on recommendations by the American Association of Colleges of Nursing in The Essentials of Doctoral Education for Advanced Nursing Practice (2006). CNS specialty focused content is based upon recommendations developed by the National Association of Clinical Nurse Specialists in Statement on Clinical Nurse Specialist Practice and Education (1998, 2004), the American Association of Critical Care Nurses in Scope of Practice and Standards of Professional Performance for the Acute and Critical Care Clinical Nurse Specialist (2002), as well as the Core Practice Doctorate Clinical Nurse Specialist (CNS) Competencies (2009) and Adult-Gerontology Clinical Nurse Specialist Competencies (2010). In addition, the pediatric CNS specialty is informed by American Nurses Association Pediatric Scope and Standards of Practice (2008). Specifically, the curricula provide not only core knowledge in theory, research, evidence-based practice, health care policy, financing, ethics and sociocultural issues, but also advanced practice knowledge in physiology/pathophysiology, physical assessment and diagnostic reasoning, pharmacology, population health, and role development. CNS specialty courses focus on diagnosis and treatment of acute, critical, and chronic illnesses across the continuum of care; improvement and monitoring of quality, safety, and performance outcomes, and teaching clients symptom and self-management strategies.

Students must select a population of interest (adult or pediatric). Sample DNP Programs of Study for Pediatric and Adult-Gerontology CNS roles can be found on the right hand side of this webpage in the tan box labeled "DNP Plans of Study."

Classroom and clinical experiences are designed to meet the CNS Core Competencies as identified by the NACNS (2004). In addition to the core content and based on the student's specialty area of interest, the program of study can be individualized to meet the student's personal career goals. Clinical practica settings, which are student-selected, include outpatient clinics, hospitals, rehabilitation centers, long-term care facilities, home health agencies, hospice programs, schools, public health agencies, and state agencies. Students also may have clinical experiences with urban or rural, underserved populations.

All courses are offered in a distance-mediated format. An on-campus visit is required for five days during the summer before coursework begins for orientation to the DNP program. Additional campus visits will be required for clinical courses.

Frequently asked questions

For what certification would I be eligible?

Graduates of the DNP program in the Clinical Nurse Specialist area of study will be eligible for advanced practice nurse certification as a Clinical Nurse Specialist by the American Nurses Credentialing Center in Adult Health (formerly know as medical-surgical) or Pediatrics.

Advanced practice nurse certification also is available through some specialty organizations such as the American Association for Critical Care Nurses (AACN) Certification Corporation, Oncology Nursing Certification Corporation (ONCC), Rehabilitation Nursing Certification Board, or the National Board for Certification of Hospice and Palliative Nurses (NBPHCN). Potential students interested in obtaining specialty certification are responsible for checking with their specialty organization to determine eligibility requirements for taking the Clinical Nurse Specialist exam. Potential students also are advised to contact their state board of nursing to determine which national certifying bodies are acceptable in their state. 

Who is eligible to be my preceptor?

Preceptors must be approved by the course faculty. Students may not begin clinical hours until the preceptor's credentials have been verified. See information on the Sinclair School of Nursing Preceptor Policy.

What type of clinical sites do I need?

Clinical sites are approved by the course faculty and may be at a location near your home. Students may not begin clinical hours until the Clinical Agency Agreement is in place. See information on the Sinclair School of Nursing Clinical Practica web page regarding Clinical Agency Agreements.

Students are advised to inquire about any additional drug testing, mandatory training, immunizations or compliance paperwork that may be required by a potential clinical agency before the student pursues an agreement or begins clinical hours.

Specific clinical site requirements needed to meet the objectives for each course are described below.

Adult-Gerontology CNS Students:

N7140 Advanced Health Assessment and Promotion - This course involves 90 hours of clinical which can be divided into 60 hours in a primary care setting and 30 hours in a specialty care setting. Since this course has a lifespan focus, you need to be able to assess patients with a variety of illnesses and ranging from children to older adults. A family practice clinic setting would be ideal. For the remaining 30 hours, CNS students can be in a specialty clinic in which one body system is the focus (e.g. cardiology, neurology, orthopedics, etc.) in the population (adult or pediatric) of their choice.

N8400 Management of Adult & Geriatric Primary Care 1- This course involve 90 hours of clinical. Since the focus of the course is primary care management of chronic illness, including acute exacerbations, outpatient clinic or urgent care settings would be ideal. The setting can be specialty specific (e.g. wound/ostomy, neurology, palliative care, etc.) or more general (e.g. family practice, geriatric, internal medicine, etc.) depending upon the student's career goals.

N8410 Management of Adult & Geriatric Primary Care 2- This course involves 90 hours of clinical and is only required for Adult Health CNS students in the DNP program. Since the focus of the course is primary care management of chronic illness, including acute exacerbations, outpatient clinic or urgent care settings would be ideal. Again, the setting can be specialty specific (e.g. wound/ostomy, neurology, palliative care, etc.) or more general (e.g. family practice, geriatric, internal medicine, etc.).

Pediatric CNS Students:

N7310 Advanced Health Assessment for Pediatric Nursing Practice - This course involves 90 hours of clinical which can be divided into 60 hours in a pediatric primary care setting and 30 hours in a pediatric specialty care setting. Since this course has a lifespan focus for the 60 hours of pediatric primary care, you need to be able to assess children that are healthy and those with a variety of illnesses ranging from newborn through adolescents. A primary care pediatric clinic setting would be ideal. For the remaining 30 hours, CNS students can be in a pediatric specialty clinic or acute care setting in which one body system is the focus (e.g. cardiology, neurology, orthopedics, etc.).

N8210 Special Healthcare Needs of Children in the School Setting - This course involves 90 hours of clinical. Eighty hours (80) of the clinical is to be spent with a pediatric health care provider in a pediatric specialty clinic setting (e.g. asthma, diabetes, oncology, neurodevelopmental, cardiac, etc.). The remaining clinical time will be spent working with a child and their family who have special healthcare needs.

N8420 Newborn through Adolescence Primary Care - This course involves 90 hours of clinical. Since the focus of the course is primary care management of chronic illness, including acute exacerbations, pediatric outpatient clinic or pediatric urgent care settings would be ideal. The setting can be specialty specific (e.g. wound/ostomy, neurology, palliative care, etc.) or more general (e.g. pediatric primary care, school health, teen clinic, pediatric urgent care, etc.) depending upon the student's career goals.

All CNS Students (MS, Post-MS, & DNP Programs):

N8710 Clinical Management of Acute & Critical Care Problems-- This course involves 90 hours of clinical which needs to occur in an acute and/or critical care setting with the population (adult or pediatric) of their choice. The setting can be specialty specific (e.g. cardiovascular ICU, pediatric oncology unit, etc.) or more general (e.g. general medical or general surgical unit) depending upon the student's personal career goals. An outpatient clinic or rehabilitation center would not be appropriate for this course.

N8720 Symptom Management of Acute and Chronic Illness - This course involves 90 hours of clinical which can occur in a variety of healthcare settings (e.g. inpatient, outpatient, rehabilitation, etc.) with the population (adult or pediatric) of their choice depending upon the student's personal career goals. Since the focus of the course is teaching clients symptom and self-management strategies, clinical settings that emphasize patient and nursing staff education would be ideal. Again, the setting can be specialty specific (e.g. inpatient pain management service, outpatient cardiac rehabilitation, pediatric diabetes clinic, etc.) or more general (e.g. general medical or general surgical unit).

N8920 Quality, Safety, & Performance Outcomes- This course involves 60 hours of clinical which can occur in a variety of healthcare settings (e.g. inpatient, outpatient, rehabilitation, etc.) with the population (adult or pediatric) of their choice depending upon the student's personal career goals. Since the focus of the course is improving patient outcomes, the clinical setting needs to allow the student to actively participate in and be a part of a clinically relevant quality, safety, or performance improvement project. A setting in which the student only does direct patient care or staff development would not be appropriate.

CNS Students in MS & Post-MS Programs:

N8980 Advanced Clinical Nursing Practicum: CNS Section-- This course involves 300 hours of clinical which can occur in a variety of healthcare settings (e.g. emergency department, inpatient, outpatient, rehabilitation, etc.) with the population (adult or pediatric) of their choice depending upon the student's personal career goals. A student may opt to do all 300 hours at one clinical site or divide their hours between two or three settings. Clinical settings for the final practicum need to provide the student with the opportunity to develop and refine CNS competencies in all three spheres of influence.

CNS Students in DNP Program:

N8540 Advanced Diagnostics & Reasoning: This course involves 90 clinical hours and is designed to allow the student to expand upon knowledge of advanced assessment, diagnostics, and procedural skills as well as gain increasing specialty-specific knowledge. Clinical settings that permit the student to refine interpretation of advanced assessment and diagnostic skills and perform advanced clinical procedures would be ideal. Depending upon the student's personal career goals, the clinical can occur in an acute or critical care setting or in an outpatient specialty clinic in their population (adult or pediatric) and specialty of interest. A setting in which the student only does patient education, staff development, or performance improvement projects would not be appropriate.

N9070 DNP Clinical Residency: The number of clinical hours for this course varies (240-330 clinical hours) depending upon the student's number of prior faculty supervised advanced practice clinical hours. The clinical hours can occur in a variety of healthcare settings (e.g. emergency department, inpatient, outpatient, rehabilitation, etc.) working with their population (adult or pediatric) and specialty of interest. The DNP Clinical Residency is designed to be intricately related to the DNP Residency Project, and, as such, the vast majority of the clinical hours for this course need to be in the same clinical site where the project will occur. Settings for the DNP Clinical residency need to provide the student with the opportunity to refine clinical knowledge and leadership skills necessary to evaluate practice problems, monitor outcomes, and implement innovative models of care in preparation for and as part of the DNP Residency Project.

N9080 DNP Residency Project: This course involves 180 clinical hours which can occur in a variety of healthcare settings (e.g. emergency department, inpatient, outpatient, rehabilitation, etc.) working on an in-depth practice-change project that will impact their population (adult or pediatric) and specialty of interest. A student must do all 180 hours at one clinical site. Clinical settings for the residency project need to provide the student with the opportunity to impact a rural or underserved population or critical healthcare system need.

For other general questions about the DNP in nursing program, see the FAQs for DNP Students.


Who can I contact if I have specific questions about the DNP programs or the application process?

Specific questions about the DNP programs or about applying to the DNP programs can be answered by the staff in the Office of Student Affairs in the Sinclair School of Nursing. You may contact the Office of Student Affairs via telephone at 573-882-0277 or 800-437-4339.

Who can I contact if I have specific questions about the Adult or Pediatric CNS program?

Specific questions about the Adult-Gerontology or Pediatric CNS program can be answered by contact Carolyn Crumley, DNP, RN, ACNS-BC, WOCN, the Coordinator of the CNS area of study. You may contact Dr. Crumley via email at crumleyc@missouri.edu.