The emerging role of the Clinical Nurse Leader (CNL) shows tremendous promise in redesigning the way health care is delivered to patients.
“What is so exciting about the role of the Clinical Nurse Leader is that it puts the decision making in the hands of people intimately aware and involved in how care is actually delivered to patients,” said Assistant Professor at Florida Atlantic University, Terry Eggenberger, PhD, RN, CNE, CNL, NEA-BC.
The CNL is a role developed in 2003 by the American Association of Colleges of Nursing (AACN) with the goal of decreasing fragmentation in the ever-changing landscape of healthcare.
“The goal was to improve patient outcomes by putting the whole picture together for patients, families, and the healthcare team,” said Joan Stanley, PFH, CRNP, FAAN, Senior Director of Education Policy at the AACN. “Although the educational level is very similar to a Clinical Nurse Specialist, unlike a CNS, they do not specialize in a certain patient population, but work as a generalist to care for patients and staff within a given unit or healthcare setting.”
According to Stanley, the AACN met extensively with nursing leaders as well as a wide array of licensed healthcare providers and administrators to develop the competencies for the CNL.
“What we wanted to know was where they felt there were gaps in patient care that were not only effecting patients but also the bottom line of the hospitals,” Stanley said. “The answers all centered around quality, patient safety, and risk. “
Prepared at the master’s level, and then certified after passing a CNL exam, this nurse is a highly skilled clinician who focuses on outcomes-based practice and quality improvement. As the role of the CNL is new and evolving, there is tremendous opportunity to influence the specialty, according to Stanley.
“The nurse who would excel in this role is one who is ready to take the next step in leadership but does not necessarily want to move away from the bedside and into administration,” Stanley said. “It is a nurse who is able to see how quality initiatives and outcome-based practice really can benefit patients on a very micro level.”
According to Eggenberger, CNLs are quickly proving their worth. There are roughly 4,750 practicing today and according to the AACN they are having a measurable impact on the quality of nursing services in the following ways:
- Improved care delivery and improved safety (i.e. falls, pressure ulcers, discharge planning, and high risk patients for readmission).
- Cost-effective problem solving, process improvement, risk assessment, and the reduction of waste.
- Increased Joint Commission readiness
- Magnet recognition initiatives
- Improved staff satisfaction and decreased turnover.
“There has always been the understanding that nurses have to be caring. But to truly advance the profession forward competence needs to be equally important. The CNL is the perfect blend of competence and caring and ideally serves as role model for all nurses,” Eggenberger said.
The challenge for CNL’s in the future is to continue to quantify the value of their practice, she said.
“We need to increasingly publicize our role to physicians and health care providers,” said Eggenberger. “Spreading the benefits of this role and what it brings to all systems of care will increase the number of hospitals and settings the CNL role is being incorporated.”
TO BECOME A CNL
Bachelor of Science in Nursing (BSN)
National Council Licensure Examination (NCLEX-RN)
You can start working as a Registered Nurse.
Master of Science in Nursing (MSN)
You’ll take advanced courses in pathophysiology, clinical assessment and pharmacology.
Clinical Nurse Leader certification exam from the Commission on Nurse Certifications.
Clinical Nurse Leader