Adult-Gerontological Clinical Nurse Specialist

Female nurse smiling in hospital




Clinical Nurse Specialists are licensed registered nurses who have masters or doctoral preparation in nursing. 

In general, CNSs are expert clinicians in a specialized area of nursing practice. The specialty may be identified in terms of a:

  • Population (e.g. adult, geriatrics)
  • Setting (e.g. critical care, emergency room)
  • Disease or Medical Subspecialty (e.g. diabetes, orthopedics)
  • Type of care (e.g. psychiatric, palliative)
  • Type of problem (e.g. pain, wounds)

Adult-Gerontological Clinical Nurse Specialist Program Information

The CNS Program at USA focuses on the specialty of Adult Gerontology only.  All CNS courses are online and students from most states are able to complete both didactic and clinical courses in their primary state of residence. Students take didactic courses in the comfort of their own home and arrange clinicals in their local communities or geographical regions. The clinical preceptors will have to meet specific criteria (see criteria in the preceptor selection section below).Throughout the three semester clinical component, students are required to complete a total of 540 clinical hours in either the acute care or the critical care setting with some hours designated in emergency/urgent care.

▼   NP Clinical Skills Intensive

All students in the Adult-Geron Clinical Nurse Specialist track are required to attend a mandatory Clinical Skills Intensive Orientation on the USA campus during the fall term in which they are registered for NU 515 and AHN 516. Students have the opportunity to request their preferred session on a first come, first serve basis through the simulation department after the request is sent out during the spring term.  Various clinical skills workshops will be held during the orientation. 

Please note the dates listed are for Simulation Intensives only. The coordinator for each specialty track will provide full orientation dates:

Adult-Geron CNS Clinical Skills Intensive Session Dates:

  • November 1 – 2, 2021 (M/T)

The Clinical Skills Intensive will take place at USA College of Nursing. You will receive more information as the date approaches via your JAG e-mail. Please make plans to attend.

▼   Clinical Nurse Specialist Curriculum

BSN-MSN students complete all support, MSN core, and MSN specialty courses for a total of 38 credit hours.  The MSN degree must be completed within five years of matriculation.

Support Courses
NU 518 - Advanced Nursing Assessment 3 credit hours
NU 545 - Physio-pathological Basis of Advanced Nursing 3 credit hours
NU 578 - Pharmacology for Advanced Practice Nurses 3 credit hours
MSN Core Courses
NU 607 - Scientific Underpinnings of Advanced Nursing Practice 3 credit hours
NU 608 - Evidence-Based Practice and Quality Improvement in Healthcare 3 credit hours
NU 610 - Healthcare Policy and Finance 3 credit hours
NU 613 - Organizational & Systems Leadership 3 credit hours
Adult-Gerontological CNS Specialty Courses
NU 515 - Clinical Concepts & CNS Role I 2 credit hours
AHN 516 - CNS Adult-Geron Practicum I - 180 Clinical Hours 3 credit hours
NU 516 - Clinical Concepts & CNS Role II 3 credit hours
AHN 517 - CNS Adult-Geron Practicum II - 180 Clinical Hours 3 credit hours
NU 517 - Clinical Concepts & CNS Role III 3 credit hours
AHN 518 -CNS Adult-Geron Practicum III - 180 Clinical Hours 3 credit hours
AHN 519 - Diagnostic Reasoning & Advanced Practice Management CNS - 60 Clinical Hours - ELECTIVE (4 credit hours)
RN to MSN students who are registered nurses with a bachelor’s degree from an accredited institution in a non-nursing discipline must also complete the following courses.
RN-MSN Courses
NU 404 - Evidence Based Practice & Informatics 3 credit hours
NU 450 - Leadership & Management Roles for Professional Nursing Practice 4 credit hours
NU 452 - Clinical Prevention and Population Health 4 credit hours
▼   More Information on the CNS

If you are interested in the CNS specialty option, there are two things you need to investigate and consider:

  1. The availability of CNS preceptors and CNS jobs within your community as you are responsible for identifying, along with faculty, appropriate CNS preceptors.
  2. The role of the CNS in the state that you plan to work. Each state has different regulations and you should be familiar with them prior to starting the CNS program.

CNSs may practice in a variety of healthcare settings (primary, secondary, and tertiary). CNSs not only provide direct patient care, but they also exert a significant influence on care outcomes by consulting with nursing staffs and by implementing improvements in healthcare delivery systems.

CNS practice is conceptualized across three spheres in which the CNS exerts influence:

  • Patients/clients
  • Nursing standards and nursing personnel
  • Systems

One of the hallmarks of CNS practice is advanced specialization within nursing. Further, the advanced specialization is a narrowing and deepening of focus of the autonomous practice of nursing as defined and protected by RN licensure in each state. A critical attribute of all CNSs, regardless of specialty, is that they possess advanced knowledge of both the basic science and the nursing science underpinning the specialty. The CNS applies that knowledge to the assessment and diagnosis of illness, defined as the subjective experience of discomfort (ANA, 2004, p. 48).

Additionally, the following are examples of how the CNS applies that knowledge in advanced practice competencies:

  • Deliver, design, and test nursing interventions to prevent, lessen, or alleviate illness experiences
  • Assure patient safety
  • Improve the quality of nursing care
  • Perform systems analyses
  • Conduct cost-benefit analyses
  • Advance evidence-based nursing practice

Traditionally, professional assessment of CNS core and/or specialty knowledge and skills has been conducted through the use of national examinations with evidence of sound psychometric properties. However, alternative mechanisms exist to create additional strategies for professional validation with equivalent psychometric soundness. National Association of Clinical Nurse Specialist (NACNS) states that verification of CNS knowledge and competencies requires three (3) multilevel indicators:

  1. Education: The CNS must graduate from nationally accredited masters or doctoral program that provides entry-level knowledge and competencies in a specialty area of CNS practice. All CNS education programs must provide a broad based foundation of advanced knowledge, as well as specialty knowledge.
  2. Validation of core CNS knowledge and competencies: Core CNS knowledge and competencies are validated with a psychometrically sound and legally defensible assessment method. This may be accomplished through examination or other psychometrically sound and legally defensible assessment methods.
  3. Validation of CNS specialty practice knowledge and competencies: Validation of the additional knowledge and competencies in the specialty practice is needed. This may be accomplished through specialty examination or other psychometrically sound and legally defensible assessment methods, such as a portfolio process administered by a testing service, like ANCC, and reported to State Boards of Nursing, like current exam scores are reported (ANA/Black, 2004).

Our curriculum is based on the American Nurses’ Credentialing Center’s (ANCC) and the American Association of Critical-care Nurses (AACN) requirements for CNS certification. Please be aware that other organizations have different requirements for certification that this program may not meet. Please visit the ANCC and AACN web sites to investigate your opportunities with regard to certification.

▼   Clinical Nurse Specialist Core Competencies

NACNS has published a Statement on Clinical Nurses Specialist Practice and Education (2nd E) (2004) in which core CNS competencies are listed. (Statement on Clinical Nurse Specialist Practice and Education, pages 25-26).The core competencies are summarized/paraphrased below and can be found on pages 25-26 of the publication.

  1. Use knowledge of illness and treatments in order to prevent or alleviate illness.
  2. Design, implement, and evaluate innovative programs of care to achieve desired quality, cost-effective nurse-sensitive outcomes.
  3. Serve as a leader, consultant, or mentor in advancing nursing practice to achieve outcomes among nursing personnel and within an organization.
  4. Use evidence based practice to direct care and improve outcomes.
  5. Lead multidisciplinary teams to collaborate and attain outcomes across continuum of care.
  6. Manage resources and provide leadership in a system to support the delivery of nursing care.
  7. Generate nursing knowledge to maintain expert clinical competencies for desired outcomes.
  8. Demonstrate fiscal responsibility in a healthcare system by focusing on health policy, resource management, and cost effective outcomes of nursing care.
▼   Clinical Hours

There are 540 clinical hours within the curriculum over three semesters. You will work with CNS preceptors to experience the seven competencies of the CNS within the three spheres of influence (patient, nurse, system). The roles of your clinical preceptor will reflect the objective of the clinical experience. The seven competencies that you will be expected to focus clinical experiences around include:

  • Direct Care
  • Consultation
  • Systems Leadership
  • Collaboration
  • Coaching
  • Research
  • Ethical Decision-making/Moral Agency/Advocacy


Please feel free to contact Dr. Chondra Butler for more information about this specialty: