What is a Clinical Nurse Specialist vs Nurse Practitioner?

Suppose you have a post-graduate education in nursing. In that case, you may well be seeking career progression as an Advanced Practice Registered Nurse, which means you might be asking yourself, 'what is a clinical nurse specialist vs nurse practitioner?'.

These internationally used job terms usually rely on broadly similar medical training, including that you have reached at least a Masters level in your nursing education. However, there are subtle but significant differences between the practical day to day activities of a clinical nurse specialist and a nurse practitioner.

You may see vacancies advertised as Clinical Nurse Specialist (CNS) or Nurse Practitioner (NP). However, there is also liberal use of the job titles Advanced Clinical Practice Nurse (ACPN) and Advanced Practice Registered Nurse (APRN). The Royal College of Nursing in the UK supports the use of the title Advanced Nurse Practitioners (ANP) but acknowledges that this is often shortened to NP.

This all helps to blur the usage and definitions of the different roles.

Confusion about the difference between a CNS and NP is also understandable because these are relatively new categories of nursing. They are evolving fast to demand healthcare services and efforts to make health services more efficient and structured.

You will find different countries – and possibly even various health authorities - use the terms to mean different things! Though some countries are finding ways to regulate and clarify nursing job roles.

There are often little or no differences in pay scales for these different categories of advanced nurse practice. These factors make it more a matter of professional preference which type of vacancy you apply for.

This article explores the fundamental similarities and the most often applied differences in these jobs. The aim is to help you to know which one best suits your experience to date and your career aims. That can also enable you to apply for confidence when clinical nurse specialist and nurse practitioner vacancies are available at a nursing locum agency.

Shared features of what is a clinical nurse specialist vs nurse practitioner

As mentioned above, both these types of job roles come under the umbrella term of Advanced Practice Nursing.

Beyond that, the most significant thing these two career paths have in common is that they were developed to provide direct care to patients at a significantly higher level of competence than traditional nursing positions.

Also, direct care is sometimes combined with managing teams, disseminating good practice, and developing a specific set of specialist skills.

What is a Nurse Practitioner?

The World Health Organisation (WHO) published a ‘State of the World's Nursing’ Report in 2020 that refers to 78 countries supporting advanced nursing roles in their healthcare systems. Most commonly, ‘Nurse Practitioner’(NP).

The most universally accepted definition of the role of an NP is to provide direct patient care with active involvement in diagnosis and treatment. They also have the qualifications and authority to dispense prescriptions for medications.

This would require them to have a generalist skillset. In some countries, an Advanced Nurse Practitioner would be expected to provide levels of care that doctors have more traditionally provided. To be clear, they do not work as a replacement for qualified physicians but do fulfil some of their roles and responsibilities.

How does this impact NHS jobs? An APN in Britain would be expected to support doctors in delivering care quality and service efficiency while safeguarding patient safety. The NHS developed the role to ease the burden on frontline doctors in general practice.

The International Council of Nurses (ICN) has taken the lead in standardising and structuring differences between NPs and APNs roles to iron out some of the ambiguities and lack of regulation. For this purpose, the ICN published a ‘Guideline on Advanced Practice Nursing’ in 2020.

What does a Clinical Nurse Specialist do?

A CNS would not be as emersed in the general management of health conditions, though they would still be working directly with patients. Instead, as the job title implies, their focus would be on one particular specialist area.

This specialism does not necessarily mean one particular medical area – such as diabetes or paediatric health. A CNS could be recruited to help a healthcare provider with one discrete aspect of all patient diagnosis, treatment and care.

To be eligible for a CNS vacancy like this, you would need to demonstrate high-level skills and strong decision-making capabilities relevant to a particular client group, aspect of healthcare delivery or clinical speciality.

There is also an increased likelihood that CNS jobs would entail non-clinical activities. These could include managing staff, delivering education and development programmes, or taking part in medical research.

The concept of focusing a nurse specialist on a particular health field, or administrative and research activities, has actually been around since the 1930s. (The NP and ANP role is more recent in its origins.)

Activities a CNS provides that are the same as an NP include physical examinations and taking histories, using diagnostic techniques to make assessments and devising care and treatment plans that include issuing prescriptions.

According to a report in the British Journal of Nursing: “One study on educational curricula indicated that the CNS's goals of care were specialised and nursing-based, whereas the goals of the ANP were broader and medically based.”

The same report concludes that: “Overall, the evidence suggests that both roles are effective (Donald et al, 2013; Tsichristas et al, 2015) despite the ambiguities.”

Where can you find Locum Nursing jobs for a Clinical Nurse Specialist or a Nurse Practitioner?

Both clinical nurse specialist and nurse practitioner vacancies are regularly advertised in many clinical specialities. However, most NP and ANP roles are within General Practice.

Now you have a better understanding of “What is a clinical nurse specialist vs nurse practitioner?”, the best place to start looking for jobs in any category of advanced nursing practice is our website and its nursing job guide.

Working with private and public sector healthcare providers internationally and offering NHS jobs UK – we always clarify any ambiguity to provide candidates with a transparent and well-defined job role.

Additional article sources: https://blogs.bmj.com/ebn/2020/07/05/clinical-nurse-specialist-cns-nurse-practitioner-np-advanced-clinical-practice-nurse-acpn-or-advanced-practice-registered-nurse-aprn-whats-in-a-title-the-icn-guidelines-on-advance/ https://www.magonlinelibrary.com/doi/full/10.12968/bjon.2019.28.20.1308 https://www.advancedpractice.scot.nhs.uk/uk-progress/specialist-and-advanced-practice.aspx