Clinical nurse consultant (CNC) is a term used primarily in Australia for master's
prepared registered nurses. Some CNCs may hold a doctorate. Like their counterparts
in the US, CNCs have extensive and highly specialized knowledge which they may use
in direct patient care, in education or in systems improvement.
Advanced Practice Nurses
APRNs developed out of a need to expand nurses' practice into areas previously
considered the practice of medicine. The first APRNs were nurse anesthetists - now
called certified registered nurse anesthetists (CRNAs) - who provided anesthesia
care under the supervision of the surgeon. This specialty began during the American
Civil War. Certified nurse midwives (CNMs) were first officially certified in 1925.
Nurse practitioners (NPs), who provide primary and specialty care to patients of all
ages, became common in the 1960s. Clinical nurse specialists (CNSs) first appeared in
the 1950s and originally practiced in the field of psychiatric nursing, eventually
spreading into all other nursing fields.
How CNCs are Different
APRNs in the US have an expanded role that includes prescribing medications and
treatments, as well as ordering diagnostic studies. In many states, they practice
independently, without physician oversight. Although the term "clinical nurse consultant"
is occasionally used in the US, it does not necessarily equate to "advanced practice nurse"
and the job descriptions and qualifications are different from those in Australia. The
CNC role in Australia was originally modeled on the clinical nurse specialist role in
the US. The idea was to create a career track for nurses who wished to remain at the
bedside while being recognized for their advanced education and expertise.
The Clinical Nurse Consultant vs the Clinical Nurse Specialist
Of all the APRN roles, the CNC is most like the CNS role. CNCs in Australia typically
specialize in one of five areas: clinical service and consultancy; clinical leadership;
research; education, and clinical service planning. In the US, the role of the CNS is
similar. Either type of APRN may specialize in a particular area of care, such as pediatric
or adult medicine. Some specialize in a work setting, such as intensive care or the emergency
room. Others specialize in diseases such as diabetes or heart disease, or in a group of
conditions such as psychiatric problems. CNCs may also work with organizations to improve
systems of care or overall healthcare quality.
Licensing and Certification
In the US, a registered nurse must complete a two- to four-year program of education
and pass a national licensing exam. APRNs are required to hold a master's degree in
nursing and there is a strong push among professional organizations for APRNs to require
a doctorate, especially for CRNAs. To become an APRN, the nurse must also pass a second
licensing examination. The APRN license authorizes a different scope of practice above
and beyond that of the registered nurse. Most states also require APRNs to be certified
in their area of practice. In Australia, the CNC holds the same license as other registered
nurses, but is required to have a minimum of five years of practice in a particular field
as well as post-licensing qualifications. Although a master's degree is not required for
practice as in the US, many CNCs in Australia are educated to a similar level or beyond.
Salaries for CNCs
APRNs are the highest-paid of registered nurses in the US, with the possible exception
of the most senior nurses in healthcare management positions for large healthcare systems.
For example, in 2016, the median wage for APRNs in the US was $107,460, according to the
US Bureau of Labor Statistics. CRNAs, the highest paid group of APRNs, had a salary range
of $107,960 to $189,880. In some states, CRNAs earned over $200,000 annually. Australia
does not break out salaries within the registered nurse group that included CNCs, but
data from Indeed indicates a salary range for CNCs of $107,804 to $117,037 in 2017.
Both figures are expressed in US dollars.
Nurses are an integral part of any healthcare system and the backbone of the hospital
industry. While all nurses contribute to the health and well-being of their patients,
APRNs like CNCs and clinical nurse specialists have a specialized role to play. The job
is demanding but also rewarding for the individual who aspires to become a nurse "with
a little extra."