Women’s Health Clinical Nurse Specialists work primarily with women across the continuum of care, from adolescence to the childbearing years, including the prenatal period, the birthing process and the postpartum period, and all the way to menopause and beyond.
These advanced practice nurses are experts in providing support and consultation through primary care services for women and their families, and oversee the nursing staff that provide women with bedside care before, during and after surgery or other procedures. They also assume roles in research, leadership, and consultation, where they drive change from the clinical environment outward into the healthcare organizations in which they practice. Rather than a top down approach coming from the executive level, clinical nurse specialists work to influence both practice and policy from within.
Women’s Health CNSs most often use their skills and expertise in hospitals and other inpatient settings like maternity units, serving as nurse managers, outreach directors, clinical educators, and staff developers.
The Women’s Health CNS: An Evolving Specialty
Unlike other APRN roles and specialties, to date, there is no specific national certification for the Women’s Health CNS. Therefore, graduate programs of study unique to this APRN role and population focus are based on the National CNS Core Competencies by the National Association of Clinical Nurse Specialists (NACNS). The competencies outlined in this document are designed to serve as the basis for future national certification.
According to the NACNS, “The Women’s Health CNS provides advanced direct and indirect care to women to address gender-related issues that may affect health and wellness across the lifespan, in the context of the women’s multiple roles, socioeconomic circumstances, and family as she defines it.”
Women’s Health CNSs applies evidence in practice designed to improve the quality of care and health outcomes across the continuum of care:
- Reproductive and sexual health (beginning in adolescence)
- Childbearing and lactation
- Newborn care (and the newborn role in the family)
- Perimenopausal, menopausal, and post-menopausal health
- Healthy aging for women
How to Become a Women’s Health Clinical Nurse Specialist
The minimum educational requirement to become a Women’s Health CNS is an MSN in the chosen APRN role and population. However, in recent years, the DNP has quickly increased in popularity for CNSs and other APRNs as these advanced practice nurses seek recognition in the largely doctorate-prepared interdisciplinary healthcare team. In the past decade, a number of well-respected national nursing organizations have recommended a transition to the DNP, so for many aspiring CNSs, the DNP is an effective way to futureproof their careers.
In addition to increasing numbers of DNP programs in the U.S. in recent years, many colleges and universities have begun offering more than one entry point to these in-demand programs:
- MSN-DNP: The traditional DNP program, which may be designed for APRNs and/or non-APRNs, consists of about two years of full-time study and 36 credits.
- BSN-DNP: This path is designed for bachelor’s prepared RNs who want to earn both their MSN and DNP through one, streamlined course of study; it features about 73 credits and three years of full-time study.
- Direct-Entry DNP: The direct-entry DNP is a unique program designed specifically for students who have earned a bachelor’s degree in a non-nursing major. Through the direct-entry DNP, students earn their RN license, MSN, and DNP. These programs take about four and a half years to complete.
The Women’s Health DNP includes all necessary coursework and clinical experiences to satisfy the AACN’s 8 DNP Essentials and the NACNS Women’s Health Clinical Nurse Specialist Competencies, which include:
- Normal physiologic change and psychosocial events during the childbearing cycle
- Pathophysiological events and chronic health conditions affecting the mother
- Fetus and/or neonate in at-risk situations
- Family adaptations
All DNP programs include about 500 hours of clinical experiences and all culminate in the DNP final project, a real-world project designed to showcase the student’s acquired knowledge in their chosen APRN role and focus.
Scope of Practice for Women’s Health Clinical Nurse Specialists
Clinical nurse specialists in women’s health enjoy independent practice authority in 28 states. Of these states, 19 grant CNSs prescriptive authority.
An additional 13 states recognize CNSs as advanced practice registered nurses; however, they are required to practice under a collaborative physician agreement or other type of physician oversight.
CNSs are not recognized as APRNs and therefore have a limited scope of practice in California, Pennsylvania, Florida, Mississippi, Alabama, New York, New Hampshire, Michigan, and Virginia. In Maryland, only psychiatric and mental health CNSs have been granted independent practice authority.
Salary Expectations for Women’s Health Clinical Nurse Specialists
A 2019 Medscape Compensation Report revealed that clinical nurse specialists earned a gross annual income of $103,000, although those paid an hourly wage earned slightly more, at $106,000. Further, CNSs with the DNP earned about $2,000 more annually than those with the MSN as their highest degree.