Clinical nurse specialists have fought for practice autonomy and prescriptive authority for decades. Their ability to practice as independent practitioners ensures outstanding care to patients and their families and support for nurses caring for patients at their bedside. As of 2020, CNSs enjoy independent practice authority in 28 states. Of these states, 19 allow CNSs to prescribe independently. Another 13 states recognize CNSs as APRNs but require them to practice under a collaborative physician agreement, while another 19 states require CNSs to enter into a physician collaborative agreement when prescribing drugs and durable medical equipment. 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 Adult-Gerontology Clinical Nurse Specialists

According to a 2019 Medscape Compensation Report, clinical nurse specialists earned a gross annual income of $103,000. Those who were paid hourly earned slightly more, at $106,000, largely due to opportunities to earn overtime pay. This salary survey found that those with the DNP earned about $2,000 more annually than their MSN-counterparts.