NUR 513 Topic 2 DQ 2
Compare two different advanced registered nurse roles with regard to ethical guidelines. Are there
any differences in the ethical guidelines that govern these roles? What situations might require one
role to respond differently, depending on the ethical guidelines?
The two roles I will be comparing are Clinical Nurse Specialist (CNS) and Clinical Nurse Leader (CNL).
Certified Nurse Specialists are considered advanced practice registered nurses (APRNs) specializing in
one or more specific areas of medicine. Certified Nurse Leaders are not technically APRNs. While both
roles require master’s degrees, curricular requirements for CNLs are slightly less clinical.
The Clinical Nurse Leader (CNL) focuses on healthcare microsystems that support patient care outcomes
at the unit level. The AACN states that CNL’s focus on Care Coordination, Outcomes Measurement,
Transitions of Care, Inter-professional Communication & Team Leadership, Risk Assessment,
Implementation of Best Practices Based on Evidence, and Quality Improvement (Clavo-Hall, Bender, &
Harvath, 2018).
Clinical Nurse Specialists (CNS) has advanced training in their specialty and can work throughout
healthcare in areas such as; population (such as: pediatrics, geriatrics, women’s health); setting (such as:
critical care or emergency room); disease or medical subspecialty (such as: diabetes or oncology); type of
care (such as: psychiatric or rehabilitation); or type of problem (such as: pain, wounds, stress) (Hatley,
Ralyea, Buttriss, & Rankin, 2019). The CNS works with multidisciplinary care teams within and across
systems.
CNL and CNS have many similarities in trying to improve patient care and satisfaction. However, the
primary difference between the two is the approach. The CNL will focus on one problem in a system
while the CNS will look at the picture as whole (Rettig, LaRue, & Pearson, 2017). If both roles work
together, ethical decision making can improve throughout the healthcare system. As nurses, both roles
must adhere to the American Nurse Association (ANA) Code of Ethics for Nurses. The nursing
profession has a code of ethics that outlines the expectations of members of the profession and
defines the personal and performance standards that represent what is best in the work of the
profession. The nursing code of ethics spells out the role and relationship of the nurse with individual
patients and addresses issues that advance the health needs (Porter-O’Grady & Malloch, 2018). A
healthcare provider’s role is to disclose accurate medical, treatment, and prognosis information and to
engage in shared decision making with the patient with the purpose of empowering the patient
making his or her own decision. A healthcare provider does not have domain over a patient’s values,
and by denying a patient’s wishes to stop treatment or refuse a treatment, the provider acts as if he or
she does not recognize and value the patient as a person capable of making her own decisions.
References
Clavo-Hall, J. A., Bender, M., & Harvath, T. A. (2018). Roles enacted by Clinical Nurse Leaders across the
healthcare spectrum: A systematic literature review. Journal of Professional Nursing, 34(4), 259–268.
Retrieved from: https://doi-org.lopes.idm.oclc.org/10.1016/j.profnurs.2017.11.007
Compare two different advanced registered nurse roles with regard to ethical guidelines. Are there
any differences in the ethical guidelines that govern these roles? What situations might require one
role to respond differently, depending on the ethical guidelines?
The two roles I will be comparing are Clinical Nurse Specialist (CNS) and Clinical Nurse Leader (CNL).
Certified Nurse Specialists are considered advanced practice registered nurses (APRNs) specializing in
one or more specific areas of medicine. Certified Nurse Leaders are not technically APRNs. While both
roles require master’s degrees, curricular requirements for CNLs are slightly less clinical.
The Clinical Nurse Leader (CNL) focuses on healthcare microsystems that support patient care outcomes
at the unit level. The AACN states that CNL’s focus on Care Coordination, Outcomes Measurement,
Transitions of Care, Inter-professional Communication & Team Leadership, Risk Assessment,
Implementation of Best Practices Based on Evidence, and Quality Improvement (Clavo-Hall, Bender, &
Harvath, 2018).
Clinical Nurse Specialists (CNS) has advanced training in their specialty and can work throughout
healthcare in areas such as; population (such as: pediatrics, geriatrics, women’s health); setting (such as:
critical care or emergency room); disease or medical subspecialty (such as: diabetes or oncology); type of
care (such as: psychiatric or rehabilitation); or type of problem (such as: pain, wounds, stress) (Hatley,
Ralyea, Buttriss, & Rankin, 2019). The CNS works with multidisciplinary care teams within and across
systems.
CNL and CNS have many similarities in trying to improve patient care and satisfaction. However, the
primary difference between the two is the approach. The CNL will focus on one problem in a system
while the CNS will look at the picture as whole (Rettig, LaRue, & Pearson, 2017). If both roles work
together, ethical decision making can improve throughout the healthcare system. As nurses, both roles
must adhere to the American Nurse Association (ANA) Code of Ethics for Nurses. The nursing
profession has a code of ethics that outlines the expectations of members of the profession and
defines the personal and performance standards that represent what is best in the work of the
profession. The nursing code of ethics spells out the role and relationship of the nurse with individual
patients and addresses issues that advance the health needs (Porter-O’Grady & Malloch, 2018). A
healthcare provider’s role is to disclose accurate medical, treatment, and prognosis information and to
engage in shared decision making with the patient with the purpose of empowering the patient
making his or her own decision. A healthcare provider does not have domain over a patient’s values,
and by denying a patient’s wishes to stop treatment or refuse a treatment, the provider acts as if he or
she does not recognize and value the patient as a person capable of making her own decisions.
References
Clavo-Hall, J. A., Bender, M., & Harvath, T. A. (2018). Roles enacted by Clinical Nurse Leaders across the
healthcare spectrum: A systematic literature review. Journal of Professional Nursing, 34(4), 259–268.
Retrieved from: https://doi-org.lopes.idm.oclc.org/10.1016/j.profnurs.2017.11.007
