What is a CNL?

The Clinical Nurse Leader (CNL®) is the first new role in nursing in over 35 years. Presented by the American Association of Colleges of Nursing (AACN), the CNL® is a masters prepared advanced generalist serving as the lateral integrator for the health care team who facilitates, coordinates, and oversees care within the microsystem and in collaboration with the macrosystem. CNLs are nursing professionals who have earned a master’s or post-master’s degree in a formal CNL education program.

The Role of a CNL

The role varies across practice settings, but is practiced at the point of care, following a cohort of patients with a focus on evidence-based practice, safety, quality, risk reduction and cost containment. As an advanced generalist, the CNL® has the opportunity to work with all patient populations in all practice settings.

The AACN provides a myriad of resources that discusses the origin of the CNL designation and describes the CNL role. In October 2013 the AACN released the updated Competencies and Curricular Expectations for the Clinical Nurse Leader Education and Practice.

Clinical Nurse Leaders from Carolinas Medical Center in Charlotte, North Carolina created a “Day in the CNL Life” to help describe the daily routines and focus points of a CNL in an acute care Level 1 Trauma Center. This detail has helped non-CNLs better understand the play-by-play actions of the CNL in the clinical setting. Such tools and resources have helped tremendously in explaining the role. See below for a sample:

A Day in the Life of a CNL 

0615: Arrive to work and print the list of patients within the microsystem and quickly round, physically looking at each patient

0645: Report to the nurses’ station for the unit’s morning huddle with all unit staff

0700: Go into report with the nightshift and dayshift Charge Nurse reviewing each patient on the unit

0730: CNLs lead the touch-base in the hallways of each microsystem discussing discharges, safety concerns, CHG Bath needs, scheduled procedures of each patient with the nurses, nurse aids, physical therapist, case manager and pharmacist after the physician provides an abbreviated report of each patient

0745: CNL rounds with physician on patients discharging that day to review last minute needs

0815: Physician enters discharge orders on all patients leaving that day

0815: CNL reviews the medical chart of each patient assigned in the microsystem in preparation for multidisciplinary rounds with the team

0945: CNL communicates organized plan of rounding with the nurses and prepares the computer on wheels for rounding

1000: CNL rounds with the physician, nurse, case manager, and pharmacist physically rounding on each non-discharging patient at the bedside

1130: After the rounds are completed, the CNL documents the rounds in the medical record, helps expedite discharged before noon and meets with the nurses as needed to reiterate the plan and assess needs

1300: CNL eats lunch

1330: CNL looks up results of labs, procedures, consults, etc. and provide updates to the team as needed

1500: CNL leads the afternoon touch-base with the physician, nurses, nurse aids and case manager to review planned next day discharges, procedures and concerns

1515: CNL gives report to the dayshift Charge Nurse

1545: CNL finishes any last minute charting, follow-up on patient care or updates to the nurses

1600: CNL leaves for the day

This example was provided by Veronica Rankin CNL after working on the 3 Tower medical-surgical LEAN unit at Carolinas Medical Center. This not reflective of every unit’s CNL practice at the facility.