The Clinical Nurse Leader (CNL) is a fairly new professional title created by the American Association of Colleges of Nursing (AACN) in 2004 in order to improve the quality of patient care outcomes. To become a CNL, a bachelor's-prepared nurse must first complete a Master's of Science in Nursing (MSN) with a CNL concentration. Upon successful completion of the MSN program, the nurse is eligible to sit for the CNL certification exam through the Commission on Nurse Certification (CNC).

In comparison, an Executive Nurse Leader (ENL) takes more of a business and administrative function in healthcare organizations. An Executive Nurse Leader is typically a master's-prepared nurse, although an MSN is not necessarily required. In addition to an MSN, a BSN-educated RN can earn a Master of Business Administration (MBA) with a focus in healthcare or a Master's in Health Administration (MHA) to be qualified to sit for the ENL Certification via the American Nurses Credentialing Center (ANCC) or the American Organization of Nurse Executives (AONE).

See our database of CNL programs.

Roles and Responsibilities

According to the AACN, the CNL position is not a role of administration or management, but instead the position is a clinical role created to improve focus on the following:

  • Monitoring and improving patient outcomes
  • Inter-professional communication and team leadership
  • Transitions of care, quality improvement, and risk assessment
  • Monitoring patient treatment plans and results across the entire facility
  • Care coordination to ensure efficient and cost-effective patient care
  • Implementation of evidence-based practice to ensure the highest quality care

In contrast, the role of ENL involves leadership, administration, management and traditional nursing methods and duties. While patient care is within the scope of practice for an ENL, most of his or her work is done behind the scenes rather than face to face with patients. Responsibilities of an ENL may include:

  • Designing and managing patient care
  • Developing budgets, policies, and procedures for practice in the healthcare facility
  • Assisting and encouraging employee development and education
  • Managing employee scheduling and discipline
  • Collaborating with healthcare professionals across the healthcare facility as well as building consumer partnerships outside the facility

Continuing Education

As with most healthcare careers, a minimum amount of continued education is required to maintain the title.

A CNL is required to renew licensure every five years with documentation of 2,000 professional hours of practice and at least 50 continuing education credits. According to the AACN, re-testing is not required, and one does not need to hold a current CNL position when applying for re-certification.

The procedure for ENL re-certification varies depending on the association:

  • The ANCC renewal occurs every five years and one must complete 75 approved contact hours (25 of the 75 required contact hours must be in pharmacotherapeutics)
  • Renewal with the Certified in Executive Nursing Practice (CENP) via the AONE occurs every three years. In order to re-certify through the CENP, a nurse can either re-take the certification exam or complete at least 45 contact hours of eligible continuing professional education.


While the role of a CNL is not meant to be a management position, a strong degree of leadership is required. The CNL should have excellent communication skills as well as research and analytical skills to plan and strategize quality patient care and outcomes.

Similarly, leadership and communication skills are very important skills for an ENL. A successful ENL should also be able to multitask and possess strong business skills. Experience with budgeting, accounting, finance, and insurance may also be helpful in an ENL role given the fiscal duties the position may entail.


A CNL can expect to make between $53,000-$102,000 per year. While this is a wide range, salaries vary from state to state and with years of experience.

ENLs can earn a salary between $86,000 and $150,000. Again, this will differ based on location, job title, experience, and education level according to

While both professional titles require advanced degrees and certification, neither CNLs nor ENLs are able to prescribe medication unless they have become Advanced Practice Registered Nurses (APRNs) and it is within their scope of practice for their state and position.

Amanda Bucceri Androus, RN, BSN
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