What are the Primary Differences Between Clinical Nurse Leader (CNL) and Executive Nurse Leader (ENL)?

The Clinical Nurse Leader (CNL) tittle is developed in the recent past by the American Association of Colleges of Nursing (AACN).

The primary reason for creating such a role is to improve the quality of patient outcomes.

The requirements for the CNL positions include completion of a Bachelor’s degree in Nursing program and a Master’s of Science in Nursing program with a focus on CNL.

Once a student completes the MSN program, he or she can take the CNL certification exam, administered by the Commission on Nurse Certification (CNC).

On the other hand, the role of Executive Nurse Leader (ENL) focuses more on the business and administration in healthcare organizations.

Typically, on the ENL position master’s prepared nurses are admitted, but the MSN isn’t always part of the requirements.

Nurses who complete the BSN program can earn an MBA – a Master of Business Administration degree with a focus on healthcare are also eligible to ENL certifications test.

Also, nurses who complete a Master’s in Health Administration (MHA) can sit for the ENL test.

The test is administered by the American Nurses Credential Center (ANCC) or the American Organization of Nurse Executives (AONE).


The AACN states that a Clinical Nurse Leader is a clinical role, created to improve patient outcomes.

It isn’t an administrative or management role, and it focuses on inter-professional communication and team leadership, care transitions, risk management, and overall quality improvement.

CNLs monitor patient treatment plans and coordinate care, seeking cost-effective care while implementing evidence-based practice to achieve the highest level of care.

On the other hand, ENL’s role focuses on leadership, management, administrative tasks, and traditional nursing duties.

The scope of practice of ENL includes patient care, but ENL has little direct contact with the patient.

Moreover, ENLs design and manage patient care, but also take care of budget development, procedures, policies, etc.

They assist in the employment process, manage employee schedules, and discipline.

ENLs work with other healthcare professionals in the facility and build partnership outside the healthcare facility.

Continuous Education

In the healthcare field, continuous education is highly important for CNL and ENL to stay up-to-date with the latest research results and case studies.

Every five years, CNLs are required to review their license and provide proof of 2.000 hours of clinical practice, and a minimum of 50 education credits.

The additional testing isn’t required, and CNLs don’t need to hold the current CNL position for the re-certification process.

The re-certification for ENL is different and depends on the healthcare association.

For example, ANCC renewal is required after five years, and to get their license renewed, ENL must complete 75 hours, and 25 of the total hours have to be in pharmacotherapeutics.

Renewal within the Certified in Executive Nursing Practice (CENP) through AONE is every three years.

A nurse can choose to retake the certification exam or to complete at least 45 contact hours of appropriate education.

Practical Skills

Even though CNL isn’t a management-related position, nurses need to have leadership skills.

Excellent communication skills, research, analytics, plan-making, and strategic skills are also required to provide quality care and positive patient outcomes.

A similar set of skills is required for the position of ENL.

ENLs need to be good at multitasking and to have strong business skills.

Skills and experience related to budgeting, finance and insurance can also be helpful as the ENL role include financial tasks as well.


There is a wide range of salaries for CNL.

A CNL can make somewhere between $53.000 and $102.000 per year.

Salaries are different across the country, and the years of experience are the significant determining factor.

A salary of ENL is somewhere between $86.000 and $150.000.

According to Payscale.com, location, job position, education, and experience affect the salary.

CNL and ENL are professional tittles with advanced degrees and certifications.

However, CNL and ENL cannot prescribe medications.

Only when they advance their credentials and become Advance Practice Registered Nurses they can start prescribing medication, of course, if the state allows them.

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