a senior woman in her home explains to a female district nurse the trouble that she's been having whilst prizefighting . The nurse is listening as the senior woman explains . they are sitting in a bay window of a house.

The Clinical Nurse Leader role exemplifies a high level of clinical practice with knowledge to expand on an effective implementation of health promotion and preventative practices, management of acute and chronic illnesses, and creative approaches to complex care.

Within home health agencies, a CNL acts to improve the quality of care provided to residents and educates other nurses to deliver higher quality patient treatment. Through the use of evidence-based practice, a Clinical Nurse Leader coordinates, delegates and supervises the patient care with the help of an interdisciplinary team.


A Clinical Nurse Leader strives to improve resident care outcomes in Community Living Centers (CLC) and people living independently. They demonstrate clinical leadership, experience and creative approaches to the management of resident care on a micro-system level. A CNL serves as a mentor and consultant to the rest of the health care staff.

In addition to the typical CNL responsibilities, working in the home health agency may also require a Clinical Nurse Leader to:

  • Supervise other nurses and health care professionals.
  • Communicate effectively with patients and families
  • Possess keen observation skills, high ethical standards and knowledge concerning changes in patients’ conditions.


The average annual salary of a CNL working in a home health agency is $83,500. The range is generally from $51,000 to 116,000, depending on factors such as location and experience. (Note: Salary data collected as of 2016.)


To work within a home health agency, a CNL needs to have an MSN with a Clinical Nurse Leader focus. The MSN coursework should fulfill the requirement of prior nursing experience in the field. However, there is a general preference for a CNL to have experience in acute and/or long term care or rehabilitation. A Clinical Nurse Leader should also be licensed in their state of practice.


Perhaps the last vestige of the house call system, frontline home health workers treat patients recovering from an injury or surgery in the patient’s own place of residence. Providing care in a person’s home creates a unique dynamic between caregiver and patient. These interactions allow CNLs to know their patient a little better, which is useful when monitoring for signs of new or worsening symptoms. On the other hand, to some patients, home visits can seem like an invasion of privacy. This raises the chances of misunderstanding and mistrust. For CNLs, avoiding those pitfalls requires sensitivity to the patient’s culture and personal boundaries.


Services vary from agency to agency and can include telemetry, long-term care, rehabilitation, and even hospice care. It is important for CNLs to develop experience and a strong comfort level in each discipline, as it will make them stronger interdisciplinary team leaders.

Often, working in a home setting means working closely with the patient and his or her family. A positive bedside manner and strong communication skills are also valuable assets when working in a home health agency.


Depending on the needs of the patient, shifts can last anywhere from four to twelve hours. This can be ideal for anyone who prefers a flexible schedule, though home visits can be scheduled on holidays and weekends, and they can even occur during natural disasters in cases where a home bound patient with a chronic illness requires medication refills or immediate care.

Ordinarily, coordinating care within a microsystem involves patients who are in the same department and clinicians who are in the same hospital. In home health care, however, all of the members of your interdisciplinary team can be scattered in various locations across town. Keeping tabs on vital information and communicating it effectively to all team members will be a vital part of your role as a CNL.