Clinical nurse specialists (CNSs) deliver expert patient care that is based on advanced nursing models with two important characteristics, clinical judgement and leadership, as summarized by Spross & Baggerly. To utilize the clinical judgement for the benefit of patients, CNSs stay within the realm of direct patient care. The leadership of CNSs is demonstrated by their subroles. When CNSs directly and indirectly provide patient care, the quality of care is improved. This is a result of (i) the important changes of specialization in nursing, (ii) the pivotal role of CNSs in direct patient care, and (iii) the subroles of CNSs that experienced registered nurses (RNs) may not have.