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Welcome to the first issue of the next 25 years of the journal! Yes, this issue begins the 26th year of Clinical Nurse Specialist: The Journal for Advanced Nursing Practice! The journal has served as a primary forum for clinical nurse specialist (CNS) communication and occupies a unique position as the only peer-reviewed journal dedicated to CNS role and practice regardless of specialty. In considering how the literature has informed and shaped the CNS role, 3 somewhat distinct phases emerge. The early, prejournal phase involved CNS role development and represents the years between the introduction of the role in the 1950s and the emergence of this journal in the mid-1980s. In this early phase, the literature about the CNS role is dispersed across journals, with a concentration of articles describing and explaining the CNS role and practice clustered in the American Journal of Nursing. Descriptions of CNS education and curricula are concentrated in National League for Nursing proceedings and monographs. Fortunately, articles in the American Journal of Nursing are well preserved and accessible. Unfortunately, National League for Nursing and other materials have not been routinely or systematically archived and are at risk for being lost to history. However, what survives in archives and personal collections demonstrates that the first 25 years of CNS literature was a period of role development.


Beginning in the mid-1980s through today, the second 25 years of literature reflect maturation of the CNS role, which is heavily documented in this journal. During this time, there is a shift toward scientific articles to guide CNS practice. The literature reflects CNSs working in teams and with mentors to conduct research and design and evaluate evidence-based practice guidelines. Promoting quality and safety, applying evidence in practice, and emphasizing cost effectiveness are themes of the second phase. One important driving force behind the move to a focus on scholarship for practice is Magnet Recognition, the American Nurses Credentialing Center's mechanism for recognizing healthcare systems with outstanding nursing practice. Clinical nurse specialist leadership is vital to organizations seeking to achieve or maintain Magnet Recognition.


As we enter phase 3, the next 25 years, I see an increased emphasis on uniting CNS practice internationally. Clinical nurse specialists exist in many countries, and the coming years will bring new opportunities for CNSs working internationally to further refine and adapt the role. In both developed and developing countries, the CNS role is the "go to" role for leadership in advancing nursing practice. Nursing practice, like all healthcare, is context bound. It is shaped by and in turn shapes the cultural and political influences in which it exists. At its core, nursing relieves suffering and promotes comfort. The nature of suffering, the interventions available, and the expected outcomes are all context bound. Currently, advanced practice nurses in United States are debating scope of practice as it applies to independent application of technology and pharmacology so prevalent in Western medicine. Such debates are irrelevant in many contexts where technology and pharmacology are limited, cost-prohibitive, or not accepted. Clinical nurse specialist practice is, at its core, leadership for the advancement of nursing within context. Interpreting the needs of people for nursing care is a foundational principle of CNS practice initially described by Peplau.1


The journal is poised to support international collaboration and growth of CNSs. The journal's Web site ( is an outstanding platform for making content more readily available to established and emerging CNS programs and practicing CNSs. The site supports traditional user-initiated access to scholarly articles, news, and announcements. Soon, you will see a collections feature-articles of similar topics clustered for easy access. Announcements now include national and international meetings of interest to CNSs. Resource links include national and international sources for evidence-based guidelines. Look for podcasts and other features in the near future. In addition, the site supports interaction among users. Associate Editor Dr Kelly Goudreau is hosting a blog about the Advanced Practice Registered Nurse Consensus Model. The journal has a Facebook page and a Twitter account. These are all great forums for CNS exchange! Find the option to "friend" on Facebook or "follow" on Twitter on the Web site. Data from 2008-2011 Web of Science shows that 27% of journal citations are from outside the United States. The international dialogue has already begun.


The International Congress for Nursing hosts an advanced practice nursing special interest group-the International Nurse Practitioner/Advanced Practice Nursing Network. Clinical nurse specialists should join this network. Membership is free! Find a link to the International Nurse Practitioner/Advanced Practice Nursing Network on the journal's Web site. Also find a link to the upcoming 2012 conference in London.


For the next 25 years, the journal will serve as a forum for exchange of scholarly work and practical commentary for CNSs around the world. Bookmark the journal on your Web browser and check in from time to time. The world of CNS practice is at your fingertips. Your participation is required.




1. Peplau H. Specialization in professional nursing. Clin Nurse Spec. 1965/2003; 17 (1): 3-9. [Context Link]