1. Manchester, Carol MS, RN, CNS

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This is my first President's Message, and as the year begins, I have spent a significant amount of time reflecting on the history of clinical nurse specialists (CNSs) and thinking about our future. As I wrote in my candidate's statement in 2011, healthcare reform, accountable care organizations, care model innovation, and transitions of care resonate across the country today. As medical centers, clinics, and providers of care respond, react, and strategize to deliver optimal and affordable care within the new environment, the CNS is positioned to effectively guide healthcare delivery systems and collaborate with providers to successful interventions and care delivery models. This is done with a common mission to improve the health of the communities and individuals we serve. Clinical quality and excellence, patient safety, and patient outcomes are enhanced, not compromised, with the vision, values, and expertise of the CNS. The CNS is the "innovation expert."


Change is happening! This change is constant, occurring rapidly and requiring action, it seems, immediately. Yet the CNS is thoughtful and pensive, considers consequences from actions taken, and explores options to resolve problems and conflict thoroughly and carefully. How do we as individuals and as an organization continue to face issues related to change, some that we acknowledge is needed and some that have been thrust upon us and pose threats? Margaret Wheatley, a writer and management consultant who studies organizational behavior wrote, "There is no power for change greater than community discovering what it cares about."1 I can honestly say we as an organization and as a community of CNSs have identified what we care about! The current strategic plan directs our work and actions to successfully achieve our mission, which is "to enhance and promote the unique, high value contribution of the CNS to the health and well-being of individuals, families, groups, and communities and to promote and advance the practice of nursing."


This year, I urge all of you to embrace the change that is here and coming while actively challenging and questioning what threatens the CNS of the future. Our annual meeting theme this year was "The CNS: Leading Innovations for Health Care Change." Each one of you, I am sure, has been called upon to lead change projects within your organization, your community, your curriculum or school. Share your thoughts and voice your concerns and ideas as active participants in our membership, our association, and the nursing community at large.


I am so thankful for the leaders who have gone before me, and I wish to publicly express my appreciation to Rachel Moody, immediate past president, for her commitment, poise, and leadership over the past year. Additionally, Melinda Mercer-Ray, our executive director, and Jason Harbonic, managing director, have provided strong leadership and support to the Board of Directors and the organization this past year. As we move forward together, I am grateful for the opportunity you have given me to serve as your president this year.



1. Wheatley MJ. Turning to One Another Simple Conversations to Restore Hope to the Future. San Francisco, CA: Berrett-Koehler Publishers; 2002.



We need your help recruiting new members! Encourage your colleagues, students, and institutions to join NACNS! Members enjoy a subscription to Clinical Nurse Specialist, reduced registration rates for the NACNS conference, volunteer leadership opportunities, networking opportunities, and much more. Plus, the more new members that list you as the referring member, the more opportunity you have to be entered in a drawing to win a free 1-year NACNS membership!


NACNS is accepting nominations for volunteer committee appointments. Help advance our mission to enhance and promote the unique, high value contribution of the clinical nurse specialist to the health and well-being of individuals, families, groups, and communities and to promote and advance the practice of nursing by volunteering to serve on one of our committees:


* Affiliate Advisory


* Education


* Legislative/Regulatory


* Membership


* Practice


* Research


* 2014 Conference Planning *NEW*



There is a new opportunity to participate in the 2014 NACNS Conference Planning Committee. We encourage anyone with an interest in helping to plan the conference to consider participating on this crucial committee. Visit the NACNS homepage for the volunteer form and information.


Connect with NACNS on Facebook! Join other NACNS members and volunteer leaders who have joined the NACNS Facebook group. It's easy to join; there's a link right from the NACNS homepage. Join the community of CNSs and help make the NACNS group the go-to resource for information, healthy debate, and gateway to membership and participation in NACNS. The NACNS Facebook group is one more way NACNS is fulfilling its mission to enhance and promote the value of the CNS profession.



The NACNS Board has appointed a task force to begin planning of the 2013 NACNS Summit. The 2014 Summit will be held July 23, 2013, in Washington, DC. Historically, the NACNS Summit has been an invitational conference focused on a high-priority issue for the association. The NACNS Summit will still attempt to retain the smaller more intimate environment of previous meetings, but the task force will work to grow the meeting and open the attendance to a mix of association colleagues, NACNS state and national leadership and members. Please watch the CNS Communique and the NACNS Web site for additional information on the 2014 NACNS Summit.



The 57th Presidential Inauguration was held on January 21, 2013. NACNS was one of many nursing associations that cosponsored this important inauguration event. NACNS leadership had the opportunity to interact with members of congress and association leaders. The ticketed "watch event" included rooftop views of the Inaugural Parade. The event was followed by a salon dinner with congressional guests. NACNS was pleased to be a sponsor. NACNS' president and president-elect, as well as some Board members, were represented at this event.



Arizona Association of Clinical Nurse Specialists

The final quarter of 2012 included the following accomplishments for a few of our members.


Ann Busch, liver transplant CNS at the Portland (Oregon) VA Medical Center, was an invited speaker at the 21st Annual International Transplant Nurses Society Symposium, October 23, 2012, "National and Local Challenges and Opportunities in Transplant Nursing in the United States." The conference was held in Seattle, Washington.


Janet Campbell, ambulatory care CNS at the Durham (North Carolina) VAMC, complete her Postgraduate Certificate for Adult CNS concentration from the East Carolina University December 4, 2012.


Larry Lemos, gerontological CNS at the VA Long Beach (California) Health Care System, was elected president-elect of NOVA (Nurses Organization of Veterans Affairs) for 2012-2013 and will serve as president from 2013-2015. Currently he is the only CNS on the board.


Submitted by Eileen Smith, MSN, RN, ACNS-BC


Michigan Association of Clinical Nurse Specialists

The Michigan Association of Clinical Nurse Specialists (MI-CNS), an affiliate of the National Association of Clinical Nurse Specialists, was founded in 2009. Current board members are Kathleen Vollman, MSN, RN, CCNS, FCCM, FAAN (President); Marcia Hegstad, MN, RN, ACNS, CDE, BC-ADM (Vice-President); Mitzi M. Saunders, PhD, RN, ACNS-BC (Secretary); Denise O'Brien, DNP, RN, ACNS-BC, CPAN, CAPA, FAAN (Treasurer); Cynthia Arslanian-Engoren, PhD, RN, ACNS-BC, FAHA, FAAN (Director-at-Large); and Cathy Lewis, MSN, RN (Director-at-Large).


The MI-CNS Board of Directors and members have been active in efforts to bring legislation forward in the Michigan House and Senate to provide title protection for CNSs and allow APRNs to practice independently within the full scope of their education and certification. Denise O'Brien, DNP, RN, ACNS-BC, CPAN, CAPA, FAAN, representing MI-CNS, presented testimony emphasizing the need for Michigan CNS title protection during the Michigan Senate Health Policy Committee meeting. MI-CNS also provides quarterly education and networking opportunities.


Submitted by Cynthia Arslanian-Engoren, PhD, RN, ACNS-BC, FAHA



The NACNS Cost & Outcomes Taskforce co-chaired by Anne Muller and Ginger Pierson will be providing their report at the March 2013 Board meeting. They are looking into the body of knowledge on cost and outcomes related to the CNS and will recommend to the Board strategies to move this important information forward to other stakeholders. In the reformed healthcare system, it is essential to tie one's contribution to cost savings and improved outcomes. While we know intuitively that the CNS does both of these, it is critical that this activity is quantified and documented.


The NACNS Transitional Care Taskforce is chaired by Carol Manchester. This taskforce is underway and is exploring the CNS contribution to transitional care and the cost savings CNS bring to the healthcare system when they provide these services. This taskforce is in the process of analyzing the body of knowledge related to transitional care and will provide recommendations for Board next steps in pursing this issue for the CNS.


NACNS continues to pay close attention to the implementation of the APRN Consensus Model. One commitment the NACNS Board made at the beginning of 2012 was to work on the development of CNS competencies for a number of the different populations. NACNS is collaborating on development of Women's Health/Gender Specific CNS Competencies with the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN). At the writing of this article, the initial drafting of these competencies is at a close and the document will soon be open for work by a validation panel.


A workgroup of CNS experts from NACNS and other specialty nursing organizations have been collaborating on the development of Individual/Family Across the Lifespan CNS Competencies. The initial workgroup is making excellent progress, and as of the writing of this article, it is expected that a validation panel will be development to provide comment soon after the March 2013 NACNS Annual Conference.


There is an immense amount of high quality work that is coming forward from our volunteer members. It is important for NACNS to develop effective methodologies to communicate the value of the CNS to the policymakers, healthcare colleagues and the public. In order to address this need the NACNS Board is in the process of identifying a government affairs firm and public relations firm to work with NACNS to craft messages for a variety of audiences and help bring the important message of the contribution of the CNS forward.


Silent Auction 2013

The CNS Foundation will hold another Silent Auction at the upcoming NACNS Convention in San Antonio in March. We hope you will donate an item for this worthwhile event. Instead of gift baskets, we are asking individuals or groups to donate items that will be more easily transportable when winners travel home. We will be approaching affiliates again to donate, but are also planning to take individual and other group donations. Please contact Debbie Danner or 717-703-0033 or Kathy Baldwin if you have an item to donate to this auction that will benefit CNS student scholarships. Details about the Silent Auction will be posted on the Events page of the CNS Foundation website at



The CNS Foundation will kick off a planned giving campaign at the 2013 NACNS Conference. Although we will accept any amount you choose to give, we will be asking our CNS colleagues to donate $5 per week ($20 per month) to the CNS Foundation. That amount is about the cost a latte or cappuccino at Starbucks. Remember with the exception of minor management fees, all of your donations go toward scholarships for CNS students. The CNS Foundation members donate their time and travel requirements to the Foundation. Please help us preserve the future of our role by supporting future CNSs! Please contact Debbie Danner or 717-703-0033 if you have any questions.


TanyaWilliams, MSN, RN, CCNS-BC, will feature an article in the American Heart Associations summer issue of The Connections Newsletter. Her item titled "The Teach Back Method: Ending Illusionary Communication and Knowing What Your Patient Really Understands" will discuss the principles of adult learning and why the "Teach Back Method" is preferred and effective.



Save the date! The NACNS 2014 Annual Conference will be held at the World Center Marriott in Orlando, Florida. The dates are March 4-6, 2014. Abstract submission will open in early July with a due date in September. Check our Web site,, for information as it becomes available.



If you have information you want to share about yourself, your NACNS peers, or your affiliate/affiliate peers, please send the news item to Tanya D. Williams at

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