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NAME: Sharon D. Horner, PhD, RN, MC-CNS, FAAN

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CURRENT POSITION AND AFFILIATION: Associate Dean for Research, The University of Texas at Austin


AREA(S) OF SPECIALIZATION: Parent-child professional


PROFESSIONAL EDUCATION: PhD, Medical College of Georgia


CERTIFICATIONS: Texas Board of Nursing, CNS Recognition


The National Association of Clinical Nurse Specialists (NACNS) presented its prestigious Sue B. Davidson Service Award to Sharon D. Horner, PhD, RN, MC-CNS, FAAN, Professor, Associate Dean for Research, and the Dolores V. Sands Chair in Nursing Research at the University of Texas at Austin School of Nursing. The award recognizes extraordinary service to NACNS. It is named for Susan B. Davidson, a founding member of NACNS who served 2 terms as president of the association and chaired the NACNS Research Committee. The award was presented at the 2014 NACNS' Annual Conference.


A member of NACNS since 1997, Horner served as Board Secretary and Board Liaison to the Research Committee from 2010 to 2012. She was chair of the 2014 Conference Program Planning Committee and served as member on this committee for the 3 prior conferences (2011-2013). She served on the Legislative/Regulatory Committee for 5 years and has reviewed abstracts for the NACNS annual conferences for 6 years. She has been a member of the Texas Clinical Nurse Specialists since 2004 and has served on the Advisory Board and as treasurer (2011-2015) for that affiliate.


"Dr Horner has served NACNS in a variety of capacities, bringing to bear her expertise, skills, and talents to help us advance our mission," said NACNS 2014 President Les Rodriguez, MSN, MPH, RN, ACNS-BC, APRN. "Her commitment to this association has helped make NACNS a stronger and more influential voice for the clinical nurse specialist (CNS) and improving patient care. We are delighted to present her with this prestigious award."


Horner holds a PhD in nursing and a master's degree in parent-child nursing from the Medical College of Georgia, Augusta. She earned her ADN and BSN degrees from Armstrong State College in Savannah.


Describe why service at the professional level is important to you, and what motivated you to commit to these particular aspects of service for which you were recognized?

After completing my baccalaureate degree, I joined the American Nurses Association and became involved with the local district in my state. I found the monthly meetings to be an important source of professional support during this time of transition in my life, and I wanted to give back to the organization. Within 2 years I was elected treasurer of the local district. My involvement taught me that the local groups could support the state organization and contribute to important activities and initiatives to improve the working environment of nurses. As an individual nurse, you are often limited in the scope of what you can accomplish, but when working with others, you can achieve important goals.


This early experience really stimulated me to become involved in a number of professional organizations over the years that have addressed different aspects of my career including nursing education, advanced practice nursing, and research. I currently hold membership in 9 professional organizations at the state, national, and international level. I provide service to these organizations through committee membership or leadership positions. I believe that it is important to contribute something (eg, time, energy, or even money, but most importantly brain power) to improve the world around us.


What first motivated you to become a CNS?

Early in my career when I was the head nurse of the pediatric unit and the pediatric intensive care unit in a county hospital, I had the opportunity to work with an excellent CNS to improve the quality of nursing care on our pediatric unit. Together we planned an educational program to upgrade knowledge and skills of the nursing staff (registered nurses and licensed vocational nurses) that was rolled out in a series of modules over 6 to 8 months. This required careful scheduling and multiple sessions to both meet the unit needs and still provide education for all the staff. When the CNS decided to leave our hospital 2 years later to pursue her doctoral degree, I took the opportunity to move into the clinical educator role as an interim position while I finished my masters' degree in parent-child nursing with role preparation as a CNS. This collaboration had shown me another route to take in nursing where I could help both staff and families with children to improve outcomes.


What, if any, professional or career issues did you face early in your career as a CNS?

Like many nurses prepared as a CNS, an opportunity to work as a clinical instructor with nursing students was offered to me. I found clinical teaching to be very rewarding but also recognized that I no longer directly impacted patient outcomes. Instead, the improvement in patient conditions and outcomes were realized indirectly through my efforts to improve the quality of bedside care delivered by the student nurses. My solution to this situation was to begin a doctoral program while still working as clinical faculty. The research preparation I received as part of the PhD program allowed me to design and test an asthma self-management program for school-aged children and their parents in the community. I see my research as the means by which I fulfill my direct CNS role to support families and improve the health of children.


What do you perceive are the key areas of service for CNS today in regard to patients, to other CNSs, and to the nursing profession in general?

I know we have a lot of wonderful and talented people in our profession who could move mountains if they worked together to achieve common goals. Within healthcare systems, CNSs need to be involved in committees or work groups that are charged with improving the system, be that at the bedside, unit level, or across divisions. Given their clinical expertise and broader vision of the system, the CNS is an ideal candidate who can help shape policy and practices that lead to improved health outcomes for patients and potential cost savings for institutions.


I firmly believe that CNSs can make a greater impact when they join forces. I would advise CNSs to not only join their professional organization but also find ways to volunteer to support the organization. Active involvement helps foster a sense of "ownership" of an organization and a desire to help make it better. It is through their professional organizations that CNSs can work to improve political or regulatory conditions that impact CNSs as a group. We continue to be faced with omissions and exclusions in new policies that affect advanced practice nurses. We must be ever vigilant to ensure that CNSs are not overlooked or deliberately excluded in these policies. It takes all of us to recognize emerging problems, be apprised about regulatory issues, and contribute to efforts to protect our professional role and scope of practice.


To date, what do you perceive as your greatest accomplishments as a CNS?

My program of research is the way in which I enact my CNS role as I work with parents and children to improve their health and quality of life. I have developed a self-management intervention to increase children's understanding of asthma and improve their problem-solving and self-management behaviors. I work with a largely minority population in underserved and underresourced (limited healthcare access) areas of central Texas. The intervention, while based on national guidelines, was refined with input from local community members to address issues of concern to them and to ensure that written materials were understandable to them (ie, used the local Spanish dialect, written at fifth-grade reading level). Fully 50% of my participants are poor, and my samples (n = 542, cumulative) have a large minority group representation with 50% to 56% Mexican American and 22% to 24% African American participants. My intervention has led to significant improvements in children's health by reducing asthma severity (frequency of symptoms) and thereby reducing hospitalizations by 50% and emergency department visits by 75%. Recently, the Texas Rural Health Association honored me as the 2013 Researcher of the Year for my work with rural underserved children and families, and the Southern Nursing Research Society recognized my research with their 2013 award for Research in Minority Health.


What advice would you give a new CNS starting out in this role?

I would tell the new CNS: "As a new CNS you may feel overwhelmed by everything you need to learn as you take on this new role as it definitely is a major life transition. But this is also the time when you need to reach outside your institution and connect with your professional organization. You will find many others who have been faced with similar situations who can advise and support you through this transition. You will also find that rather than being a burden on your time, when you go to meetings and network with CNS peers you can revitalize your spirits."