1. Barksdale, Peggy MSN, RN, CNS-BC, OCNS-C

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To everything there is a season and a time to every purpose under the heaven.


-Ecclesiastes 3:1-8


I am writing my final message to the membership of the National Association of Clinical Nurse Specialists (NACNS). As I have read the messages of previous presidents, I too have discovered "how fast the time has passed."


It was not too long ago that we celebrated our 20th anniversary in Coronado, California, and I took on the position of NACNS' 20th president. I am still humbled to be in this position. When I look back over the year, the quote from Ecclesiastes came to mind. Like all other leaders, it is the people who surround us that make us successful. I had the privilege of being surrounded by many talented and passionate colleagues.


Thank you to President-Elect Sharon Horner, who was that "second set of eyes and ears" that I bounced thoughts off. I plan to support her in her upcoming term. Thanks also to Vice President Rachel Moody, who accepted a second term so that she could assist the Board with decision making; to Secretary Anne Hysong, who was instrumental in the updating of our bylaws and who will continue her service for an additional year until the secretary and treasurer positions are consolidated; and to Treasurer Susan Fowler, who brought insightfulness and experience with numbers to this position.


Thank you to the 4 members-at-large: Gayle Timmerman, whose leadership and wisdom helped to guide the Board during her 2 terms; Tracy Chamblee, who shared with us her boundless energy ; Vince Holly, whose experience at the affiliate level is serving us well; and I especially want to thank Yvonne Dobbenga-Rhodes for being willing to complete the term of Deborah Tuggle.


I must express appreciation to our executive director Melinda Mercer Ray and managing director Jason Harbonic, as well as immediate past president Les Rodriquez and past president Carol Manchester. The Board benefited immensely from their assistance.


In my March letter, I mentioned how important NACNS' legacy was to me. I identified communications with our members as 1 of my highest priorities. We held teleconferences in June, November, and February with all committee chairs and members, including affiliates, to give them the opportunity to discuss concerns or present ideas. And we held special open forums with the task force members in September to address questions about the Doctor of Nursing Practice Statement that the NACNS released in July. So many people registered for our second Educator's Forum and 14th Summit that NACNS had to move the meeting to a larger venue. And our webinars, featuring expert presenters, were more popular than ever and evaluated highly by attendees.


This year, we also restructured our committees to better support our efforts on the legislative-regulation, research, practice, education, membership, and affiliate fronts. We were especially pleased with the work done by the 2016 conference committee and look forward to a great meeting in Philadelphia.


As we look ahead, the 2017 Conference Planning Committee, the new Research Priorities Task Force, and the 2016 Webinar Planning Committee have begun their work. We look forward to seeing the questions in the NACNS 2016 CNS Census survey.


We were busy increasing the visibility of the clinical nurse specialist (CNS) on so many fronts this year. We supported federal legislation extending advanced education grants to support CNS education and continued our vital involvement with the implementation of the Consensus Model for APRN Regulation through the national Legislation, Accreditation, Certification, and Education coalition.


I am delighted to be seeing so many new members coming forward to volunteer their expertise, time, and energy to this national association. I applaud those whose dedication to NACNS does not end when their official service does. I embrace you all with open arms.


Our main goal is for the one organization established 20 years ago specifically for CNSs to remain strong and vital for the next 20 years and beyond.


I am grateful to have had the opportunity to serve the NACNS membership for a season. Thank you.



The NACNS is excited to continue our high-quality webinar programming in 2016 to 2017; the theme for the year is "Pharmacology and Technology for the CNS." Because of the popularity of these webinars, we will be increasing the number of offerings to 1 per month!


As in the past, these cutting-edge webinars are designed to provide the CNS with contemporary clinical and role information. The topics have been selected with an eye toward issues that cross specialties and may be seen in a variety of clinical situations.



As members of the advanced practice nursing community, the NACNS is pleased by the provisions included in the new budget package that support expanding advanced practice nurses' scope of practice and supporting nurse workforce development and nursing.


Specifically, the package allows the Veterans Health Administration to proceed with publishing a proposed rule supporting veterans' access to quality care through full practice authority for advanced practice registered nurses (APRNs) and funds Title VIII nurse workforce development programs and nursing research.


These provisions support not only nurses but also healthcare consumers by ensuring that nurses are able to practice to the full extent of their skills and education and by supporting the nursing workforce and crucial research that improves health and healthcare.


We want to thank the members of Congress who voted to support these crucial provisions.



In December 2015, the NACNS appointed Kathy A. Baker, PhD, RN, ACNS-BC, FAAN, to be our representative on the American Association of Colleges of Nursing's (AACN's) Competency-Based Education for Doctoral-Prepared APRNs Work Group. The goals of this work group are to


* Establish a common language or taxonomy by adopting definitions for competence, competencies, and competency framework that are recognized by APRN organizations and other health professions.


* Identify common, measurable APRN doctoral-level competencies that cross all 4 roles and build on the expected outcomes for the APRN core courses: advanced physiology/pathophysiology, advanced health assessment, and advanced pharmacology).


* Identify and describe progression of competence or milestones across each of the common competencies. These milestones may vary for each of the 4 roles; however, the goal will be to reach consensus on 2 milestones: competence before entry into clinical experiences and at end of program.



Dr Baker is associate professor and division director, Graduate Nursing Studies & Scholarship at the Harris College of Nursing & Health Sciences of Texas Christian University. She is also deputy director, Center for Evidence Based Practice & Research: A Collaborating Center of The Joanna Briggs Institute. Dr Baker will be reporting on the progress of this Work Group to the NACNS Board of Directors.



On December 1, the AACN and the American Nurses Association (ANA) jointly hosted a meeting of stakeholders to review and discuss the accomplishments that have been made in state adoption of the Consensus Model for APRN Regulation (Consensus Model). The NACNS was engaged in the planning of this meeting as a member of the planning committee, and our executive director, Melinda Mercer Ray, both facilitated a session and presented as part of a panel.


The focus of the meeting was to identify where the Consensus Model has been successful and where there are continuing issues and/or unintended consequences that need to be addressed. The NACNS, through our representatives as well as other CNS attendees at the meeting, were able to raise our key concerns:


* Lack of available certification examinations for licensure for CNSs in all of the populations. Much discussion was held on the issue of the lack of a national licensure examination for women's health.


* The need for a transition plan for the CNS for licensure where no national certification examination exists.


* The potential to consider another model for licensure in the event that there are not sufficient numbers of individuals to develop and maintain an accredited national certification examination.


* The concerns with different state interpretations of grandfathering.



At the conclusion of the meeting, it was determined that AACN/ANA would make the speaker slides available and the speakers would collaborate on the writing of a short report of the meeting. The NACNS will communicate the availability of these materials on the NACNS Web site-



The NACNS Legislative and Regulatory Committee, chaired by Melanie Duffy, is interested in hearing from you! As the state legislative sessions get underway in 2016, the committee wants to keep track of legislative and regulatory activity that has an impact on CNS practice and licensure. The NACNS can provide some information for states who are engaged in advocacy for the CNS. At the end of 2015, NACNS wrote a letter to the legislature in Arizona in support of the CNS role as well as sent a letter concerning proposed changes to public health regulations in Illinois.


"We are encountering increased awareness of the CNS role which can be a double edged sword in the legislative and regulatory community. For many years, the CNS has been grouped with other APRNs such as NPs and been able to achieve advances in independent practice and prescriptive authority. Of late, opponents, such as the American Medical Association and some state medical associations have begun to specifically target the CNS and attempt to restrict our scope of practice," stated Peggy Barksdale, NACNS 2016 president. Because of the increased pressure on states to open their practice acts to accommodate the Consensus Model for APRN Regulation, there is anticipated to be a number of states with legislative and regulatory activity in 2016. The NACNS Legislative and Regulatory Committee and the NACNS Board want to offer the information resources we have to states to support their hard work in advocating for the CNS role.


To inform the NACNS Legislative and Regulatory Committee of anticipated and/or ongoing legislative and regulatory issues in your state, please e-mail Please put state legislation/regulation in the subject line so your e-mail can be forwarded to the committee.



Continuing the 14-year winning streak, nurses were again rated the highest, meaning the most trusted profession, according to Gallup's December 21, 2015, news release. Nurses have topped Gallup's Honesty and Ethics ranking every year but 1 since they were added to the list in 1999. Understandably, the year that nurses were rated below no. 1 was 2001, where firefighters took the lead, shortly after the September 11 terrorist attacks.


The 2015 Gallup poll on honesty and ethics rates nurses at an impressive 85%. The second and third place slots went to pharmacists (68%) and physicians (67%). For honesty and ethics rating-tying their high point-nurses have no serious competition atop the Gallup ranking this year. Pharmacists and medical doctors constitute the next tier, with about two-thirds of Americans viewing each highly, followed by high school teachers at 60% and police officers at 56%.


Less than half of Americans consider clergy (45%), funeral directors (44%), or accountants (39%) to be highly ethical. Still, Americans are much more likely to view these professions positively than negatively.


In contrast, there are 3 professions that rank the lowest on the honesty and ethics poll. Congress, telemarketers, and lobbyists are considered by most Americans completing this survey as having low or very low scores for honesty and ethics.



Washington State Affiliate

Washington State expects to add CNSs to advance practice licensure by a vote of the Nursing Commission, January 8, 2016, amending the APRN rules. A big thank you to Heather Schoonover and her tireless effort of 8 years to get us here. Heather has stepped down as chair of the WA State NACNS affiliate and is now a Pro Tem member of the nursing commission. Having a CNS on the nursing commission is a boost to practice for WA State CNSs and a service to the citizens to expand access to care. Susan Eardley has assumed the chair of the affiliate; e-mail for the affiliate is, and we now have a closed group Facebook page: Clinical Nurse Specialists Washington State; request to join.


Submitted by Susan Eardley, RN, ACNS-BC, CHFN

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