1. Horner, Sharon D. PhD, RN, CNS, FAAN

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The Secretary of Health's Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020 (Healthy People, 2020) proposed that focusing on the social determinants of health would move us closer to the goal of achieving health of all the population.1 Social determinants of health are defined by the World Health Organization as the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life."2 As healthcare professionals, clinical nurse specialists (CNSs) are well aware of the forces outside healthcare that can affect how well an individual manages his/her health. One's residential zip code is a leading indicator of health status. The impact of the home environment, neighborhood characteristics, and availability of family, neighbor, or friend support is fundamental to maintain one's health.


Critical components that underlie social determinants of health include economic stability, education level, social and community context, neighborhood and built environment, and health and healthcare access. Factors such as the cleanliness of our food, air, and water; feeling safe in our neighborhoods, our schools, our churches, our work places, and other social settings; having adequate resources to feed, clothe, and house our families; and access to quality healthcare are integral to the health of individuals, families, and communities.3 Fully 80% of healthcare costs are related to social determinants of health factors. Over time, as we develop and implement full transitional care models, the CNS, recognizing the importance these factors play in improving healthcare outcomes across the continuum of care settings, will develop programs of healthcare that address these factors.


One's health status is a highly individualized and personal condition. Efforts to maintain or improve health begin at home, in our neighborhoods, and communities and must be sustained in the places where we work and gather together.3 The American Nurses Association has issued a Grand Challenge, Healthy Nurse, Healthy Nation, with the goal of improving the health of nurses. Nurses are the most trusted professional group, and the people we care for look to us for inspiration and advice. Yet, we often place ourselves last in the list of people who need our attention-often to the detriment of our health and well-being. Making a commitment to a healthier lifestyle, in essence to care for ourselves, will in fact help patients and families.


As we head into the long holiday season, now is the time to put your exceptional CNS skills to work to plan and then implement your own health promotion plan (maybe these are your "holiday contingency plans"). Often when people think about "health promotion" and "the holidays," these 2 phenomena are seen as contradictory. If you have a holiday tradition that might not be seen as "health promoting," such as partaking of Mom's special fudge or homemade pies, you should think again. Incorporating cherished holiday traditions into your plans actually promotes those important social connections with families and friends that can increase well-being. The obvious strategy in this example is to not eat the whole pie, rather adhere to a practice of "portion control."


In addition to your personal health plan, don't forget to consider the "health" of your home this season. When was the last time you checked your fire extinguisher and smoke alarm? (Do you have a fire extinguisher?) Do you have fresh (not expired) batteries for your flashlight and emergency radio? The holiday season, with all its attendant activities, is one that is ripe for accidents. We don't want an accident to happen at your home. Remember that safety is one of the critical social determinants of health.


On behalf of the board of directors and the staff of the National Association of Clinical Nurse Specialists (NACNS), I would like to wish you and yours a safe and healthy holiday season.


1. Healthy People 2020: an opportunity to address social determinants of health in the United States. (March 6, 2010). Accessed August 1, 2016.


2. World Health Organization. Social determinants of health. 2015. Accessed August 1, 2016.


3. Institute of Medicine. A Framework for Educating Health Professionals to Address the Social Determinants of Health. Washington, DC: The National Academies Press; 2016.




The launch of the NACNS 2016-2017 webinar series started off with an excellent topic on Capnography followed by a second topic in April on Meeting the Needs of the Diabetic Child and Family. The theme for 2016-2017 is pharmacology and technology.

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Upcoming Webinars:

November 8, 2016-Improving Cognitive and Functional Outcomes in Hospitalized Older Adults With Dementia


December 6, 2016-APRN Consensus Model and APRN Compact-What You Need to Know


January 12, 2017-Malnutrition and Pharmacology: Implications for CNS Practice


Webinars will now be held monthly and will provide CE at a reduced price of $25.00 for members. Nonmember price is $60, and students, $30. Group pricing is available; please e-mail for specific group size information. Webinar pricing has been restructured for 2016-2017. To register, visit the NACNS Web site.


aYour purchase of the webinar includes access to the national-level, CNS-specific continuing education and one person's CE. If multiple individuals are listening to the webinar, the CE will be available for only 1 attendee. If you wish to register a group on one call-in line, please A group discount will be given for each additional CE on a single line.


All webinars have been archived for later viewing. E-mail to order an archived webinar. Listen at your leisure and apply for CE certificate.


aThis activity has been approved for contact hours by the Alabama State Nurses Association. The Alabama State Nurses Association is accredited as an approver of continuing education by the American Nurses Credentialing Center's Commission on Accreditation. Each webinar is worth 1 CE credit.



Don't forget to participate in the 2016 CNS Census! Stand up and be counted!

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Clinical nurse specialists are valuable healthcare resources. In identification of the importance of the role, the NACNS Board of Directors has directed the collection of crucial national data on the demographics, education, and practice of the CNS. If you were educated as a CNS (yes, you don't have to actively be practicing under the CNS title), don't forget to help by going to the survey. The link can be found on the NACNS homepage at Look for the 2016 CNS Census icon and click on to link directly to the survey, or you can go directly to the survey at http://www.surveymonkey/r/2016cnscensus. NACNS designed the first survey, the 2014 CNS Census to capture information about people who identify themselves as or who were educated as CNSs.


This survey was the first national survey of the CNS workforce. An infographic is posted on the NACNS Web site that summarizes key facts from this first survey.


NACNS has received assistance from the University of San Diego, California, PhD nursing students to refine the survey and improve the speed of someone completing the survey. Don't miss the chance to be part of this important initiative! And, let your friends know! It is important that we get as many individuals educated as a CNS to be part of the 2016 CNS Census!



At its 21st Annual Conference in March, NACNS presented the Sue B. Davidson Service Award to Melanie Duffy, MSN, RN, CCRN, CCNS, a CNS in critical care at Pinnacle Health System in Harrisburg, Pennsylvania, and adjunct faculty in the nursing programs at the University of Detroit Mercy, Widener University, and York College.


"Melanie was instrumental in drafting and passing legislation to ensure CNS Title Protection in Pennsylvania," said NACNS 2016 President Sharon Horner, PhD, RN, MC-CNS, FAAN. "She has been extremely active in NACNS. In addition to her roles on the board, she was the editor of the first and second editions of Clinical Nurse Specialist Toolkit, A Guide for the New Clinical Nurse Specialist."


Duffy has served in several roles with NACNS, including chair of the Legislative/Regulatory Committee, president, vice president, and board member. In her role as chair of the Legislative/Regulatory Committee, Duffy has updated NACNS members on a range of issues affecting CNS practice. She has also spoken at a congressional briefing on Capitol Hill about the role the CNS plays in improving care and at numerous conferences in the United States and abroad.



NACNS presented the Brenda Lyon Leadership Award for extraordinary leadership in service to NACNS to Rachel Moody, MS, CNS, RN, the administrative director for Critical Care and Infection Control at Franciscan Alliance in Hammond, Indiana.


"Over the years, Rachel has demonstrated a deep commitment both to NACNS and to promoting the role of the CNS in healthcare," said NACNS 2016 President Sharon Horner, PhD, RN, MC-CNS, FAAN. "Her skills, talent, expertise, and dedication to ensuring that the CNS continues to play a central leadership role in healthcare are truly inspirational. We have benefitted greatly from her leadership and are deeply grateful for all she does and will continue to do to help improve healthcare and the health of patients."


Moody has served on the NACNS Board of Directors since 2009, including as vice president and president. She was also the cochair of the NACNS Annual Conference Planning Committee in 2010 and 2011. Moody has spoken to a variety of audiences about the role of the CNS in the changing healthcare landscape at national and local conferences and meetings.


On the state level, she sits on the Practice Committee of the Indiana Center for Nursing and was a member of the workgroup that wrote a white paper on reimbursement for advanced practice registered nurses (APRNs) in Indiana.



At its 21st Annual Conference in March, NACNS presented its President's Award to Kathleen Baldwin, PhD, RN, ACNS, ANP, GNP, CEN, for her work with and commitment to NACNS.


"Kathy's history of service to nursing, to patients, and to NACNS is unparalleled," said NACNS 2015-2016 President Peggy Barksdale, MSN, RN, OCNS-C, CNS-BC. "Her contributions to building this association into what it is today are legion. She has worked tirelessly in every position she has assumed and served as a mentor and a cheerleader to many of us, including me. She encouraged and supported so many of us, while working alongside us to strengthen the CNS role and help to ensure that patients always get the highest-quality, evidence-based care."


Baldwin is a nurse researcher at Texas Health in Fort Worth and a former faculty member at Texas Christian University. In addition to working with the CNS Foundation, which closed in 2014, Baldwin has served on the CNS Educational Standards Taskforce, the Education Committee, and the Doctoral Competencies Taskforce. She also held many leadership positions in NACNS, serving as chair of the Nominating Committee, on the Board of Directors, including as president for a term.



Texas Clinical Nurse Specialists Affiliate Holds 2016 Annual Conference

Texas Clinical Nurse Specialists (TxCNS) hosted a phenomenal conference on June 10 to 11, 2016, in Round Rock, Texas. Topics offered included Texas jurisprudence, pharmacology, pediatric, adult, and geriatric continuing nursing education credits. Ms Bobbi Leeper, MN, RN, CNS-M/S, CCRN, FAHA, was honored as TxCNS of the year for her 25 years and immense contributions as a CNS for cardiovascular services at Baylor University Medical Center. Dr Gayle Timmerman, PhD, RN, CNS, FAAN, associate professor, the University of Texas at Austin, was honored as TxCNS Researcher of the Year for her contributions and research aimed at health promotion with focus on eating patterns and weight in women.


Clinical nurse specialist students presented professional posters at the conference and attended the first Texas CNS Certification Review course presented by Dr Kathy Baldwin, PhD, RN, ANP, GNP, CNS. The review course was well received by graduates from all 3 Texas CNS programs (The University of Texas at Austin, University of the Incarnate Word, and Texas Christian University) preparing to take certification. Several members of the 2015-2016 TxCNS Board of Directors are pictured in the following paragraphs including incoming president Dr Linda Humphries, DNP, RN, ACNS-BC, CCRN, and Sonya Flanders, MSN, RN, ANCS-BC, CCRN-K, immediate past president. Highlights from the 2016 TxCNS Conference can be viewed on social media (#TXCNS2016).


California Association of Clinical Nurse Specialists

Julie Semper and Elizabeth Scruth, CNSs from Torrance Memorial Medical Center, presented a poster, "Clinical Nurse Specialists Guide Staff Nurses to Promote Practice Accountability Through Peer Review" at UCLA's 15th Annual Research and Evidence-Based Practice Conference 2016, held September 20 and 21.


Scruth was one of the investigators for a study on ICU visitation practices that was recently featured in Wall Street Journal ( The study was published in Critical Care in 2013 (


Paddy Garvin Higgins, MN, RN, CRRN, CNS, PHN, and Peggy Kalowes, PhD, RN, CNS, FAHA, presented a poster on "Structural Empowerment Using Lean Methodology: Development of a CNS Led Multi-system Fall Prevention Model" about their hospital's work on fall prevention at the annual rehabilitation nursing educational conference in Philadelphia, Pennsylvania, held from September 28 to October 1. Higgins and Kalowes also have received an award from AEIX (American Excess Insurance Exchange) for this work. They are working on a plan to extend this endeavor to improve partnerships with patients and their family, pharmacists, and technology advocates.


Elissa Brown, Linda Gorman, and Marilyn Shirk, all CNSs, made a presentation on Ethics and Perspectives on Bullying in the Workplace at the ANA/California 20th Anniversary and General Assembly on October 15, in Redondo Beach, California. Elissa, Linda, and Marilyn are 3 of the founding members of Ethics of Caring. Elissa and Linda currently serve on the board, and Marilyn continues to be active in Ethics at Cedars Sinai Medical Center.


Oklahoma Association of Clinical Nurse Specialists

The Oklahoma Affiliate hosted its ninth Annual APRN Pharmacology Conference in April and had 44% increase in attendees over the previous year. They promoted the conference on their Web site,, and Facebook page, Their quarterly membership dinner meetings are well attended, with practicing CNSs and CNS students consistently filling all available seats.


Oklahoma Association of Clinical Nurse Specialists (OACNS) collaborated with other APRNs across the state to introduce a bill to grant APRNs full practice authority. Despite tremendous support, the bill was not heard this year, but OACNS will continue to work with other groups to push the bill forward. Several OACNS members participated in the Future of Nursing Oklahoma Network APRN Action Coalition, lobbying in 2016 for full practice authority with Schedule II drug inclusion at the state capital, including Tamara Meier, MS, APRN-CNS; Susan Dresser, MSN, APRN-CNS, CCRN; and Melissa Craft, PhD, APRN-CNS, AOCN.


This year, several OANCS members are serving on state and national organizations and committees: Susie Jones, PhD, APRN-CNS, is president of the Oklahoma Board of Nursing, and Mandy Nelson, MS, APRN-CNS, is a board member, and Elaine Haxton, MS, APRN-CNS; Carol Stewart, MS, APRN-CNS; and Tracy Walker, MS, APRN-CNS, serve on the Advanced Practice Advisory Committee of the Board. Shelly Wells, PhD, MBA, MS, APRN-CNS, serves on the board of the Oklahoma Nurses' Association. Several OACNS members also serve on NACNS committees: Stephanie Moore, MS, APRN-CNS, is on the Affiliate Advisory Committee; Susan Dresser MSN, APRN-CNS, CCRN, is on the NACNS Legislative Regulatory Committee, and coedited and authored a chapter for the second edition of the CNS Toolkit: A Guide for the New Clinical Nurse Specialist; Melissa Craft, PhD, APRN-CNS, AOCN, served on the DNP Task Force, which was instrumental in drafting the NACNS position paper on doctoral level for CNS entry to practice, and also serves on the Education Committee.


OACNS 2016 Board: president-Ruth Ann Fritz, president elect-Lori Ormsby, secretary-Stephanie Moore, treasurer-Debra Perdue, immediate past pres-Tamara Meier


Directors-at-large: membership-Lisa Lee, CE committee-Lynette Gunn, public relations-Cherene Black, legislative committee-Susan Dresser, nominations committee-Melissa Craft


Other board members: student reps-Samantha Kuplicki, Keri Houck, and Jamie Hunt