1. Dunn, Kathleen L. MS, RN, CRRN-A

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Kathleen L. Dunn is the 2003 recipient of the Clinical Nurse Specialist of the Year Award, which was presented by the National Association of Clinical Nurse Specialists (NACNS) at its annual meeting in Pittsburgh, Pa. Ms Dunn was selected based on her outstanding level of skill and knowledge in her specialty area, CNS practice competencies, commitment to quality patient outcomes, support for the advancement of nursing practice, and collaboration to improve patient care. Chris Trelease, MSN, RN, C, and several other CNS colleagues at the VASDHS nominated Ms Dunn. Kathleen graciously shared her insights about nursing in response to the following questions.


What first motivated you to become a clinical nurse specialist?

As with many nurses, I wanted to advance in the area of clinical practice. The breadth and depth of CNS practice and the flexibility of CNS positions were most appealing. I enjoyed teaching, and the practice competencies included teaching patients, families, and nursing staff.


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

My first CNS job was in the same hospital where I worked as a staff nurse. Making the transition from staff nurse to CNS had its challenges, primarily in changing relationships. Also, I had to learn to structure my day and not rely on the typical routine of a staff nurse role. I had to schedule up meetings, plan for rounds, and establish educational programs. I needed to balance my agenda with making time available for staff-initiated projects. As a new CNS, I found my nursing supervisor to be an enormous help in assisting with getting organized, setting priorities, and managing time. I kept a log for the first 6 months and, on a weekly basis, discussed time spent in each of my areas of responsibility with my supervisor. With the supervisor's help, I set goals for 2-week blocks of time. I found this helpful and recommend this same activity to any new CNS.


What do you perceive are the key issues for CNS practice today?

I believe continued recognition of the value of CNSspecialist practice by other nurses, administrators, and the public is our greatest challenge today. CNS practice is unique, as are our contributions to patient care. The notion of an advanced practice nurse as one entity is damaging CNS practice. It is our responsibility to educate nurses, regulators, and professional organizations about the unique elements of our practice.


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

I believe my contributions to the 1989 opening of the Spinal Cord Injury Center at the VASDHS is one of my greatest accomplishments. I have been serving as the CNS in this program since its inception. One of the most gratifying aspects of my practice involves providing sexuality counseling and education to patients with spinal cord injuries. I started the first Internet-based nurse-advice discussion board for people with spinal cord injuries. I coordinate the panel of 6 CNSs who moderate, answering consumer questions at Recently, I was honored by an opportunity to teach spinal cord injury care in Ribierao Preto, Sao Paulo, Brazil.


What do you enjoy or value most about being a CNS?

I enjoy direct care. I like the flexibility of my CNS practice and the ability to affect the quality of patient care both directly and indirectly by educating staff and changing practice norms.


What advice would you give a new CNS?

Find a need and fill it. Get your foot in the door any way you can, and make sure what you do becomes important and indispensable to the system. Establish your competencies by tackling a problem for the system. Success with a system-defined problem will give you leverage for projects that you find interesting. Be stalwart for quality, and continuously question the status quo.



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