Article Content

The following is a great example of our volunteers in action-clinical nurse specialists donating their time and energy for the benefit of others. This May I attended a called meeting for the American Nurses Credentialing Center (ANCC) for the Clinical Nurse Specialist (CNS) Role Delineation Study. The participants all volunteered their time and efforts for this important meeting in Washington, DC. The purpose of the meeting was to review and update the list of work-related activities performed by CNSs; compile a list of knowledge, skills, and abilities needed to perform CNS-related activities; review a draft of demographic-related questions to be included in the national survey; and discuss other survey development-related issues, as required. The time frame for this meeting was an intensive 20 hours on Thursday, May 15, to Saturday, May 17, 2003. During these few hours, we had an overwhelming responsibility to complete our assigned tasks.


Our facilitators from ANCC were Christine DePascale and Barbara Burnham.


The participants of the meeting were:


Clinical Specialist in Adult Psychiatric and Mental Health Nursing


Loretta Birckhead, EdD, APRN, BC, CGPDella Derscheid, MSN, APRN, BC, PHN


Clinical Specialist in Child/Adolescent Psychiatric and Mental Health Nursing


Leslie Murtagh, MS, APRN, BC


Celia Wintz, PhD, RN, CS, BC, PMHNP, LPC


Clinical Specialist in Medical-Surgical Nursing


Janice Hawkins, MN, APRN, BC


Theresa Posani, RN, CNS, CS, APRN, BC, CCNS, CCRN


Clinical Specialist in Gerontological Nursing


Theris Touhy, ND, APRN, BCCaroljean McLean, MSN, APRN, BC


Clinical Specialist in Community Health Nursing


Sandra Brennan, PhD, APRN, BC


Clinical Specialist in Home Health Nursing


Vickie Britson, MS, APRN, BC


Mary Curry Narayan, MSN, APRN, BC, CSN, CTN


Clinical Specialist in Pediatric Nursing


Nancy Page, MS, APRN, BC, CDE


Nancy Noonon, MS, RN, APRN, BC



Volunteers were selected because of their knowledge, expertise, and contributions to the profession of CNSs. They worked diligently and donated tremendous efforts to respond to the compiled data that will affect CNSs in vast specialties. We represented more than 7,390 CNSs in adult psychiatric and mental health nursing, more than 1,024 CNSs in child/adolescent psychiatric and mental health nursing, more than 2,377 CNSs in medical-surgical nursing, more than 738 CNSs in gerontological nursing, more than 422 CNSs in community health nursing, more than 56 CNSs in home health nursing, and more than 33 CNSs in pediatric nursing throughout the United States.


The purpose of the ANCC CNS Role Delineation Study was multifocused: define a specialty's "domain of practice; link 'domain' of practice to specialty's examination; collect evidence for content validity; and provide a current test content outline (TCO) for examinations." Ms DePascale presented the initial information on the purpose of the meeting and our roles/responsibilities as volunteers with this study. In her presentation, Ms DePascale defined content validity and our steps to establish content validity through the identification of activities performed on the job; identification of knowledge, skills, and abilities (KSAs) required to successfully perform the identified activities; and the required test items written that demonstrate the examinees KSAs to perform the activities of the job.


Participants identified the KSAs through an interactive process that integrated nursing theories, research, and several resources developed by our organization and published in our journal. Examples include A Description of the Roles, Activities, and Skills of Clinical Nurse Specialists in the United States, by Rhonda Adams Scott, PhD, RN, CNS, Past-President of NACNS (Clin Nurse Spec. 1999;13:183-190.). Another excellent resource used by many members of the group was the NACNS Statement on Clinical Nurse Specialist Practice and Education (September 1998). With such a diverse selection of CNSs in our group, this initial listing of activities was extensive.


The significance of KSAs lies in their link to test items. Test items demonstrate the KSAs that the examinee must have to perform the activities for our specialty areas. For example, if the test item requires the examinee to know the steps of facilitating change in the work environment, then the examinee must know about change theory; how to facilitate change; how to facilitate change in groups of people (staff, physicians, patients, families, etc.); and how to measure if and when change takes place.


The May 2003 meeting represents the strides NACNS continues to make as a key player in the healthcare arena. Endeavors from this meeting reflect the commitment of our volunteers to represent the organization in advancing the role and practice of the CNS. The next phase of this project involves the pilot survey and data analysis. Ultimately, the role-delineation panel for each specialty examination will meet independently to review and analyze data from the survey and prepare a TCO for its individual examination and appoint the Content Expert Panel (CEP). A major responsibility of the CEP is reviewing the TCOs to validate them for their specialty examination. The CEP members are practicing CNSs and faculty CNSs in these specialty areas for each examination. As the CEPs are formed, there will be a call for members. Members are strongly encouraged to submit their names for the CEP when ANCC has a call for volunteers.


NACNS Statement on Clinical Nurse Specialist Practice and Education

This document articulates the competencies requisite to CNS practice, outlines the necessary outcomes of nursing, and provides direction to schools of nursing regarding the preparation of CNSs. You can purchase your copy of this landmark document through the NACNS Office. The cost is $15 per copy for members of NACNS and $25 per copy for nonmembers. Discounts are offered on purchases of 15 copies or more. Contact the NACNS Office today to order your copy of the Statement.