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Going From Good to Great

It is my honor as the incoming President of NACNS to send a greeting to you. We have had some wonderful leaders in our organization past and present, and I hope to provide continuity on our worthwhile ongoing projects and a vision of where we can go. Dr Jan Fulton has served as our President for the past 15 months rather than the usual 12, due to a change in by-laws to match our operational year to the March conference. She has made a remarkable impact on the visibility of our organization, charting our course nationally. Fortunately for NACNS (and me), she will continue with us as Past-President for the next year and continue to share her wisdom and experience. Somehow, she has found the energy to serve as President and also as Editor of the Clinical Nurse Specialist (CNS) journal during the same time period-an amazing woman!!


To prepare for this next challenge, I have served the organization in a variety of roles: chair of the Nominating Committee; Vice President for 2 years; President-Elect for 15 months; and co-chair of the Task Force to revise the NACNS Statement on Practice and Education, a task that took almost 2 years. My family keeps asking how much I get paid for all of these opportunities and they are astonished to find that it is all volunteer service!! Like many of you, my career brings so many personal and professional rewards that aren't measured by dollar amounts. Two main things particularly make it worthwhile-one, there is great satisfaction knowing that we are advancing CNS practice with our many NACNS activities, and two, the people who are attracted to become active in the organization bring great passion, the willingness to debate tough issues, and an unselfish spirit where the organization and CNSs come first before personal gains.


Good is the Enemy of Great

At a recent faculty meeting, my Dean, Dr Dolores Sands, described a fascinating book about why some companies are so successful compared to others, and challenged her faculty colleagues to glean some of the messages applicable to our field of work. The book titled Good to Great1 was written by Jim Collins, a former business professor at Stanford, and has sold over a million copies thus far. He and a team of 20 other researchers analyzed the journeys of 11 successful companies who made the leap from good to great and sustained the results for at least 15 years. Measures included beating the general stock market by an average of 7 to 15 times in 15 years. What qualities did these companies and organizations possess? His thoughtful analysis of some of the premises1 may be fitting in our NACNS organization at this juncture in time.


* The good-to-great leaders began their company's transformation by first getting the right people on the bus and only then figured out where to drive it.


* Good-to-great companies faced as much adversity as the comparison ones but responded to that adversity differently-they hit the reality of their situations head on and emerged stronger than ever.


* If you have the right people in the organization, you don't have to spend time on trying to motivate them. If you have the right people, they will be self-motivated. The key is to not demotivate them.


* Although a bit of a paradox, retain faith that you will be successful in the end regardless of apparent difficulties, but keep confronting the most brutal facts about your present reality.Admiral Stockdale is the exemplar described in the book because of his bravery and survival during 8 years in Vietnam as a prisoner of war. He never ever lost faith in the positive outcome of his story, feeling that he would prevail in the end, despite the unbelievable reality of those years for him. He said that it was the optimists who didn't make it-because they suffered repeated disappointments when they were not rescued.


* Great results depend on building a culture of self-disciplined people who engage in disciplined thought and then take disciplined action.



Strengthen Our Power

The work of NACNS as the professional organization representing more than 67,000 CNSs in the national policy arena is so vital. We need you and your leadership skills to stay involved with NACNS on our journey to become a truly great organization. Become an ambassador for NACNS and speak up for CNS practice whenever you get the chance in order to influence CNS visibility, nursing practice, and patient outcomes. Consider forming an NACNS affiliate in your city or region. Study the membership directory and see if there are CNSs who you find are not current members and recruit them. CNS educators should encourage their colleagues and graduate students to join the organization and become team players. We must increase our membership to support continued legislative and regulatory initiatives for protecting the rights of CNSs to practice. I am so honored to serve as President of NACNS for the next year and am ready to join the new Board of Directors in the challenge ahead as we advance CNS practice. I look forward to dialogue and interaction with you!!


2004 Election Results



Theresa Posani




Kelly A. Goudreau




Peggy S. Gerard




Barbara Munroe


Pat Bielecki


Nominating Committee


Margo Halm


Pat O'Malley


Jan Powers


Patti Zuzelo


Cheryl Westlake Canary


These are your newly elected officials. They will be taking office at the March 2004 annual meeting. We offer our appreciation to all outgoing members who have served us well this last year. Thank you for your never ending time and efforts.


Members on the Go

In November 2003, Dr Angela P. Clark, our incoming President, was inducted as a Fellow into the American Heart Association (aFAHA). Dr Clark is an associate professor at the University of Texas at Austin School of Nursing where she teaches CNS students, and is a CNS in cardiopulmonary and diabetes care. She has presented her research at many national/international scientific conferences, has a variety of peer-reviewed publications about care of patients with cardiovascular conditions, and has received federally funded research support. Her research and clinical interests include care of people living with heart failure, prevention of cardiopulmonary arrests, nursing interventions for critically ill patients, and family presence during resuscitation and invasive procedures.


Notes From Committees

Research Committee


The 2004 Membership Census was approved and launched in January.


The committee is working on revisions to the Membership Survey, which will be implemented after the annual conference in March 2004.




The number of NACNS affiliates has expanded with the establishment of groups in central New York State and in southern California.


The informational packet for groups considering affiliate designation has been finalized and approved for distribution by request to the national office of NACNS.


Volunteers in Action

Just this winter your volunteers here at NACNS have been busy on your behalf. I was recently in Washington, DC, as part of the Board on Certification as the Chairperson of the Medical-Surgical Clinical Specialist Content Expert Panel (CEP) with the American Nurses Credentialing Center (ANCC). I was 1 of the 17 advanced practice nurses present who were representing their own CEP at this meeting. The ANCC staff brought us up to date on the goals for the upcoming year and our progress on these same goals for 2003. With many of our examinations experiencing decreased candidates taking the exams for the first time, several of our CEPs are concerned about their survival. As of October 2003 all 7 of the CNSs examinations are showing a low number of applications. According to ANCC the end of the year is typically a time of high numbers for the certification examinations for both first-time applicants and recertifying candidates. Let us hope this trend continues for the last few months of 2003. If many of our states are requiring CNSs to have advanced practice certification for recognition, where are the CNSs becoming certified? What certification examinations are the CNSs completing? We need to continue to support our peers in their efforts to successfully complete their advanced practice examinations.


As of October 2003, there are a total of


* 7366 CS in Adult Psychiatric and Mental Health Nursing


* 1020 CS in Child/Adolescent Psychiatric and Mental Health Nursing


* 2396 CS in Medical-Surgical Nursing


* 731 CS in Gerontological Nursing


* 415 CS in Community Health Nursing


* 56 CS in Home Health Nursing


* 38 CS in Pediatric Nursing



As members of NACNS we do receive a discount toward the cost of the CS examinations with ANCC. Take advantage of this discount when applying for your certification examination by listing your membership on the application. During the year NACNS will be posting opportunities for volunteers to serve on the CEPs as positions become available. Watch for these opportunities and remember that we seek your expertise as a CNS for these volunteer positions with ANCC.


Submitted by,


Theresa Posani, RN, CNS, CS,




Texas Clinical Nurse Specialists

Are you interested in networking with other CNSs


Are you interested in learning more about legislative efforts that affect your practice as a CNS?


Are you not interested in going to one more meeting?


If you answered yes to any of the above questions, you may want to join our virtual group of CNSs here in Texas. Our group will be known as Texas Clinical Nurse Specialists (TxCNSs).


To join or request more information send an e-mail to or send a note to TxCNSs at PO Box 830460, Richardson, TX 75083. We will send you information on how to join our listserv (e-mail group).


Who may join? Past, present, future CNSs in Texas and faculty in CNS programs.


Cost? $15.00/year; student membership $10.00/year.


Affiliation? National Association of Clinical Nurse Specialists (NACNS) (pending).


Look for us at the annual meeting in San Antonio in March 2004. We will have a get together during this time. Look for the posters on display announcing when and where.


New Statement on CNS Practice and Education

The new NACNS Statement on CNS Practice and Education, 2nd edition, 2004, has just been published!! After almost 2 years of analysis of NACNS positions, regional work sessions, and continuous dialogue with CNS educators and practicing CNSs, the Statement Task Force and NACNS Board of Directors completed the document. During this time, it was also circulated to a variety of stakeholders who provided vital feedback and suggestions. In September 2003, it was available for public comment nationally, and following those valuable reviews and critiques, further refinements were made to clarify important areas of discussion.


The Statement has 4 goals: (1) to articulate competencies for CNS practice and associated outcomes; (2) to make explicit the contributions of CNSs in meeting societal healthcare needs; (3) to provide a foundation for core CNS credentialing, including certification examination, portfolio, or other mechanisms; and (4) to provide a standardized framework for CNS education at the graduate level. It is organized into 3 main sections: (1) CNS practice including essential characteristics of a CNS, and a conceptual model of CNS practice; (2) CNS competencies and outcomes of CNS practice; and (3) recommendations for graduate preparation of CNSs. Appendices include a glossary of key terms, and a comprehensive annotated bibliography of research studies and articles about CNS practice. To order a copy of the Statement go online to


NACNS expresses its gratitude to all who participated in the revisions and preparation of this second edition, including the Statement Task Force, the NACNS Board of Directors, the Education Committee, and to all who provided such thoughtful critiques along the way, promoting excellence in the final product.


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.


2004 National Association of Clinical Nurse Specialists Board of Directors



Angela Clark


Immediate Past President


Jan Fulton




Theresa Posani




Nancy E. Dayhoff




Peggy S. Gerard




Kelly A. Goudreau




Kathleen Baldwin


Theresa Murray


Barbara Munroe


Pat Bielecki


Newsletter Editors


Theresa Posani


Deborah Antai-Otong




Executive Director


Christine Carson Filipovich




2090 Linglestown Rd, Suite 107


Harrisburg, PA 17110


Telephone: 717-234-6799


Fax: 717-234-6798






On January 30, 2004, NACNS membership reached 1500. Congratulations!! This represents a 20% increase in membership over last year (1247 members as of January 30, 2003).




1. Collins J. Good to Great: Why Some Companies Make the Leap and Others Don't. New York: HarperCollins Publishers; 2001. [Context Link]