1. Haldeman, Sioban MSN, RN, CNS
  2. Gonzalez, Colleen MSN, RN, CNS
  3. CIerpal, Chelby L. MSN, RN
  4. Cox, Erin MSN, RN, CNS
  5. Silva, Judith H. MSN, RN

Article Content


To describe a unit-based strategy to create a culture where staff is developed, retained, and empowered to solve unit and organizational problems.



The development of clinical staff in direct care roles has historically been imbedded as a core value of CNS practice. Through the development of staff, the quality of clinical practice can be optimized and the CNS can affect the spheres of influence directly for patient care and clinical staff. The added value of CNS practice to the organization includes quality clinical practice, patient satisfaction, and staff retention. In addition, staff who are empowered and capable of meeting their potential as care providers. CNSs, while directing their efforts towards staff, are not alone in this development work. In settings where there are multiple nursing job roles, navigating and ensuring the development of every clinical staff person can be complex.



At our academic medical center, with Magnet designation, there are many nursing roles that influence the development of clinical staff. CNSs are unit-based or service-based within this organization. The clinical staff are expected to maximize their full potential by embracing the efforts of many resource persons and groups. Within the staff nurse role, there are individuals who develop their peers every day.



The Interventional Cardiology Unit, a 36-bed inpatient service, uses an NP-based model, as part of an interdisciplinary patient and family centered care model. There are 2 CNSs who share accountability for the unit-based clinical staff development with the nurse manager. The unit's entire clinical and operational staff is managed by a nurse manager. There is also a CNS who is a dedicated nurse researcher and who is based within the cardiology nursing units, that also contributes in a unique way to the development of clinical staff and nursing leaders.



The success of this model can be recognized through the clinical practice in direct clinical care, the retention of the clinical staff, the satisfaction of patients, and the achievements of the clinical staff.



CNS practice remains integral in the development of clinical staff. To succeed in developing and retaining staff, there is an inherent need for all To contribute to sustaining this culture.



CNS practice must remain closely aligned with the development of staff. Concentrating on the unit-based clinical practice development will ensure a highly functional team of clinical staff and nursing leaders. Communication and a culture that can support such development will thrive in the presence of highly developed clinical staff.


Section Description

This year's annual NACNS conference is planned for Orlando, Fla, March 9-12, 2005. Over 300 clinical nurse specialists (CNSs) are expected to attend, and as with past conferences, attendees will also include graduate faculty from CNS programs, nurse administrators, and nurse researchers. The theme of the conference, CNS Leadership: Navigating the Healthcare Environment Toward Excellence, was selected to showcase the many ways CNSs acquire and disseminate knowledge and innovative practices in their specialty areas. Two preconference sessions are scheduled. One session, sponsored by NACNS Legislative/Regulatory Committee, targets information for CNSs interested in understanding the legislative/regulatory process as it deals with the practice of nursing, and will also help build skills CNSs need to engage in the process. The second session, sponsored by NACNS Education Committee, focuses on CNS education issues, and as with the education preconferences of past years, anticipates informative dialogue and much sharing among CNS educators around curriculum design, teaching strategies, and indicators of quality in the curriculum that link to the NACNS education standards to program review and excellence. The conference planning committee is proud and pleased to have Jeanette Ives Erickson, MS, RN, CNA, Senior Vice President for Patient Care Services and Chief Nurse Executive of Massachusetts General Hospital as the opening keynote speaker. She will begin the conference by highlighting the importance of CNS practice on patient safety. The planning committee is equally proud and pleased to have NACNS past-president Rhonda Scott, PhD, RN, Chief Nursing Officer of Grady Health System as the closing speaker. Dr Scott will challenge attendees to use the information from the conference to shape quality care delivered in a safe environment and to advance the profession of nursing through direct care to clients, influencing standards of care delivered by other nurses, and influencing the healthcare delivery system to be to support innovative, cost-effective, quality nursing care. A total of 64 abstracts for podium and poster presentations were selected in addition to graduate student posters. The abstracts address the 3 spheres of CNS practice with a strong emphasis on clinical practice improvements. As you will note from the abstracts published in this issue of the journal, specialty practice areas represented in the abstracts include children, adults, and gerontological patient groups; hospital, outpatient, and home care settings, and community health. In addition, a wide variety of specialty topics including smoking cessation programs, end-of-life care issues, and protocols outlining nursing approaches to improved diabetes, cardiovascular and ventilator management. A number of the abstracts described hospital and healthcare system level innovations that resulted from CNS practice. Collectively, these abstracts reflect the breadth, depth, and richness of CNS contributions to the well-being of individuals, families, groups, and communities. The following abstracts are from those presenters who elected to have their work published in the journal so those who are unable to attend this year's conference can share in the knowledge of the conference. As you read each abstract, consider the talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to improved outcomes for patients and healthcare organizations. You may want to contact individual presenters to network, collaborate, consult, or share your own ideas about these topics. Watch for next year's call for abstracts and consider submitting an abstract for presentation at NACNS's next conference in Salt Lake City, Utah, March 15-18, 2006.