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Are We Broken?

As you all know, there have been 2 new nursing roles advanced by the American Association of Colleges of Nursing (AACN). They are the Clinical Nurse Leader (CNL) and the Doctor of Nursing Practice (DNP). Our first CNL white paper is currently in revision as the role has evolved from baccalaureate to master's level. The white paper on the Nursing Practice Doctorate is published in this issue of the journal and posted on the NACNS Web site. This column addresses that role.


Is advanced practice nursing currently broken? I have seen and heard a lot of reasons about why the DNP is needed, some of which are covered in the NACNS white paper. What I have not seen is good data to support that advanced practice nursing is now broken and in need of the DNP role. There are no data to show that clinical nurse specialists (CNSs) prepared at the master's level are unsafe and need further education at the doctoral level. I understand from colleagues in the other advanced practice roles that significant harm data does not exist for them either. There is no data from graduate nursing students that they wish to prolong their educational programs. There is no data from employers that they need doctorally prepared advanced practice nurses, instead of master's prepared advanced practice nurses.


If I assume that advanced practice nursing is broken, then the next logical question is: Can the DNP role fix it? Being an educator, I searched for curricular requirements for DNP education. The AACN Essentials document for the DNP is being developed, so at present no national-level requirements were available.


My next step was to review the 8 DNP programs currently operating to see if I could determine the requirements based on what those programs included. There is little consistency across these programs. Credit hours for nurses with master's degrees vary from 30 hours to 71 hours and for those with a baccalaureate degree vary from 82 hours to 124 hours. The majors in the DNP programs also vary significantly. Some prepare only advanced practice nurses, whereas others included preparation in advanced practice and other areas. Required coursework is as varied as the majors. Clinical residencies are required in 3 programs and vary from 1 semester to 1 year. So the 8 programs are preparing 8 different DNP products.


That brought me to my final question: Does the DNP fix advanced practice nursing? I invite you to take the same journey I did and to come up with you own conclusions to that question.


NACNS Update

News From Our Committees

Marketing, Publications and Communications Committee: The CNS-who is she/he? Have you noticed how there is ambiguity surrounding our existence? The marketing committee is working on this issue. We would like to "brand" the term CNS so that others, such as patients, nurses, and administrators, know who we are and what our value is. We are beginning by asking you for your help.


Can you think of up to 5 words that describe the CNS? We are looking for words that describe who we are, no matter what our area of specialty is. We are looking for words that describe our essence, not our tasks or the old subroles. Can you help? Please e-mail any thoughts to [email protected].


In addition if you are interested in helping with this vital, vibrant committee, please send your CV to [email protected]. Thanks so much.


Membership Committee: Don't forget our annual Member-get-a-Member campaign!! Now, more than ever we need to speak with a single voice. The NACNS is the only organization that speaks for all CNS specialties at a national level. As we grow in number of members, the power and voice of NACNS will ensure the future viability of the CNS role within healthcare. Win a free membership for a year if you recruit more than 10 new members. The person who recruits the most new members wins a free registration to the next annual convention and free membership for a year!!


News From Our Affiliates

Montana: The newly formed Montana Association of Clinical Nurse Specialists (MACNS) held its spring meeting in Bozeman, Mont, on May 4, 2005. This meeting was held at the same time as the Montana State University College of Nursing spring faculty meeting to facilitate discussion between the College of Nursing faculty and the MACNS regarding their collaboration on the college's new clinical nurse specialist distance education programs in adult health: Care of Adults with Complex, Acute, and Chronic Health Problems and in Community/Public Health.


In addition, the MACNS is organizing a statewide database of practicing CNSs to improve communication between rural specialists and to encourage partnerships with specialists and our newly formed association. Another objective in increasing statewide communication between CNSs is to identify educational needs within CNS practice in Montana so that future educational activities of the MACNS can be designed to meet these needs.


Oregon: The Oregon Council of Clinical Nurse Specialists is working hard to get our bill for optional prescriptive authority through the legislature this year. Our bill passed in the senate with a unanimous vote in the affirmative. On to the House!!


Member Accomplishments

Dr Nancy Dayhoff Tribute and Scholarship Fund Establishment

The Nursing Division at Major Hospital recognized Nancy E. Dayhoff as a nurse leader who has contributed immensely to elevating and advancing nursing practice and patient care at Major Hospital. Dr Dayhoff, the immediate past president of Major Hospital's Board of Directors and a 2-term vice-president for NACNS, has been a champion for nurses and patients at Major Hospital since 1978. Dr Dayhoff, a professor Emeritus in Nursing at Indiana University taught many advanced practice nurses who in turn have brought their knowledge, skills, and talents to the nursing community. Upon retirement from Indiana University, she received the Sagamore of the Wabash Award from the Governor and was recognized by the Indiana Senate and House of Representatives. As a result of this dedicated service, nurses throughout the Major Hospital system established a nursing scholarship fund through the local Blue River Foundation in her honor. This fund will support an annual scholarship in the amount of $500 to be given to a Major Hospital nurse wishing to continue his/her formal education or attend a professional nursing seminar/conference. The intention is to honor Dr Dayhoff by recognizing her annually, supporting her life's work of nursing education and continued advancement of nursing practice in our community. Thank you Nancy for everything you've done for nursing, Major Hospital, and this community.


Alumna of the Year

Barbara Hazard Munro, PhD, RN, FAAN, received the University of Rhode Island College of Nursing Alumni Award this year (April 15, 2005). Dr Munro currently serves as a member of the board of directors for NACNS and associate editor for the journal.


New Investigator Research Award From the American Geriatric Society

Dr Patty Coleman, a member of the NACNS Gerontology Task Force, received the New Investigator Research Award from the American Geriatric Society. Dr Coleman works as both a CNS and NP in gerontology in a nursing home practice. Dr Angela Clark stated that "her research clearly demonstrates the power of on[horizontal ellipsis]and is about oral hygiene as an intervention to prevent acquired pneumonias in the nursing home setting." Congratulations Dr Coleman!!


Share Your Accomplishments!!

Do you know NACNS members who have had awards and recognitions of note? Share the information with your peers. Let our newsletter editor know of the many stellar things you and other members are doing!! Contact her at [email protected]


Are You Preparing for the 2006 Annual Convention?

March in Utah? Not what you might expect!! Skiing, shopping, sharing, learning, and more in very temperate weather. We will be reaching for the highest heights in Salt Lake City, Utah, in 2006!!


The Clinical Nurse Leader Initiative From the American Association of Colleges of Nursing-An Update

When the AACN first issued its white paper on the new role being proposed, the Clinical Nurse Leader, the NACNS wrote and released a position paper. Although it has been a little more than a year since that document was issued (March 14, 2004), it is outdated due to the fact that the preparation of the CNL moved from baccalaureate to master's level preparation.


NACNS is in the process of revising the position paper. Please keep an eye out on the NACNS Web page for current documents and/or revisions of documents as issues of national importance are reviewed and a response is formulated by your board of directors.


New Web Page!!

Please check out the new Web page for NACNS!! We are making an effort to keep our pages current and up to date so that you can receive immediate information about the latest information on national issues. Check it out at


Also, be on the lookout for a survey that will ask you to review our competency statement and give feedback on how the document relates specifically to the competencies required for your work as a CNS. This survey will be available soon on the Web page. Watch for it!!


Do You Use CPT Codes?

NACNS is looking for CNSs who use CPT codes in their every day activities. If you do and would be willing to serve on a committee exploring the use of CPT codes for CNSs, please contact Christine Filipovich, MSN, RN, at the NACNS office at [email protected]


Think About Nominating Someone for the NACNS Yearly Awards

Each year at convention there are a number of awards that are given to members who have made significant contributions to the care of patients or the advancement of the profession. In the next issue of the newsletter we will give detailed descriptions of the criteria and nominating process but be thinking about the following categories for all members:


* CNS of the Year


* Affiliate of the Year