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Thousands of Points of Light-Not Visible to the Naked Eye

In May our Executive Director Christine Filipovich and I visited with Dr Denise Geolot, the director of the Division of Nursing in the Health Resources and Services Administration (HRSA), and Dr Patricia Calico, a nurse consultant to HRSA. Each year the National Association of Clinical Nurse Specialists (NACNS) president and executive director visit the HRSA to update the Division of Nursing about CNS practice and education. Our hope is that these annual visits will help increase funding opportunities for CNSs and CNS education. Our visit brought to mind the critical importance of describing and publicizing outcomes of CNS practice. Dr. Geolot asked for NACNS's help in making national health policy leaders aware of the difference that CNSs make. She suggested that NACNS should disseminate outcomes of CNS practice to demonstrate the need for CNSs and CNS education and suggested that this data would be helpful for her budget request to Congress. She also suggested that CNS programs would include this information in their applications for HRSA funding. It also brought to mind one of my first tasks as an NACNS board member. The NACNS Statement on Education and Practice was under revision and I was assigned to that project. I volunteered to do the bibliography, not really knowing what I was getting myself into! My assignment was to collect and critique all articles published by CNSs from 1998 to 2003. I had significant issues collecting the information and spent hours trying to track down appropriate articles.


So I have spent the past little while thinking about these 2 events and have come up with the following conclusion-although we may be bright and shining stars in our individual facilities, we are often invisible in larger venues. Why? I am sure there are other reasons, but here are 2 I have identified.


1. We don't publish often enough. The following are comments I have heard from CNSs about why they don't publish.


a. "I don't write well." No one is born writing well. It is a technical skill that can be learned. Ask for help with your manuscript from someone who has published. Consider a co-author who will help you develop your manuscript. Start a writing club with other CNSs for support and critique.


b. "I'm too busy doing the project to write about it." If you don't publish your work, you may not be busy for long. This is a volatile time in healthcare and each professional group must carve out and hold onto its market niche or someone else is going to grab it. Publishing our projects is one way to let everyone know exactly what CNS work is about.


c. "What I do isn't really research, so no one would publish it." If what you are doing is making a difference in patient care outcomes, it is publishable. If what you are doing saves your institution money, it is publishable. If what you are doing creates a safer working environment, it is publishable.


d. "What if I write the article and the journal rejects it?" If a journal rejects your manuscript, they are going to provide you with feedback that can serve as an excellent starting point for revision. Sometimes your article is just not a good fit with the journal. If you are rejected, you just revise and resubmit to another journal.


2. Sometimes it is difficult to identify CNSs who do publish. Here are some of the issues I had when I did the literature review.


a. Some authors do not identify themselves as CNSs. In some states CNSs are grouped under advanced practice nurses and are referred to as APNs or APRNs. Some CNS authors use this abbreviation instead of CNS, making it almost impossible to identify them.


b. Some journals do not identify authors as CNSs. This also adds to the difficulty in identifying articles published by CNSs.


c. The term, CNS, may not be referenced as a search term for the article. The best example I found of this was an article written by a multidisciplinary group. The CNS member had a significant part in implementing the study protocol. I found the article quite by accident. I would never have known about it if I had searched for it using any of the search engines, because CNS was not referenced as a search term.



Please publish your work and please let NACNS know when you do. We owe it to ourselves to make certain that the public, health policy leaders, and other health care providers see clear evidence that what CNSs do every day makes a critical difference to patients and to health care systems, and has a major impact on the quality, safety and cost effectiveness of care!



Member Recognition

Are you or someone you know doing something on behalf of NACNS on a national level? Are you an active NACNS member who now holds office or is on a taskforce looking at issues of relevance to CNS practice? Have you received an award that you would like to let us know about? Please let us know so we can share the good news and good work you are doing with your peers in this newsletter! Feel free to contact the newsletter editor, Kelly A Goudreau, DSN, RN, CNS at and share the news! Here are just two of our members who have been active and recognized for their contributions:


Denise O'Brien attended a July 21, 2005 CMS-sponsored informational meeting on behalf of NACNS in Lansing, Michigan. The meeting was a forum for addressing certain HIPAA provisions, including the National Provider Identifier number.


Colleen Lucas RN, MN, CNS, APRN-BC, recently received the 2005 Honorary Nursing Education Award from the Oregon Nurses Association (ONA) for her mentorship of clinical nurse specialist (CNS) students and excellence in teaching. She is an assistant professor at the Oregon Health and Science University (OHSU) School of Nursing, Marquam Hill Campus, in_Portland. She is also magnet recognition project coordinator for the OHSU hospitals and clinics. The Oregon Council of Clinical Nurse Specialists and CNS students at OHSU nominated Lucas for the award.


Board of Directors News

Alternative Link and Pepid Products: NACNS members are actively involved in editing and providing content for the two projects listed above. Be on the lookout for products for your PDA that have been developed or co-sponsored by NACNS! Want to know more about them? Check out our Web site!


Members Recruited for California Governor's Nursing Summit: In response to a request from ANA, NACNS recruited several members interested in attending a Summit to be convened by California Gov. Schwarzenegger. ANA intended to submit their names and contact information for the invitation list. Another example of CNSs and NACNS ensuring that our voice is heard in healthcare!


October 2005 Board Retreat: Each year your board of directors convenes in a face-to-face retreat where a tremendous amount of work is conducted. Our hosts are the Hill-Rom family. On an annual basis, they host our board of directors on their farm so that a face-to-face board retreat and much work can be accomplished. It is with gratitude and many thanks that the board acknowledges the hospitality of the Hill-Rom family. They are just one group that has demonstrated enduring support of the NACNS and our mission to serve our members.

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Introduction of New Board Member

Hello! As one of the newest members of the NACNS Board of Directors, I would like to introduce myself. I live in Oklahoma, having moved here from North Carolina about 15 years ago. I have been a CNS since 1989, graduating from the Critical Care CNS program at Duke University. I have held a variety of CNS positions both under the employment of a physician and hospitals. I currently am one of three CNSs in my hospital. My interests are anything cardiovascular, especially heart failure management. I am married, have 3 practically grown children, a dog, and a cat. Prior to becoming a board member, I served as President of the Oklahoma NACNS Affiliate Chapter, as a member of the NACNS Practice Committee, and was a CNS representative on the Oklahoma Board of Nursing Advanced Practice Committee. I obtained prescriptive authority about 5 years ago and became a Medicare provider at that time as well. I am especially thrilled to have the opportunity to work with the talented members of the NACNS Board of Directors to continue to define, promote, and practice in the CNS role.


Susan Dresser, RN, MSN CCRN, CNS


News From the Affiliates

California: We Californians are actively moving toward building our statewide CNS membership and reaching to the north. This year the California CNS Network is moving to support our northern and central California members. Two of our educational programs will be held north of the Los Angeles county line.


We held an educational meeting on July 30 from 11:30 to 3:00 in Fresno, in central California. Keitha Mountcastle hosted us at the California State University Smittcamp Alumni house. Evelyn Burruss presented "Show them the Money: Using the Research Process to Justify your Practice, your Curriculum or your Job." Lunch was served at 11:30 and the business meeting was conducted from 2:00 to 4:00 pm. The conference was on a Saturday, which allowed our LA members to plan a day trip to meet our newest CNS central California affiliates.


This year our all-day conference will be held in Northern California at the Lucille Packard's Children's Hospital in Palo Alto near Stanford University. The conference will be on October 28th at the Sheraton Palo Alto. We are grateful to Ann Becker for agreeing to host this event and we're looking forward to our keynote NACNS speaker Rhonda Scott.


I am excited about working with all of our California CNSs and hope to build a strong and supportive state organization. I am indebted to our outgoing chair Cheryl Westlake Canary for her active mentorship this last year. Hope to see you at either our October conference or at NACNS in Utah March 2006.


Submitted by


Margaret Talley, RN, CNS


Chair California CNS Network


Southwestern Michigan and Northwestern Indiana: The NACNS Illiana Lakeshore Affiliate is the newest affiliate to be established. Located on the southern shore of Lake Michigan, this affiliate will be accessible to CNSs from Southwestern Michigan, Northwest Indiana, and the greater Chicago area. Under the capable leadership of Kim Nagy, MS, RN, the affiliate's immediate plans are to recruit additional members, establish goals, and develop by-laws. The affiliate is looking forward to providing valuable networking opportunities for the many CNSs in this area. They are also looking forward to promoting the work of CNSs and helping CNSs expand their influence with respect to healthcare safety and quality.


Oregon: The Oregon Council of Clinical Nurse Specialists (OCCNS) can finally say that we have our bill for optional prescriptive authority! On June 16th we received word that our bill had passed the final vote in the house and was unopposed. We had already passed the senate with no opposition. A 4-year trek back and forth to the legislature had finally come to an end. Now we have new rules to write as we move forward with optional prescriptive authority for CNSs in Oregon.


We also have a new chair for our organization and this will be my last contribution as the chair of the Oregon affiliate. Our new chair is Sherri Atherton, MSN, RN, CNS, CIC. She comes to the position of chair with more than 20 years of nursing experience and more than 10 years as a CNS. Please welcome Sherri and send your good wishes our way here in Oregon as we celebrate many successes!


Submitted by


Kelly A. Goudreau, DSN, RN, CNS


Immediate Past Chair, OCCNS


Task Forces and Committee Reports

NACNS Research Committee

The Research Committee provides support to NACNS in a number of ways. This past quarter, some of the committee members had the opportunity to consult on 3 national-level data-based projects. American Association of Colleges of Nursing (AACN), Health Resources and Services Administration (HRSA), and American Nurses Credentialing Center (ANCC) were the recipients of our consultative services.


AACN Annual Enrollment and Graduations Survey Project

This is an annual survey of Schools of Nursing. NACNS partners with AACN on the CNS portion of the survey. The annual report captures institutional CNS profile, enrollment, and graduation data. Annually, the NACNS Research Chair reviews and gives input regarding the survey design, data sets, and data publication tables. In addition to Ann Mayo (Research Chair), Jan Fulton (NACNS Journal Editor), and Christine Filipovich (Executive Director), a member of the Education Committee (Mary Heye) also participated in the 2005-2006 survey review process.


HRSA RN Population Survey

The HRSA RN Population Survey uses a national stratified, random sample of active licensed RNs (employed and not employed) every 4 years (since 1975) to gather data regarding educational background, specialty areas, employment setting, position levels, salaries, job satisfaction, and demographics. The report has many purposes, including the allocation of nursing educational monies by the federal government. Ann Mayo, as well as Jan Fulton and Christine Filipovich, provided the consultative services to assist HRSA in the interpretation of CNS education and practice related data.


ANCC CNS Role Delineation Study

This role delineation study of 7 clinical nurse specialties (adult psychiatric and mental health, child and adolescent psychiatric and mental health, medical-surgical, gerontology, community health, home health, and pediatrics) was recently completed by ANCC for the purpose of updating ANCC test blueprints for national CNS certification examinations. Ann Mayo, Sue Davidson (research committee member), and other NACNS members assisted ANCC in a review of their study data and provided recommendations regarding dissemination.


Research committee members for 2005 include Ann Mayo, Chair; Jan Buelow; Sue Davidson; Kathi Ellstrom; Barbara Goldberg-Chamberlain; Gay Goss; Juanita Keck; Mary Duffy, and Barbara Munro, NACNS Board Liaison. For more information about NACNS Research Committee activities, contact Ann Mayo at


Submitted by


Ann Mayo


News From the Clinical Nurse Specialist Foundation

The CNS Foundation continues its mission to support the educational and scientific purposes of NACNS. The Board of Trustees is actively seeking additional members for the Board, as well as, designing strategies to enhance gifts to the Foundation. At the Foundation's first gala in Orlando, over $60,000 in gifts were pledged. The "1000 members at $1000" campaign allows NACNS members to invest $200 a year for 5 years (that's less than $17 a month) in the future of healthcare through clinical nurse specialists and their outcomes. When 1000 members participate, one million dollars will be available in 5 years to support scholarships, research, and the promotion of clinical nurse specialists. This is an exciting time for all of us. We appreciate your support through gifts, recommendations of board members, and ideas regarding development opportunities. Working together, NACNS members and the trustees of the Foundation can be successful in meeting our objectives. If you have questions regarding the CNS Foundation or would like more information regarding the "1000 members at $1000" campaign, please contact the NACNS office.


Thank you


Jan Bingle, MS, RN, Chairperson,


Board of Trustees, the Clinical Nurse


Specialist Foundation


Convention is Coming! Convention is Coming!

Please join us March 15-17, 2006 in Salt Lake City, UT. The NACNS 2006 conference titled "CNS Leadership: Soaring to New Heights" will focus on the outcomes and competencies of CNS practice for clients, nurses, nursing practice, and healthcare systems. The conference will highlight new strategies to change organizational culture, uncover system complexity, identify resiliency in nurses and other health personnel, and bridge gaps so that quality outcomes are achieved. The conference will be held at the Salt Lake City Marriott Downtown, 75 South West Temple, Salt Lake City, Utah 84101. Phone: 801-531-0800.


Each year at convention there are a number of awards that are given in recognition of our members and their ongoing contributions to the profession. Please review the following criteria and consider nominating a peer or a group of peers that you think are deserving of recognition.


NACNS CNS of the Year: NACNS created the award to nationally recognize a NACNS member for outstanding professional achievement in the 3 spheres of CNS influence. The award acknowledges a nurse who demonstrates CNS competencies and exemplary practice in patient care, nursing, and healthcare delivery systems.


NACNS Affiliate of the Year: The NACNS Board of Directors sponsors a yearly award specifically designed to acknowledge one of its affiliate members. Currently, there are 21 NACNS affiliates. This rotating award is given to an affiliate that illustrates one or more of the following: In the first 2-3 years, it has demonstrated sustained growth of the NACNS member component; Has offered an innovative, creative continuing education class, conference, or program that focuses on CNS practice; Has a leadership development effort to prepare CNSs for local, regional, and/or national office in a professional group; Has contributed to the growth and activities of NACNS (eg, co-hosting an annual NACNS conference); A member and/or members of the Affiliate have contributed an article to the CNS Journal on a topic of interest to CNSs in practice.


Two Additional Awards are given out at the discretion of the Board of Directors:The Sue B. Davidson Service Award and the Brenda Lyons Leadership Award.


Coming Next Year! Three new awards! The board is currently developing the criteria for 3 new awards: CNS Educator of the Year, CNS Preceptor of the Year, and the CNS Journal Article Author of the Year.


Please note! The deadline for submission of information for any of these awards is December 31, 2004.


Please submit all information and supporting material to:




2090 Linglestown Rd., Suite 107


Harrisburg, PA 17110




Kathleen M. Baldwin, RN, PhD, CEN, CCRN, ANP, GNP


Associate Professor and Director of Graduate Studies in Nursing


Texas Christian University


Harris School of Nursing




Theresa M. Murray, RN, MSN, CCRN, CNS


Critical Care Clinical Nurse Specialist


Community Health Network


1500 Ritter Ave.


Indianapolis, IN 46219




Jane Walker, PhD, RN, CNS


Associate Professor and Director of Graduate Programs


School of Nursing


Purdue University Calumet


Hammond, IN




Kelly A Goudreau, DSN, RN, CNS


Director of Education/Associate Chief of Staff for Education


Portland VA Medical Center




3710 SW US Veterans Hospital Road


Portland, OR 97239




Angela P. Clark, PhD, RN, CS, FAAN, FAHA


Associate Professor of Nursing


University of Texas at Austin


1700 Red River


Austin, TX 78701




Peggy Gerard, DNSc, RN


Professor and Dean, School of Nursing


Purdue University Calumet


Hammond, IN


MEMBER, TERM-3/12/2007


Susan Dresser, RN, MSN, CCRN, CNS


Critical Care Clinical Nurse Specialist


St. Anthony Heart Hospital


1000 N. Lee St.


Oklahoma City, OK 73101


MEMBER, TERM-3/13/2006


Sue Sendhelbach


MEMBER, TERM-3/13/2006


Barbara Hazard Munro, PhD, RN, FAAN


Dean William F. Connell School of Nursing


Boston College, Cushing Hall


140 Commonwealth Ave


Chestnut Hill, MA 02467-3812


MEMBER, TERM-3/12/2007


Linda D. Urden, DNSc, RN, CNA, FAAN


Executive Director, Nursing Quality, Education & Research


Palomar Pomerado Health System


Escondido, CA


Clinical Professor


University of San Diego


San Diego, CA




Christine Carson Filipovich, MSN, RN


Executive Director


2090 Linglestown Rd. Suite 107


Harrisburg, PA 17110


Phone: 717-234-6799


Fax: 717/234-6798




Announcements From Other Organizations

American Nurses Credentialing Center (ANCC)-Announcement re: CNS Certification Examinations: Clinical Nurse Specialist Supervised Clinical Hours


As a follow up to their previous announcement, this is a reminder that effective January 1, 2006, individuals seeking initial ANCC certification as a Clinical Nurse Specialist must have a minimum of 500 hours of faculty-supervised clinical practicum in their specialty as part of their masters CNS educational program and on their transcripts.


If you graduated from a CNS program with less then 500 hours of faculty-supervised clinical hours, you can make up the additional formal supervised clinical practice hours post graduation before January 1, 2006. Effective January 1, 2006, graduates from a CNS program with less than 500 hours of supervised clinical practicum will be unable to submit documentation indicating completion of the additional clinical hours post graduation beginning January 1, 2006, and thus, will be ineligible to take the CNS certification exam. This change reflects the Commission on Collegiate Nursing Education (CCNE)Standards for Accreditation (Amended 2003) on curriculum development in which the masters curriculum incorporates knowledge and skills identified in The Essentials of Masters Education for Advanced Practice Nursing (AACN, 1996). If you would like to comment on this change, please send your comments in writing to either Certification Services Director Dr Mary Smolenski, or Certification Services Assistant Director Diane Thompkins.


Section Description

NACNS Statement on Clinical Nurse Specialist Practice and Education,Second Edition, Newly Revised!


This document articulates the core competencies requisite to CNS practice, outlines the outcomes of CNS practice, and provides direction to schools of nursing regarding the preparation of CNSs. Endorsed by the American Organization of Nurse Executives (AONE) as "a comprehensive reflection of the contemporary role that Clinical Nurse Specialists play in the delivery of quality nursing care," this new and updated version contains information for contemporary clinical nurse specialist practice and education. You can purchase your copy through the NACNS Office at a cost of $25 per copy for members of NACNS and $45 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.