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Welcome to Texas

I am writing this a little over one week since Hurricane Katrina hit the Gulf Coast and Texas has received about 300,000 new residents displaced by Katrina. My home town, Fort Worth, has received a little over 3,000, with another 1,000 due to arrive soon. We also have 21 displaced animals in the Fort Worth Animal Care Center that are up for adoption, with more on the way.


Although there has been a lot of bad press this past week about the emergency response or lack thereof following the hurricane, I am very proud of the response from my fellow Texans. My daughter and I went to Walmart on Sunday to buy supplies for the evacuees. We stood in a shopping cart line to get into the toiletry aisles because so many others were doing the same thing. We then took our donations to the largest shelter in Fort Worth and sat in an automobile line to donate because so many others were doing the same thing. Churches are adopting families, apartment complexes are providing free/reduced rate housing, Texans are opening their homes to evacuees, restaurants are providing free meals, and schools, many of which are already crowded, are welcoming new students with open arms.


But, I have to tell you that I am not very proud of myself right now, because I was professionally unprepared. ME-a certified emergency nurse, the overachiever with a PhD, and a post doc fellowship under my belt, not to mention THREE advanced practice certifications!! That 8-hour Red Cross healthcare volunteer course that I was always going to find time to take, but never did, has become the major impediment to my ability to respond as nurse.


I have been asking myself a lot of questions since this disaster happened. Here are a few that have been running through my mind about disaster preparedness.


1. Why didn't I take that 8-hour Red Cross healthcare volunteer course? There were a lot of reasons, none of which seem any good now however. If you have been putting off taking this same course, please do it soon.


2. Why don't I have an emergency plan that involves my husband and kids evacuating while I stay behind at a hospital caring for patients? I have never even considered that the entire family would not be together. Yet, that is the reality here after Katrina. Husbands, wives, and children are separated, sometimes states apart. And, there is still no efficient way to find out where loved ones are or if loved ones are alive.


3. Why don't I have that rainy-day nest-egg of cash in a national bank? Hurricane survivors, who kept their money in local banks or credit unions, don't have access to it yet. So they are essentially homeless, displaced, and without funds. I could be in the same situation if I lived through a natural disaster that destroyed Fort Worth.


4. What happens if I'm at work and all the utilities fail? When we prepare for disasters, we always practice receiving numerous victims into a fully functioning hospital. I have never participated in a disaster drill that focused on losing all of the utilities-an internal disaster drill. There are back-up generators for short-term loss of electricity. But how long will they really last and how do you decide who lives and who dies when they fail? How do you dispose of waste if you cannot flush a toilet? How do you maintain cleanliness if there is no water? How do you communicate if there are no phones/computer systems? How do you move patients if there are no working elevators? How do you treat patients if diagnostic tests (both labs and x-rays) can't be performed? How do you get medicines and supplies if the ordering system is not working? What do you do when supplies run out? There are many more questions, but the biggest on is why haven't we always been practicing for the internal disaster that could occur with major external disasters?


5. How would my hospital react if armed gunmen demanded hospital supplies/drugs? It only took the hold-up of one hospital supply truck for New Orleans hospitals to lock-down. Could my facility accomplish that? Would that be sufficient to prevent break-in? How would staff/patients respond to being locked in?


6. Could I start over again with little to nothing left of what I previously had? I think I could, but I sure hope I never have to find out. I would imagine it will take a long time for Katrina's victims to recover, if they ever do. Already we are seeing some who are anxious to return to their Gulf Coast communities and start rebuilding. But, we have also seen others who never want to go back and put themselves in harm's way again.


7. And on a purely personal note, could I have left my dogs behind? I have to tell you that BB, Hawley, and I would still be sitting in New Orleans. I couldn't leave them behind and it was heartbreaking to watch others have to do so. The human-animal bond is tremendously strong, and being required to abandon a beloved pet can have catastrophic consequences. Why didn't any of the relief workers understand that? When people have lost everything else and only have their pets left, separating them from those pets is, to me, the ultimate injustice.



By the time you read this, Hurricane Katrina will be a memory, the survivors will be adjusting to starting over, and I will have completed that 8-hour healthcare provider Red Cross course. But I still would like to ask each of you to take the time to develop your own personal disaster preparedness plan, just in case.


NACNS Updates

Changes at the Journal

Many, many thanks to Kathleen Wright, MSN, RN, C, CWOCN, for years of service to the journal as column editor for Books at a Glance for NACNS's official journal Clinical Nurse Specialist: The Journal for Advanced Nursing Practice. Kathy has resigned her editorship effective September 2005. Under her direction, the regular feature column has grown into a reliable source of information for CNSs about new and interesting publications. Kathy has been responsible for developing guidelines for reviewers and for recruiting knowledgeable and thoughtful reviewers. Kathy is taking on new challenges as the President of the Wound, Ostomy and Continence Certification Corporation. Best of luck with your new adventures!


Welcome Sue Sendelbach, PhD, RN, CCNS, FAHA, new Column Editor for Books at a Glance. Sue is a clinical nurse specialist and currently is the Nurse Researcher at Abbott Northwestern Hospital in Minneapolis, MN. She was also 2004-2005 chairperson of Minnesota Affiliate of NACNS. Sue plans to continue the fine tradition of the column and invites authors to submit books for review. Welcome Sue! Janet S. Fulton, PhD, RN, Journal Editor.


News From Our Affiliates

DELAWARE VALLEY NACNS NETWORKING GROUP (DVNG): The DVNG is hosting its Fall dinner meeting on November 16, 2005. The invited speaker, JoAnne Phillips, MSN, RN, CCRN, CCNS, is the Patient Safety CNS with the Hospital of the University of Pennsylvania. The presentation, The Role of the CNS in Patient Safety, is timely and relevant t o CNSs working in a variety of care settings. The meeting will include a legislative update as well as information specific to NACNS. Delaware Valley CNSs are encouraged to attend. For more information, contact Patti Zuzelo, DVNG Leader at or Elizabeth Bayley, PhD, RN at The program will be held at Widener University, Chester, PA.

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Patti Zuzelo, EdD, APRN, BC, CNS, provided testimony on August 22, 2005 before the Pennsylvania State House Professional Licensure Committee concerning House Bill 1063 (HB 1063). Dr. Zuzelo spoke on behalf of the DVNG. This bill addresses regulatory protection of the title "Clinical Nurse Specialist (CNS)" in the state of Pennsylvania. Melanie Duffy, MSN, RN, CCNS, an NACNS member and a leader in spearheading efforts for this bill on behalf of Pennsylvania CNSs, also provided testimony on behalf of the Pennsylvania State Nurses Association.


Committee Reports

Legislative/Regulatory Committee: CNS Community Meets to Discuss CNS Practice Competencies: The National Association of Clinical Nurse Specialists sponsors and hosts an annual summit which provides a forum for the CNS community to discuss current issues affecting Clinical Nurse Specialists. Summit participants are made up of associations with significant numbers of CNS members and CNS certifying bodies. Over the past year, NACNS has been asked in various professional forums to demonstrate national consensus on the CNS practice competencies described in the NACNS Statement on CNS Practice and Education. To that end, this year's focus at the July 21-22, 2005 CNS summit convened at Sigma Theta Tau Headquarters in Indianapolis, Indiana was on CNS Practice Competencies. Fifteen organizations participated: ANA, ANCC, APNA, WOCN, WOCN Certification Board, BCEN, AORN, ONCC, ONS, Federal Nursing Services Council, AWHONN, AACN (critical care), AACN Certification Corporation, MSNCB, and NGNA. The National Council of State Boards of Nursing (NCSBN) and the NCSBN APRN Advisory Panel representatives were invited as special guests due to the summit focus and progress with the core CNS exam. A total of 29 individuals attended.


NACNS provided an overview of the preliminary data compiled about each state's legislation and regulations pertaining to CNSs. We distributed the draft certification White Paper that included a detailed description of the processes used for development of the 1998 Statement and also for validation of the content of both the 1998 and 2004 Statements. We also distributed the White Paper clarifying NACNS's position on CNS education and practice related to pharmacology. The White Paper will soon be published as an NACNS Position paper.


The major outcome was general affirmation that the NACNS core competencies reflect CNS practice. "The specialty organizations at the Summit confirmed that our core practice competencies apply across specialties, which is very important information for our colleagues in education, regulation and certification," stated NACNS President Kathleen Baldwin, PhD, RN, CNS, ANP, GNP. NACNS will continue to seek formal endorsement of the CNS competencies. It should be noted that previous to the summit, voluntary endorsement of the Statement and the CNS Practice competencies was offered by the American Organization of Nurse Executives and the National League for Nursing NLN-AC.


State by State Analysis of CNS Legislation and Regulation: At the request of the NACNS Board of Directors, the Legislative/Regulatory Committee has embarked on a thorough review of each state's legislation and regulation of CNS practice. This analysis covers APN recognition, title protection, scope of practice, regulatory requirements for recognition, certification requirements, waiver options, prescriptive authority and collaborative agreement requirements, continuing education requirements, current state practice act activity related to CNS practice, CNS representation on State Boards of Nursing, and Psychiatric Mental Health CNS recognition. The initial analysis has been completed and now the information will undergo a validation process with each individual state board of nursing. The final results will be published in the Clinical Nurse Specialist: The Journal for Advanced Nursing Practice. Stay tuned for this comprehensive update! Jo Ellen Rust, MSN, RN, Co-Chair.


News From the Clinical Nurse Specialist Foundation

Greetings from the board of trustees of the Clinical Nurse Specialist Foundation. I am happy to announce the addition of 2 new members to the board. Both members come from industries outside of nursing and bring competencies to our work which will enable us to be successful in the areas of investment and development. The Board continues its efforts surrounding the "1,000 members at a $1,000" campaign and will be inserting information regarding this fund raiser and other opportunities for gifting in the NACNS membership renewal letters. Through the generosity of one of our trustees, the Foundation will be awarding its first $1,000 scholarship in 2006. Details for application will be found on the NACNS Web site and will be e-mailed to schools of nursing preparing clinical nurse specialists.


Plans are underway for our second CNS Foundation gala in Salt Lake City. At last year's, over $65,000 was pledged. We hope to surpass that amount in 2006. Please consider a gift to the Foundation. It is our legacy to future clinical nurse specialists and to the people they serve. Janet M. Bingle, MS, RN, Clinical Nurse Specialist, Chairman of the Board of Trustees, The Clinical Nurse Specialists Foundation.


Member Recognition

Congratulations to Rebecca E. Long, MS, RN, CCRN, CMSRN, an Academic Educator/Clinical Nurse Specialist in the VA Healthcare System in San Diego and at San Diego State University. She recently published her article From Revolution to Revelation: Critical Care Nurses' Emerging Roles in Public Policy in Critical Care in Nursing Clinics of North America, 17 (2005) 191-199.


In the August 2005 issue of Urologic Nursing, Peggy Ward-Smith, PhD, RN (an NACNS member in Missouri) and Deborah Kapitan, BSN, RN, present results of their study allowing men with localized prostate cancer who chose external beam radiation treatment to self-evaluate their quality of life (QoL) before and after treatment. Ward-Smith and Kapitan recommend healthcare professionals understand how different prostate cancer treatments affect QoL so they can help patients make the appropriate treatment choice. (Quality of Life Among Men Treated with Radiation Therapy for Prostate Cancer; Peggy Ward-Smith, PhD, RN; Deborah Kapitan, BSN, RN; Urologic Nursing; August 2005;


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 national office or is on a national task force looking at issues of relevance to CNS practice? 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!


Introduction of New Board Members

Linda Urdin, DNSc, RN, CNA, FAAN

Dr. Linda Urden is one of the newer members of your Board of Directors. She is presently the Executive Director, Nursing Quality, Education & Research at Palomar Pomerado Health in North County San Diego and Clinical Professor and Coordinator of the Executive Nurse Leader Graduate Program in the School of Nursing at the University of San Diego. Dr. Urden is known for her work in critical care, evidence-based practice, outcomes, professional practice environments, and nurse executive decision support databases. Her research is in the areas of care delivery models, professional practice environments, and the impact of nursing on nurse-sensitive outcomes. She is a Fellow in the American Academy of Nursing, and the immediate past Chair of the ANCC Magnet Nursing Recognition Program Commission, serving on the ANCC Board of Directors. She also serves on the ANCC Research Committee. Her 2 books-Critical Care Nursing: Diagnosis and Management, and Priorities in Critical Care Nursing, are in their fourth and fifth editions and have been adopted in numerous undergraduate and graduate programs in the United States and internationally.


News Briefs

Convention is Coming! Convention is Coming!

Please join us this year at our 2006 Annual Conference "CNS Leadership: Soaring to New Heights" in Salt Lake City, UT. We will be at the Salt Lake City Marriott, 75 South West Temple from March 15-18, 2006. For more information or to register please visit our Web site at


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 three 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 to 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.



The deadline for submission of information for either of these awards is December 31, 2005.


Please submit all information and supporting material to:




2090 Linglestown Road, Suite 107


Harrisburg, PA 17110


Section Description

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


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 National League for Nursing and 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 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.