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A President's far

It's official...the term of my Presidency of the National Association of Clinical Nurse Specialists is more than half over. Always a reflective soul, I routinely look back at experiences in an effort to set the pace and direction for the future. As I reflect on my time as your President, my thoughts center on a critical issue to which you will need to respond: an emerging new vision of advanced practice. Equally important is the path that we collectively-NACNS and CNSs in all specialties-will establish for years to come....our future.


NACNS represents you at several national forums focused on CNS practice, educational preparation for the CNS role, and appropriate regulation of CNSs. I am privileged to participate as the NACNS representative, which means that I am representing YOU and CNSs in your specialty. When I speak, it is not with the voice of only my own specialty-adult health-but rather the voice for all CNSs across all specialties.


As I am asked to react to ideas and concepts that have significant and far-reaching implications for CNSs and the future of CNS practice, my commitment is to inclusiveness. Many specialties are represented within the NACNS membership, which now exceeds 2,000. So, when proposals are made to describe advanced practice or define what advanced nursing practice is, I must carefully consider what words on paper might mean for CNSs in every specialty.


There is growing support for a vision that the title APRN should be available only to those who care for individual patients and are educationally prepared to prescribe. How would that impact your practice?


In addition to thinking "inclusively," discussions about the future of CNS practice require flexibility to accommodate the growth and change in our profession. We take seriously the social mandate that is the basis for our very existence-to meet societal demands for safe, quality, cost-effective nursing care. Societal need changes over time. If we box ourselves into a very tightly defined and confining definition, I think we do more harm than good. A new vision of advanced nursing practice that would eliminate any group of CNSs from being recognized as APRNs is harmful, especially amidst the change, chaos, and challenges from other disciplines that are concerned about infringement on their own scopes of practice. I and NACNS leaders before me have stood firm that such a definition is not good for nursing and the patients we serve.


Admittedly, there is simple elegance in ensuring that all advanced practice nurses "look the same" when we use a single phrase to define the skill set and characteristics of the advanced practice nurse of the future. Regulators may relish the administrative ease that will result when the box for this widget or that one is clearly defined and agreed to by all. But we are not widgets to be fit into a box, and we don't all look alike!


Some of us provide care directly to individuals and some do not. Aggregate care is becomingly increasingly more valued by society. Public health and pandemic preparedness, issues related to toxic exposure and epidemiology, are the business of advanced practice nurses who should be considered APRNs. I question the merit of narrow thinking about advanced practice roles that would limit them from expanding to meet the health needs of public.


So what does the future hold for us as CNSs? As visions and definitions of advanced nursing practice and APRN are being discussed and debated, the outcome is not yet clear. One thing I know for sure is that CNSs will not disappear. There is far too much work to be done in this healthcare system that is the primary work of the CNS. We are system thinkers, and in many instances, we are the glue that holds the system together. More and more people are recognizing that we are the patient safety and quality net that keeps the gaps from widening.


At the NACNS conference last March I asked for member volunteers to assist with the development of a paper that will articulate our perspective on the future of CNS practice. I convened a group of our past leaders to draft sections of that paper and these are being edited into a single document. Our member task force will receive the draft soon and I anticipate that we will have a draft to share with all of you for your comments and feedback at the 2007 conference.


Please come to the conference, ready to work together to create the future of CNS practice.


So far my time as your president has been filled with deep contemplation, learning, and hope. More to come as we move toward the future.


NACNS Updates

Membership Milestone

October 31, 2006 was an important day in NACNS's history. On that day the Association reached the milestone of 2,000 active members. This milestone is indicative of the excellent work being done by the NACNS Affiliates, Committees including the Membership Committee, the NACNS Executive Director Christine Filipovich, and the NACNS Office Staff. The milestone also reflects the strength of the CNS role across the country. Congratulations, NACNS!


Last Call for the 2007 NACNS Convention

This is your last chance to plan your spring get-away to sunny Phoenix, Arizona to attend the 2007 NACNS convention that will be held from February 28 to March 3. The theme of this year's conference is "CNS Outcomes: Ensuring Safety and Quality." You will have opportunities to hear excellent, nationally known speakers that include Marianne Chulay, DNSc, RN, FAAN, and Bernadette Melnyk, PhD, RN, CPNP, NPP, FAAN, FNAP. There will also be 30 concurrent presentations and over 30 posters about clinical practice, research, and CNS education.


In addition to the regular conference, there will be 2 Preconference Sessions on February 28, 2007. Participants will be able to attend both the annual Educators' Summit, "Creating a Culture of Quality Care and Safety," for CNS program faculty and other educators, and also our ever-popular legislative/regulatory training to assist CNSs to become effective advocates for CNSs in their home states.


A new addition to the conference this year will be a Postconference Session on Saturday, March 3, 2007, from 1 to 5 PM. The title of the postconference is "Clinical Nurse Specialists: Leaders in Falls Prevention Outcomes" and it will be presented by Pat Quigley, PhD, MPH, ARNP, CRRN, Deputy Director, VISN 8 Patient Safety Center and Gail Powell-Cope, PhD, ARNP, FAAN, Associate Chief of Nursing Service for Research at the Tampa VA and the Director of the VA RR&D Research Award Enhancement Program (REAP) in patient safety technology. Materials for this session can be previewed at


News From Our Affiliates

CACNS Affiliate News

The California CNS Network's Annual Conference held on November 4 in Rancho Mirage was a huge success. The Safety and Quality theme resonated for all attending. The speakers complemented each other with a synergy that we take credit for predicting, but which actually reflected the convergence of multiple influences.


The first speaker, Dr Elizabeth Henneman, kicked off the event with "First, Do No Harm: The Nurse's Role in Keeping Patients Safe." Dr Henneman described how flawed systems are the culprits in most medical errors, and introduced an intriguing concept addressing ways bedside nurses can prevent many medical errors from reaching the patient. The Honorable Tricia Hunter, ANA/California lobbyist and former legislator, provided valuable political insights and strategies to accomplish political objectives (optional prescriptive authority for CNSs in California). Diane Brown, CNS, gave a most beneficial presentation on women and heart disease, a topic that hits close to home for many. She presented all the latest information on hormones and other information needed to take care of our female heart patient population (as well as ourselves).

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The vendors, sponsors, and poster presenters provided the lunch and break diversions. The hosting facility, Rancho Las Palmas Resort and Spa, gave all attendees the royal treatment with a stunning setting, abundant tasty buffet, and VIP treatment.


After lunch, Drs Kathi Ellstrom and Ann Mayo provided a preview of the NACNS Outcomes Survey results. Dr Ellstrom asked the difficult question, "Who is responsible for outcomes and how can we prove that the CNS affected the positive outcome versus another care provider on the team?" Dr Mayo emphasized the importance of having valid before and after measures for CNS outcomes. We are looking forward to the full survey analysis at the 2007 NACNS Conference in Phoenix!


Bonnie de los Santos from Cedars-Sinai in Los Angeles related lessons learned from implementing a rapid response team at her Magnet facility and the improved interdisciplinary teamwork that resulted. Dr Pat Quigley rounded out the conference agenda with her insights into implementing evidence-based practice from the patient safety perspective. Dr Quigley outlined the need to evaluate evidence critically from the nursing standpoint and described the issues associated with obtaining quality evidence to support nursing practice. We look forward to seeing Dr Quigley at the NACNS Conference in Phoenix.


This year we decided to wrap up our all-day conference with a panel presentation. The participants were able to do a roundtable question-and-answer period with the speakers at the end of the day.


This is also the first year we were able to have poster presentations. We had 2 member and 6 student abstracts displayed. Additionally, we had an optional postconference hospitality session where attendees had a chance to unwind and network in an outdoor cafe by the golf course. This was a time for relaxing and enjoying each other's company. The weather in the desert was balmy and we had clear skies and a beautiful full moon.


The California CNS Network is truly fortunate to have such a dedicated Board. My endless gratitude goes out to them for their role in making this conference a huge success. The Board members are: Bonnie De Los Santos, Marketing; Cheryl Westlake Canary, former Chair, Mentor and Newsletter; Ginger Pierson, Vendor Support; Paddy Garvin, Membership; Evelyn McLaughlin, Co Chair; Renee Pozza, Historian; Maureen le Danseur, Treasurer; Geri Westad, Hospital Liaison; Cathy Tucker, Educational Program; Stacey Fridley, Corresponding Secretary; Patti Radovich, Legislative Rep; and Kathleen Ellstrom, Research.


Submitted by Margaret Talley, RN, CNS; Chair California CNS Network


News from the Clinical Nurse Specialist Foundation

A Campaign to Shape the Future of CNS Practice and Education

Do you have a passion about CNS practice and the differences CNSs make in people's lives by the quality of care delivered? Be an Ambassador for the future of CNS practice and education by joining the CNS Foundation's drive to raise $1 million by 2010. It only takes 1,000 Ambassadors contributing $1,000 over the next 5 years to achieve this goal-1,000 at $1,000 is the goal! Your tax-deductible investment of $200/year or $16.60/month for the next 5 years would cost you less than 4 gourmet specialty coffees a month! Join the 63 people listed below1 and become an Ambassador for the future of CNS practice and education. Your investment will help the Foundation leverage contributions from corporations and other foundations to help reach target goals for:


1. CNS scholarships (including preparation of new CNSs with master's degrees and CNSs seeking PhD education to become faculty and/or nurse researchers); and


2. Research projects demonstrating the impact of CNS work on patient outcomes and cost-effectiveness.



CNS Foundation Ambassadors by State1












Kathleen Dunn


Yvonne Fonsworth


Paddy Garvin


Barbara Hickman


Karen Knight-Frank


Ginger Pierson


Margaret Talley


Linda Urden




Jill Rocarro








Jo Ann Green




Terri Murphy






Jill Anderson


Catherine Prinzing


Weslee Wells




Susan Davis


Peggy Gerard


Mary Gniady


Sue Surane




Constance Baker


Peggy Barksdale


Janet Bingle


Lorie Blythe


Janel Borkes


Kathryn Davies


Nancy Dayhoff


Jennifer Dunscomb


Patricia Ebright


Debra Ferguson


Janet Fulton


Barbara Hasbargen


Vince Holly


Kathleen Hubner


Juanita Keck


Brenda Lyon


Lenora Maze


Rachel Moody


Theresa Murray


Kimberly Nagy


Michelle Peck


Jo Ellen Rust


Don Shuck


Robin Waggoner


Jane Walker








Robin Dennison


Julie Senn-Reeves










Barbara Hazard




Cathy Lewis


Kathleen Vollman








Jo Ann Burns








New Hampshire


New Jersey


Cathy Gettis


New Mexico


New York


North Carolina


Donald Kautz


North Dakota




Margie Campbell


Michelle Madison




Joanne Alderman




Sue Davidson


Valerie Vitale


Mary Waldo




Christine Filipovich


Joanne Phillips


Rhode Island


South Carolina


South Dakota






Angela Clark


Hue Handy


Mary Heye










West Virginia




Tim Heyse





Member Recognition

Angela Clark, PhD, RN, CS, FAAN, former president of NACNS, continues to influence acute and critical care nursing. Dr Clark has been very busy writing articles on a variety of critical care topics. She has coauthored animpressive total of 8 journal and book chapter manuscripts of which 6 were published in 2006 and 2 are in press. The topics of the publications include cognitive impairment and health promotion in heart failure; functional recovery following neuromuscular blockade in ventilated patients; end-of-life issues; and family presence during codes. Our profession is fortunate to have all of these new contributions to our knowledge!


Susan Dresser, MSN, RN, CCRN, Cardiology CNS at Deaconess Hospital in Oklahoma City, has been selected to serve on 2 review panels for the American Association of Critical Care Nurses (AACN). In October, Ms Dressser was selected to begin work as a panel member of the Awards Review Panel. This panel takes part in the selection process of AACN awards by reviewing and evaluating nominees' applications and exemplars. The awards are presented each year at AACN's NTI convention (National Teaching Institute).


Ms Dresser was also chosen to participate in AACN's Continuing Education (CE) Review Panel. The purpose of the CE Review Panel is to assist in the development and re-evaluation of education resources. As a volunteer on this panel, participation consists of reading and evaluating printed material and other educational resources including videotapes, audiotapes, and electronic material, as well as providing feedback for educational resources during development and re-evaluation. The feedback received from this panel is vital in helping to maintain AACN's standards for self-directed learning.


Marlene Nadler-Moodie, MSN, APRN, BC, CNS, a NACNS California member, has been elected to the Board of Directors of the American Psychiatric Nurses Association. The APNA is the largest professional organization representing psychiatric nurses throughout the nation. The APNA has almost 5,000 members, with 35 national Chapters and an international Chapter as well. Marlene's Member at Large position is for a 2-year term of office which began in October 2006.


Lynne Whitney-Caglia, MSN, RN, CNS, CWOCN, a member of the Central California Clinical Nurse Specialist Network (CCCNSN), published 2 articles in the recent issue of Healthy Skin (Volume 3, Issue 3). The first article appears on page 22 and is titled, "Identifying and preventing pressure ulcers: 8 basics for healthy skin." The second article appears on page 28 and is titled, "Keeping an eye on skin care." Her colleagues at Community Medical Centers in Central California are very proud of her.


NACNS members Rose Ruppert, Martin Manno, and Patti Zuzelo were honored on October 13 at the Nightingale Awards of Pennsylvania. The Nightingale Foundation is about 16 years old and exists to provide nursing scholarships and recognize nursing excellence in Pennsylvania. Ms Ruppert was a finalist for the Advanced Practice award; Martin Manno was a finalist for the Nursing Educator award; and Patti Zuzelo received the Nursing Research award. NACNS Board member, Melanie Duffy, was a finalist for the Advanced Practice award last year.


Scholarship Opportunities From the CNS Foundation

Silver Oak Search Consultants, a firm dedicated to promoting and supporting nursing leadership, has graciously given funds to support clinical nurse specialist (CNS) education. Silver Oak is providing one $1,000 scholarship to be awarded to a CNS student and $4,000 to support 4 students who will display their posters at the 2007 National Association of Clinical Nurse Specialists (NACNS) conference in Phoenix, Ariz. The Foundation will also award 2 other scholarships. One is a $1,000 scholarship from the Don Dayhoff Memorial fund to a CNS student from Indiana. The other $1,000 scholarship is awarded from the CNS Foundation to a CNS student. The application form for all 3 scholarships is the same. The scholarship application form can be found on the CNS Foundation Web page, accessible from the NACNS home page Please click on the logo to obtain the scholarship application and to find out more about the CNS Foundation. The deadline for applying for all these scholarships is January 31, 2007.


1Approved release of names. [Context Link]


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.