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Orville Wright never had a pilot's license. His occupation was as a printer/publisher and bicycle retailer/manufacturer. However, Orville (1871-1948), along with his similarly employed bother Wilber (1867-1912), is credited with inventing the first fixed wing aircraft and subsequently being its first pilot. History is replete with examples of innovators who worked in relative solitude pursing their hunches. Innovation, it may be fair to conclude, is highly related not only to knowledge but also to passion, persistence, and due diligence.


Like the Wright brothers, clinical nurse specialists (CNSs) are employed in traditional roles and occupations, usually by a hospital or healthcare system. However, CNSs are licensed to practice nursing and, through graduate education, are advanced practice nurses. Where the Wright brothers brought mechanical skills gained from years of working in their shop with printing presses, bicycles, motors, and machinery to the design of an airplane, CNSs bring theoretically and scientifically grounded clinical expertise to the design of innovative interventions, evaluation methods, and programs of care for specialty populations.


This issue of the journal includes the abstracts from the 2007 National Association of Clinical Nurse Specialists Conference. The abstracts are evidence that CNS-generated innovations for patients and healthcare systems are solving problems, bridging gaps, reconciling factions, and removing barriers to advance the practice of nursing for the purpose of improved patient outcomes. Among the abstracts are differing innovations for similar problems and similar innovations for differing problems. There are also examples of innovations for directly improving patient outcomes and examples of innovations for indirectly improving outcomes by changing nursing practice or modifying systems.


Orville did not ask permission to fly; he invented flying, conquered the risk, and secured his place in history as a pilot. Innovation is a way of thinking about what might be. Innovation is a CNS core competency applied by those who are passionate, persistent, and willing to take calculated risks to move beyond what is.