1. Murray, Theresa M. MSN, RN, CCRN, CCNS

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Welcome to Spring!!! I hope that wherever you are reading this, the days are getting longer, the sun is shining, and birds are chirping with renewal of spring.


We are coming off a great conference in Phoenix. I know many of you were able to join us. Our conference attendance was the highest ever, with many walk-in registrations. This increase made things a little tight for space, but as good clinical nurse specialists (CNS), we made the accommodations as pleasant as possible and continued on with our work. The quality and content of the conference sessions, as well as the overwhelmingly positive feedback we received, tells us that we are on the right path as we articulate the work of the CNS. We know that CNS work is about safety and quality for the patient, staff competence, and the practice system as a whole. This validation is extremely helpful as we continue to navigate the state of CNS practice, regulation, and education. The work of evidence-based safety and quality is clearly the work of the CNS, a work that is making a difference each and every day in healthcare.


As my illustrious predecessor has made note in her updates, what a difference a year makes! Last March at our conference, we were concerned about the first draft of a Vision Paper on the future regulation of advanced practice nurses (APRN) by the National Council of State Boards of Nursing (NCSBN). As you recall, the NCSBN proposed a number of changes in education and regulation of the APRN, and particularly disquieting for us was the proposed elimination of the CNS as an APRN. We acknowledge that there really was no malice in this intent-the goal was to develop a system that allows all APRNs to be uniformly regulated. However, as we know, the work of these 4 APRN roles is very different, thus making uniform regulation problematic. NACNS continues to work with NCSBN to facilitate better understanding of the work of the CNS. We want to create a standardized regulatory mechanism that will allow CNSs to be recognized and be able to provide the services they are trained to perform-services that our patients, staff, and the healthcare system so badly need.


Many of us, as well as many in the larger professional nursing community, responded with very thoughtful letters and feedback to the NCSBN paper. I thank each of you for your energy, commitment, and passion in crafting responses. NACNs response was a reflection of the values we as an organization hold dear-wisdom, courage, and integrity. I represented you at the NCSBN APRN roundtable in March 2007, and am pleased to report that our efforts have been successful in informing others about the work of the CNS and options for the regulation of CNSs. The NCSBN APRN meetings with key stakeholders have been very productive and professional. To quote my predecessor Dr Kelly G, "We now have hearts full of hope."


NACNS continues working with stakeholders to craft regulation that is not overly restrictive. This regulation must allow CNSs in all geographic and specialty areas to be recognized at the state level where they can continue to provide the service that the CNS is uniquely educated to give.


At our conference this year, we discussed the latest draft of the NACNS position paper "A Vision of the Future for Clinical Nurse Specialists." This document has been developed by present and past leaders with input from our members. NACNS members can access the document from the NACNS Web site ( in the "Members Only" section. We invite your comments about the future education, regulation, and recognition of the CNS. This document will be used to inform regulators and other interested parties of our vision for our role and invite continued dialog with all interested stakeholders. We also hope the document will help the nursing community, and specifically the APRN community, to see and perhaps better understand our vision of the world of the CNS.


NACNS is also working collaboratively with the American Nurses Credentialing Center (ANCC) to develop a core examination for CNSs. This collaboration with ANCC will help expand certification options for smaller specialty practices as, there are not enough advanced level certification examinations to address many of CNS specialties. Therefore, when a state requires certification for recognition/approval to practice, some CNSs must take an examination that does not truly match their specialty. To that end, NACNS is proposing an examination to test core CNS content in combination with specialty portfolio. More information will be coming as this important initiative develops.


Thank you again for your dedication to and support of NACNS. Enjoy your spring!


NACNS Updates

The 2007 annual NACNS conference "CNS Outcomes: Ensuring Safety and Quality" was held in Phoenix from February 28 to March 3. This conference was our largest ever, with approximately 450 attendees and a record number of presenters. The conference was highly successful and provided multiple opportunities for learning and networking. NACNS and the Board of Directors want to extend a sincere "Thank you!" to the Arizona NACNS Affiliate for all of the support and hours they volunteered to help make this conference such a success. NACNS and the Board of Directors also want to gratefully acknowledge and thank the following conference sponsors, exhibitors and contributors for their support.




Integrated Voice Solutions







Mayo Clinic


University of Wisconsin Hospital and Clinics


Maxim Healthcare Services


Rady Children's Hospital


Palomar Pomerado Health


JA Thomas & Associates





A Fashion Hayvin, Inc


ABC Coding Solutions


Advocate Health Care


Allina Hospitals and Clinics


American Nurses Credentialing Center


Banner Health


Calmoseptine, Inc


Clarian Health Partners


Cottage Health System


Dale Medical Products


Department of Veterans Affairs


Durfold Corporation


Doc's Duds


Eastern Idaho Regional Medical Center


Extreme Integration




ICU Medical


Indiana Center for Evidence Based Nursing Practice


J.A. Thomas and Associates


Johnson & Johnson BIOPATCH Division


Jones & Bartlett Publishers


Kaiser Permanente




MD Anderson Cancer Center


Optivox/The White Stone Group, Inc


Pepid, LLC


Phoenix Children's Hospital


Poudre Valley Health System


Premier Health Partners


Safe-T Medical Devices Limited


Sage Products, Inc


Silver Dream


Silver Oak Search Consultants, Inc


Sanofi Pasteur


Sutter Health Sacramento Sierra Region


The Gideons International


The University of Kansas Hospital


TMC Healthcare-Tucson Medical Center


TriLine Medical


University of Minnesota Medical Center


UCLA Health System


US Army Medical Recruiting


Woltwers Kluwer Health-LWW



News From Our Affiliates

The California CNS Network

The California CNS Network continues to be actively engaged in reinventing our roles and responsibilities as Advanced Practice Nurses in our state. We are embarking on an informed journey to investigate prescriptive privileges for those of us who are in practices where it is needed. Board member Patti Radovich has authored a simple yet comprehensive survey and a cover letter that will go to more than 2,000 State Board-titled CNSs. We hope that the survey will shed light on the value and urgency for championing prescriptive authority for our profession. We also hope that the survey will find the voice and opinion of the state's CNS population. We are fortunate to be forging a relationship with our Oregon neighbor CNS group who has been down this path and obtained prescriptive authority for their CNSs last year.

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California CNS Network was very well represented at this year's NACNS Conference in Phoenix. We turned the reins over to the new Affiliate of the year, Oklahoma! There were more than 24 members from California at the National Conference to congratulate the Oklahoma contingent. We hope they felt as much pride and elation as we did in their accomplishment.


As a member of the Affiliate Advisory Committee, I was happy to see how our committee supports new state affiliate formation. Committee chair Cindy Balkstra did a fine job of setting the agenda and bringing the committee together to mentor interested future affiliates. There is a lot of work involved, but it is rewarding to see all the evidence of professional activity and scholarly practice our colleagues are engaged in. In California we are challenged with a large geographic area. We would like to find out how each state affiliate uses telecommunication and other strategies to handle the challenges of geographical spread. The Affiliate Advisory Committee meets via conference call and may provide us with a template we can use. It was wonderful to get together for dinner and finally meet some of the "voices" on the committee. Looking forward to seeing everyone next year in Atlanta!


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


Central Indiana Affiliate

The big news from the Central Indiana Affiliate is that our very own Theresa Murray is our new President of NACNS. We are all so very proud of her and know that she will represent everyone well.


Submitted by Jan Powers, MSN, RN, CCRN, CCNS, CNRN, CWCN, FCCM


Greater Kansas City Clinical Nurse Specialist Group

The Greater Kansas City Clinical Nurse Specialist Group was contacted by 2 Missouri groups to represent CNSs. Nancy Richards, RN, MSN, CCNS, CCRN, is representing us on the Missouri State Board of Nursing as they review the Advanced Practice sections of the Nurse Practice Act. Mary Stahl, RN, MSN, APRN-BC, CCNS-CMC, CCRN, is representing us by serving on the Missouri Nurse's Association Coalition on Nursing Practice. Both groups "found" us through NACNS. We are the only Affiliate in the state of Missouri.


Submitted by Mary A. Stahl, RN, MSN, APRN-BC, CCNS-CMC, CCRN


Montana Affiliate News

The Montana Association of Clinical Nurse Specialists (MACNS)cosponsored with Zeta Upsilon Chapter of Sigma Theta Tau International the annual "evening of research" gathering held at the Hilton Garden Inn in Missoula, Mont. Speakers presented on a variety of topics of interest to APRNs. The evening was a success, and MACNS is considering cosponsoring meetings with other professional organizations in the coming year.


Four members of the MACNS attended the 2007 NACNS conference in Phoenix, Ariz. Two members, Charlene Winters (MACNS Chairperson) and Rebecca Echeverri (CNS student member), presented posters at the conference. Ms Echeverri received the Silver Oak/Clinical Nurse Specialist Foundation Student Poster Award for her outstanding work! Rebecca's poster detailed findings from her research to explore community level barriers to participation in cardiac rehabilitation experienced by rural dwellers.


MACNS has developed a Web site that they will link to the NACNS Website! They have also received permission to post a link to MACNS on the Montana State Board of Nursing Web site.


Submitted by Charlene A. Winters, DNSc, APRN-BC, CNS


News From the Clinical Nurse Specialist Foundation

Clinical Nurse Specialist Foundation Raises $54,000

The Clinical Nurse Specialist Foundation (CNSF) held its third annual gala on Friday, March 2, 2007, at the annual conference in Phoenix, Ariz. The Fiesta and Fun reception was attended by approximately 150 conference attendees. The reception was sponsored by the National Association of Clinical Nurse Specialists, St. Vincent's Hospitals in Indianapolis, Ind, and Community Hospitals in Indianapolis, Ind. Jan Powers, PhD(c), MSN, RN, CCRN, CCNS, CNRN, CWCN, FCCM, the Director of Clinical Nurse Specialists and Critical Care Clinical Nurse Specialist from St. Vincent's, showcased the impact she and her fellow CNS colleagues are having on patient care, the system's culture, and its recognition of the contributions clinical nurse specialists (CNS) can make.


Enjoying Mexican cuisine amidst a colorful flower-adorned atmosphere, clinical nurse specialists shared the reasons they contribute to the CNS Foundation. By the end of the evening, the foundation had raised roughly $54,000. It is with great appreciation that we thank each of you who shared your personal treasure to help us reach our goal of $1 million by 2010. Your dollars support the work of CNSF in promoting awareness of CNS practice and its impact on cost-effective quality patient outcomes, providing scholarships to CNS students in Masters and PhD programs and determining CNS workforce needs by specialty practice, practice setting, and geographic location. The following 3 scholarship winners were announced and will be featured in the next CNSF update:


* Clinical Nurse Specialist Foundation Award: Randy Lee Norby, Montevideo, Minn


* Silver Oak Clinical Nurse Specialist Award: Kathie A. Kobler, Buffalo Grove, Ill


* Donald Dayhoff Clinical Nurse Specialist Award: Eleanor S. Johnson, Muncie, Ind



In addition, four $1,000 student scholarship poster awards provided by Silver Oak Search Consultants, Inc, were awarded to:


Melanie Banks, BSN, RN, La Salle University School of Nursing and Health Sciences. "Improving Outcomes for Patient Post Joint Replacement: An Evidence-based Teaching Tool." Faculty Advisor: Dr Patty Zuzelo


Rebecca Echeverri, BSN, RN, Montana State University College of Nursing. "Barriers to Participation in Cardiac Rehabilitation: A Rural Perspective." Faculty Advisor: Dr Charlene Winters


Ann Marie Lazarus, BSN, RN, University of Texas Health Science Center at San Antonio. "Searching, Finding and Using Evidence for Cardiac Rehabilitation." Faculty Advisor: Dr Mary Heye


Colleen Quinn, BSN, RN, La Salle University School of Nursing and Health Sciences. "Keeping the Public Safe: Emergency Preparedness in the Face of Mass Casualty Incidents." Faculty Advisor: Dr Patty Zuzelo


Visit the Silver Oak Search Consultants, Inc, Web site at to view pictures of the student award winners!


Submitted by Jo Ellen Rust, MSN, RN, CNS


Member Recognition

Angela Clark, PhD, RN, CS, FAAN, former president of NACNS, was recognized by the American Academy of Nursing as an Edge Runner for her work with Cathie Guzzetta, RN, PhD, AHN-BC, FAAN, on family presence during codes. Edge Runners are recognized by the Academy for their innovative work that moves practice forward leading to long-lasting change with a wide impact. The Edge Runner program is part of a larger "Raise the Voice" campaign to showcase nurses' contributions to the healthcare system and to make nurses' work visible to the public at large.


Kathleen L. Dunn, MS, RN, CRRN-A, CNS, has been appointed by the Association of Rehabilitation Nurses as their representative to the Consortium for Spinal Cord Medicine Steering Committee for a 3-year term. Ms Dunn previously represented the American Association of Spinal Cord Injury Nurses on the Steering Committee. The Steering Committee is made up of 22 organizations of professionals and consumers related to spinal cord injury/disease (SCI/D) and coordinates development of interdisciplinary clinical practice guidelines related to SCI/D. Ms Dunn is currently the SCI/D Clinical Nurse Specialist at the VA San Diego Healthcare System.


Barb Gobel, RN, MS, AOCN, an Oncology Clinical Nurse Specialist at Northwestern Memorial Hospital in Chicago, was recently elected to the Oncology Nursing Society Board of Directors. She is currently the CNS for inpatient services where she is responsible for 3 acute oncology units. Her primary duty in this role is to advance the practice of nursing in her institution. She is committed to helping nurses at the bedside understand and appreciate the importance of providing evidence-based nursing care to their patients and families. Within the Oncology Nursing Society, she is the national project leader for the "Putting Evidence into Practice" Resources project. This project addresses the attainment of optimal nursing-sensitive patient outcomes by using nursing interventions that are evidence based. "Putting Evidence into Practice" resources can be found on outcomes. Ms Gobel believes that CNSs have the opportunity through our spheres of influence to lead, direct, support, and educate about the best available evidence to support nursing practice.


Jan Powers, MSN, RN, CCRN, CCNS, CNRN, CWCN, FCCM, Director of Clinical Nurse Specialists and the Critical Care Clinical Nurse Specialist at St. Vincent Hospital in Indianapolis, was inducted into the American College of Critical Care Medicine as a Fellow of Critical Care Medicine (FCCM) on February 18, 2007, in Orlando, Fl. The prestigious designation of FCCM honors practitioners, researchers, administrators, and educators who have made outstanding contributions to the collaborative field of critical care. The College is composed of nurses, pharmacists, physicians, respiratory care practitioners, and other healthcare professionals who are all experts in their field.


Nancy Richards, RN, MSN, CCNS, CCRN, and Mary A. Stahl, RN, MSN, APRN-BC, CCNS-CMC, CCRN, recently published an article entitled "Ventricular assist devices in the adult." This article was published in the April/June edition of Critical Care Nursing Quarterly. Both authors are members of the Greater Kansas City Clinical Nurse Specialist Group, which is an Affiliate of NACNS, and where Ms Richards is the current President.


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.