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The future is not inevitable; the future is inventible. That was the opening greeting at a conference, and of all the things I have known and forgotten, this comment has stuck with me. The speaker's point was for us, the nursing audience, to take control of our future by first envisioning the future and then placing ourselves in it.


This issue of the journal includes the National Association of Clinical Nurse Specialists' Vision for the Future of Clinical Nurse Specialists. The Vision, developed with extensive input from national and international clinical nurse specialists (CNSs) in practice and education, is a beacon that will guide CNSs into the future. The Vision retains the familiar basics. The framework for practice has 3 domains (also called spheres of influence) focusing on patients/clients, nurses and nursing practice, and systems/organizations. The CNS role remains grounded in specialty-focused expert clinical practice. However, the future will find CNS practice moving toward greater emphasis on evidence-based care, innovation for safety, quality and cost effectiveness, and interdisciplinary collaboration for change. The future of CNS education, while assuring CNS core practice competencies, will include increased content in research, data management, and analysis applied to clinical practice-all to prepare CNSs to bridge the gap between what is known and what is practiced.


The future brings new challenges and greater responsibility for leadership in the clinical setting. The increasing complexity of health problems, an aging population, greater demands on families as caregivers, increasing costs, and unresolved issues in resource allocation all demand our thoughtful attention. Clinical nurse specialists will find continuing requirements for coaching and mentoring of nurses in all types of settings. Clinical nurse specialists will continue to lead, advise, and support multidisciplinary teams. Through the coming days and in many ways, CNSs will continue to advance the practice of nursing, assuring that the public receives high-quality, safe, scientifically sound, and empirically grounded nursing care.


A CNS student recently noted that she was one of only a small handful of CNS students in her school's newly reinstated CNS program. Although initially dismayed, she was delighted when she discovered that many employment opportunities were awaiting her upon graduation. For her, the future was exciting and filled with possibilities. Indeed, the future for all CNSs is one of opportunity and possibility.


We CNSs are the champions of the CNS role. The Vision will help us articulate our unique role to employers, educators, legislators, regulators, and the public. It is our future, and it is inventible. I invite your comments on this thoughtful Vision.