1. Sendelbach, Sue Ellen PhD, RN, CCNS, FAHA

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"Strategy is not some mystical vision that only the people at the top understand." Strategy informs all of the things that get done every day, and aligns those things in the same direction. Michael Porter, Leadership Excellence; June 2006;23(6):6-7.


It is with this mind-set that the 2008-2009 National Association of Clinical Nurse Specialists (NACNS) Board of Directors (BOD) set out to re-evaluate the strategic plan the weekend of June 13 to 15 in Harrisburg, Pennsylvania. We reviewed the current NACNS strategic goals:


1. increase the national visibility and influence of clinical nurse specialists (CNSs);


2. promote the growth and development of NACNS;


3. provide a national and international forum for CNSs to exchange information, share resources, and discuss current issues;


4. maintain NACNS as the national authority for CNS practice, education, and research; and


5. demonstrate the linkage of CNS practice to innovative, safe, quality, evidence-based, cost-effective healthcare.



The BOD affirmed that the strategic goals continue to be relevant and appropriate to support the NACNS mission: "NACNS exists to enhance and promote the unique, high value contributions of CNSs to the health and well-being of individuals, families, groups, and communities, and to promote the practice of nursing."


The BOD also reviewed all our current initiatives in relationship to the "things that get done every day." Let me point out how our strategic plan guides our work.


Goal 4 supports maintaining NACNS as the national authority for CNS practice, education, and research. We have recently been involved in a project to review our core master's level CNS competencies and the CNS competencies of specialty nursing organizations to achieve into one set of core CNS competencies. This work evolved from the advance practice registered nurses (APRNs) consensus work group convened by the American Association of Colleges of Nursing's Alliance for Nursing Accreditation. The APRN consensus work group asked NACNS to engage in a process that mirrored the process through which national nurse practitioner organizations developed a nationally validated set of core nurse practitioner competencies. National Association of Clinical Nurse Specialists asked the American Nurses Association and the American Board of Nursing Specialties to be the neutral conveners for a work group first convened in May 2007 and charged with drafting one set of master's level CNS competencies. The core master's level competencies were posted on the American Nurses Association Web site for public comment until May 24, and the work group met on May 29 to 30, 2008, to review the feedback gathered during the public comment period. The National Association of Clinical Nurse has been well represented by its past president, Theresa Murray, in this initiative, and NACNS will be the custodian responsible for these core master's level CNS competencies, including revisions on a regular cycle, which will be every 5 years.


When I started my career as a CNS in 1992, there was no NACNS. The National Association of Clinical Nurse was started in 1995, and 13 years later, NACNS continues to lead the CNS community in many ways, not the least of which is through our responsibility for the national CNS practice competencies. As I write this message, we are about to convene for our sixth annual CNS summit that will be attended by a large number of specialty nursing organizations and certification boards. The major topic for this year's summit is our collaboration with American Nurses Credentialing Center to develop a core CNS certification examination.


The wisdom and strategic planning of the early NACNS leaders laid a strong foundation for the accomplishments we enjoy today. The current BOD members have committed their time, energy, intellect, and resources to continue to move NACNS and CNSs forward to achieve the mission of our organization.


News From Our Affiliates

California Affiliate (California Clinical Nurse Specialists)

The California CNS network welcomes 2 new board members from Northern California, linking the state's CNS network and strengthening our bonds.


Taking advantage of technology, our newest board members, Garret Chan and Ann Wilkinson, as well as our central California board member, Vicki Lekas, are able to participate in board meetings via conference call. We value their insights and input on our affiliate initiative to obtain prescriptive authority for CNSs in California.


California Clinical Nurse Specialists' statewide membership stands at 354 and growing. Our membership director, Paddy Garvin, has taken on the additional role of Web mistress. In the near future, members will be able to pay dues and register for conferences online! Our new Web address is Check out our new logo too!


Palomar Pomerado Health recently celebrated the successful graduation from University of San Diego of 7 CNS from graduate programs. Dr Brenda Fischer and Dr Caroline Etland, both current CNSs, completed their PhDs this spring, and Jennifer Randles, Melissa Dennis-Rouse, Lourdes Januszewicz, Ann Rocha, and Jin Brown are all new CNSs. The entire Nursing Quality, Education, and Research department now includes a total of 18 CNSs led by former NACNS board member Dr Linda Urden. The CNSs celebrated this monumental achievement with dinner and a party at a local restaurant.


California Clinical Nurse Specialists member Jeanne Maiden not only received her PhD from University of San Diego but was also awarded a research grant from the Zeta Mu Chapter of Sigma Theta Tau in April this year. Her research title is "A Quantitative and Qualitative inquiry in to Moral Distress, Compassion Fatigue, and Perception of Medication Error in Critical Care."


Jeannie Badertscher, a maternal-child CNS at Pomona Valley Hospital Medical Center, presented a poster at the Association of Women's Health, Obstetric and Neonatal Nurses convention in Los Angeles this month to more than 3,000 maternal-child nurses. Her poster was entitled "The Pipeline to Labor & Delivery describing how she successfully revised a plan for precepting and training new labor and delivery nurses to reduce use of traveling and registry nurses."


Submitted by Margaret Talley, RN CNS CWCN-AP


Veterans Affairs Virtual Affiliate

Cathryn Vogeley and Ann Busch (Veterans Affairs Medical Center [VAMC], Portland, Oregon) have obtained CNS prescriptive authority in Oregon. The option of prescriptive authority was granted to Oregon CNSs through 2005 legislation that was written into the Oregon State Board of Nursing Division 56 in 2006.


Kimberly Bishop (VAMC, Birmingham, Alabama) presented "PRN What? Ways a New BCMA Coordinator can Increase Compliance of Medication Documentation" at the VA Information and Technology Conference in Maryland on July 6, 2008. The lecture is 1 hour long and can be viewed on the Veterans Health Administration internal internet system intranet as a live meeting.


Pamela Page (VAMC, Syracuse, New York) was the invited speaker for the Syracuse Area Psychiatric Nurses group in February. She spoke about posttraumatic stress disorder, stress reaction pathways, adaptation, and resiliency and explained VA programs for Operation Iraqi Freedom/Operation Enduring Freedom (the Iraqi & Afghanistan ongoing war/operations) veterans, traumatic brain injury and suicide prevention. The Syracuse Area Psychiatric Nurses group was founded 20 years ago by a retired VA CNS, Jackie Hicks.


Cissi Wimberly Oloomi (VAMC, Houston, Texas) presented a poster at the American Association of Neuroscience Nurses 40th annual seminar in Nashville, Tennessee, held on March 27 to March 31, 2008. The title was "Mission Possible: Recognition of Cervical Artery Dissection." The seminar had approximately 1,000 nursing participants from the United States, Canada, and England.


Kathleen L. Dunn (VAMC, San Diego, California) presented a preconference workshop on the interdisciplinary management of bowel and bladder problems for the Contemporary Forums Spinal Cord Injury conference in San Francisco in May.


Kathleen Ellstrom has been accepted as a postdoctoral fellow in Dyspnea Management in the Nursing Research Training Program in Symptom Management at University of California San Francisco School of Nursing starting in September.


Submitted by Kathleen L. Dunn, MS, RN, CRRN-A, CNS


Oklahoma Association of Clinical Nurse Specialists

Oklahoma Association of Clinical Nurse Specialists has experienced continued growth in our membership and activities over the past few years, and as a result, we hired a new administrative assistant in March to assist the BOD members with their duties. Sandi Hinds brings computer, Web site, and organizational skills to the position and will be an asset to our organizational initiatives.


The University of Oklahoma College of Nursing graduated 22 CNSs this May. The 20 acute care CNS graduates also received the Graduate End of Life Nursing Education Consortium Trainer Certificate, which will allow them to train nurses in their facilities in end-of-life care, participate in palliative care teams, or set up palliative care programs in their facilities. We are expecting 20 new acute care CNS students beginning in the fall semester!


Leigh Ann Morrill, one of our current CNS students, has been awarded a fellowship for the Health and Human Services Administration Neurovascular Fellowship Program (NET-SMART). The program is a collaborative endeavor offered by the Arizona State University and the University of Alabama/Birmingham, merging the expertise from 2 leading US centers with highly diverse populations under the guidance of NET-SMART-APN's Principal Investigator and Project Director Ann Wojner Alexander, PhD, CCRN, FAAN.


The Oklahoma Association of Clinical Nurse Specialists and the University of Oklahoma College of Nursing is sponsoring the third Annual Clinical Nurse Specialist Recognition Day Fall Conference.


Theme: Oklahoma Clinical Nurse Specialists: One Voice, One Vision


Friday, October 10, 2008


Saint Francis Hospital Education Center


6161 South Yale Ave, Tulsa, Oklahoma 74136


For more information, contact Sandi Hinds at


Submitted by Susan Dresser


Association of Central Florida Clinical Nurse Specialists

The Central Florida affiliate members are in the process of obtaining Florida licensures as CNSs for the first time in Florida. Several affiliate members have applied to sit for the core certification examination offered later this year.


Submitted by Barbara Hatfield, ACNS-BC, MS OCN ACRN


Member Recognition

The American Association of Critical-Care Nurses recently announced the recipients of the 2008 Circle of Excellence Awards, a program recognizing contributions and achievements that exemplify the association's mission, vision, values and ethics of care. Patricia Ebright, DNS, RN, CNS, vice president of NACNS, was awarded the 2008 GE Healthcare Pioneering Spirit Award. This award recognizes significant contributions that influence acute and critical care nursing and that exemplify a pioneering spirit.


Dr Ebright's research examines 2 critical issues in healthcare today: (1) how healthcare providers make decisions in the context of actual care situations and (2) how work complexity influences patient safety and quality care. Her current research funded by the National Patient Safety Foundation has uncovered a decision-making approach called stacking used by nurses to cope with variable and complex workloads. Stacking is the continuous prioritizing and reprioritizing of care delivery goals and timelines, adjusting outcomes, and even abandoning some goals without adverse consequences. Stacking is invisible and dynamic. It has not been reported in the literature, and nursing schools do not teach it. So it is experienced nurses who discover and use stacking as a failure prevention strategy when they come upon the many flawed operational systems in hospitals today. The award was presented in Chicago on May 5th during the opening sessions of this year's National Teaching Institute and Critical Care Exposition


News Briefs

Do not forget that the call for nominations for all NACNS awards is fast approaching. If you know someone deserving of the award for CNS of the Year, Researcher, Educator, or Preceptor of the Year, please consider nominating them. The deadline for each award is October 15th. Applications and guidelines can be found on the NACNS Web site.


Health and Human Services Administration is seeking grant reviewers who are CNSs. Grant reviewers help Health and Human Services Administration evaluate and select the best projects from competitive applicants for funding. For more information on this opportunity, please go to the NACNS Web site.


Celebrating CNS Practice

The Cleveland Clinic will be presenting a one day conference on September 19 designed to provide valuable knowledge and creative ideas regarding CNS practice. The keynote speaker will be Michelle L. Dumpe, Associate Chief Nursing Officer of the Department of Nursing Education and Professional Practice Development for the Division of Nursing at the Cleveland Clinic. Concurrent sessions will focus on role development, professional practice, and sharing clinical expertise. For more information call 1.216.444.8495. or visit the Cleveland Clinic website at:


Minnesota Affiliate NACNS Conference

The Minnesota Affiliate of NACNS will hold their annual conference Friday, October 3, 2008. This year's conference theme is "Clinical Nurse Specialist: Leadership and Excellence." Sue Sendelbach, NACNS president will present "The CNS in Today and Tomorrow's Healthcare System." Additional presentations include "DNP or PhD? How Do You Choose?" by two CNSs, Pam McCabe who is currently in a PhD program, and Germaine Edinger who is currently a student in a DNP program; "Critical Questions for Exemplary Leadership" by Dr Gary Boelhower of College of St. Scholastisca; as well as current sessions addressing clinical topics. Kay Greenlee, president of the Minnesota Affiliate will provide the closing remarks to this year's conference. Poster presentations by CNSs and CNS students is also a part of the day-long conference.