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

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"However, the core concepts of the competencies are enduring and must be maintained as the foundation of CNS practice regardless of changes in the degree attained (masters vs doctorate)." Goudreau KA et al. A vision of the future for clinical nurse specialist. Clin Nurse Spec. 2007;21:310-320.


Our founding mothers were very wise in their approach in establishing the National Association of Clinical Nurse Specialists (NACNS). One example of their wisdom was the publication of the Statement on Clinical Nurse Specialist Practice and Education in 1998. This document articulated the competencies and outcomes of contemporary clinical nurse specialist (CNS) practice and was the result of a rigorous methodology. In a previous column, I shared information about a recent initiative through which the NACNS core competencies and the CNS practice competencies developed by specialty nursing organizations were reviewed by a national task force. A single set of competencies was agreed upon and will soon be disseminated for endorsement by stakeholder organizations. The final document will be the property of NACNS. Theresa Murray represented NACNS in this 2-year long project.


In addition to the development of master's degree competencies, NACNS has also been developing doctoral-level CNS practice competencies. The doctoral-level competencies have as their foundation the mater of science-level competencies and were developed by a task force comprised of representatives of organizations with large constituencies of CNSs.a The task force members drafted doctoral-level practice competencies intended for CNSs who obtain a clinical doctorate degree, building and expanding on existing master's degree competencies. The development of the draft competencies included an examination of CNSb and/or advanced practice competenciesc developed by nursing organizations and comparing them to NACNS competencies. Those competencies with either strong consensus (present in NACNS statement and at least 6 specialty organizations' competencies) or moderate consensus (competencies present in NACNS statement and 3-5 specialty organizations' competencies) were brought forward. Competencies unique to NACNS or to any specialty organization were also examined. The draft competencies were discussed at the 2007 NACNS annual CNS Summit and subsequently reviewed by the task force. After the NACNS Board of Directors' approval of the draft competencies, phase II of the competency development process is now underway. The draft doctoral competencies will be distributed for review by individuals involved in the education of CNSs, CNSs involved in direct delivery of CNS care, organizations that credential CNSs, organizations that regulate CNSs, organizations that accredit graduate CNS nursing programs, employers of CNS, and past presidents of NACNS who have not been involved in the development of the doctoral competencies. This phase II panel of reviewers will have an opportunity to rate the relevance, specificity, and comprehensiveness of the draft competencies. National Association of Clinical Nurse Specialists membership will also have an opportunity to provide feedback about the competencies after the completion of phase II, as they will be posted for public comment. The final doctoral-level CNS competencies will be the property of NACNS.


These new doctoral-level competencies and the updated master's level competencies will be published in the next edition of the Statement on Clinical Nurse Specialist Practice and Education. This document is to be updated every 5 years, and the last edition was published in 2004. As noted in the 2004 edition, "[t]he NACNS statement is an evolving document and it will continue to be shaped over time[horizontal ellipsis]." The inclusion of doctoral-level competencies is just one example of this evolution. However, there are some things that will not change. The rest of the sentence is as follows: "it will always reflect NACNS's commitment to ensuring that society benefits from the full range of nursing services and competencies characteristic of CNS practice." It is with this commitment that NACNS moves forward but remains fully committed to explicating the value of CNSs' contributions to patients/clients, nurses and nursing practice, and organizations/systems of healthcare.


News From Our Affiliates

The CNSs of NYS continue their quest for title protection. The letter has been drafted and sent to affiliate members for endorsement, after which it will be forwarded on to the NYS Nurses Association. Anyone willing to help or interested in more information, please contact Melanie Kalman at or Lorissa Plis at


Melanie Kalman, CNS, PhD


Associate Professor


Director of Research College of Nursing


Veterans Affairs Virtual Affiliate

Christine Valdez and Christine Locke of the Portland OR VAMC are among the authors on an abstract accepted for podium presentation at the 2008 ANCC Magnet Conference entitled "Best Practices in Medical-Surgical Nursing-Introduction to Integrative Health: A Multidisciplinary Approach."


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


Clinical Nurse Specialist and Rehabilitation Case Manager


California CNS Network

The California CNS Network has remained busy throughout the summer months. In July 2008, the baton for chair was handed over to Paddy Garvin, RN, MN, CRRN-A, CNS, who took over for Evelyn McLaughlin, RN, MSN, CNS. Thanks to Evelyn for all of her hard work over the past year. Paddy will remain as chair until July 2009. We have also added new board members and have a full slate now! Welcome to all of our newest board members!


We have several items to report. Our summer quarterly educational meeting was held in the beautiful Santa Barbara at Cottage Hospital on August 2, 2008. Many thanks to Vicki Lekas for hosting this! Our speaker was Anna Gawlinksi, RN, DNS, FAAN, who presented an engaging talk entitled "The Power of Clinical Nursing Research: Engage Clinicians, Improve Patients' Lives, and Forge a Professional Legacy." Many thanks to Dr Gawlinski for taking time out of her busy schedule to share her vast knowledge with us.


Our network has also been busy preparing for our upcoming annual conference to be held at the Rancho Las Palmas Resort in Rancho Mirage, California, on Saturday, November 8, 2008. This all-day conference will focus on the theme of CNS-leaders in clinical excellence. A slate of informative speakers has been prepared, and we are excited to present it once again. In addition, we will continue our discussion regarding the pursuit of prescriptive authority for CNSs in the state of California. There is an additional summit meeting planned for Saturday, September 13, 2008, with leaders of many of the advanced practice organizations throughout the state.


Our network also has redesigned our Web site and encourages folks to visit us at for further information about our newest board members and upcoming programs. We remain excited about the ever-expanding role of the CNS in the state of California and sharing that knowledge with others!


Submitted by Paddy Garvin, RN, MN, CRRN-A


Chair, California CNS Network

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Oklahoma Association of CNSs

The Oklahoma Association of CNSs (OANS) continues to grow, and with the help and talents of our administrative assistant Sandi Hinds and president elect April Merrill, OACNS now has a brand new Web site and logo! The logo was developed with input from our members and incorporates the following ideas:


Circles. Represent the 3 spheres of CNS practice and influence-patient, nurse, and organization.


The lamp. A symbol of the care and devotion the nurse administers to the sick and injured in the practice of nursing.


Colors. Blue is the color of the sky and sea. It is often associated with depth and stability. It symbolizes trust, loyalty, wisdom, confidence, intelligence, faith, truth, and heaven.


Dark blue. Represents knowledge, power, integrity, and seriousness.


Light blue. Associated with health, healing, tranquility, understanding, and softness.



The Web site has links to education, upcoming events, newsletters, and NACNS. Please feel free to pay us a visit at


October 10, 2008, marks the date for the Third Annual Clinical Nurse Specialists Recognition Day Fall Conference. Three years ago, this day was proclaimed by the governor of Oklahoma as CNS Recognition Day. Sponsored by OACNS and the Oklahoma College of Nursing, this year's conference entitled "One Voice. One Vision" will feature keynote speaker Susie Jones, MS, RN, APN, CCNS-P, CCRN-P, the 2007 CNS of the Year. The conference will focus on current topics related to the CNS as a member of the healthcare team.


Montana Affiliate News

Two members of the Montana Association of Clinical Nurse Specialists have been successful this past spring and summer in securing funding. Edie Ellsworth, a palliative care CNS, successfully applied for the American Academy of Hospice and Palliative Care mentoring program. Edie will be mentored by Linda Gorman, a palliative care CNS at Cedars-Sinai in Los Angeles. Edie will travel to Cedars-Sinai in September for a week with Linda, and then Linda will come to Great Falls, Montana, at a later date. Member Sandra W. Kuntz, PhD, PHCNS-BC, was accepted into the National Institutes of Health Loan Repayment, Health Disparities Research Program, and will conduct community-based participatory research with Native American populations in Montana. Congratulations Edie and Sandy!


Members are also busy presenting to national audiences. Dr Susan Luparell, who has a robust speaking schedule, spoke with nurses in Arkansas about incivility in nursing. Other members, Drs Sandy Kuntz and Charlene Winters, presented their research on the health status of persons exposed to amphibole asbestos mined in and around Libby, Montana, at the 2008 National State of the Science Congress in Nursing Research in Washington, District of Columbia.


Members of the Montana affiliate continue to work toward increasing the research base for CNSs in Montana through the conduct of research studies, presentations, publications, and dialogue.


Submitted by Charlene A. Winters, PhD, APRN, ACNS-BC


Member Recognition

Jan Bingle Receives Top Honor for Philanthropic Leadership

The Community Health Network Foundation Board of Directors has awarded Jan Bingle, MS, RN, and Community Health Network chief nursing officer, the Jack Heiney Award for philanthropic leadership. For more than 25 years, Jan has generously given her time, talent, and treasures to make an impact in the lives of our nurses, patients, and families. Many of her colleagues, family, and friends gathered at an award dinner to pay tribute to her exemplary philanthropic leadership and dedication to advancing the nursing practice at Community Health Network and central Indiana.


Jack Heiney, retired president and chief executive officer of the Indiana Gas Company, has been a philanthropic leader in the Community Health Network for nearly 40 years. This award was created to honor his ability to inspire a culture of philanthropy and to salute other philanthropic leaders.


Bess Hannigan Member of Employee Education Service

Bess Hannigan of the Salem, Virginia Veterans Affairs Medical Center, recently became a member of the Employee Education Service as the CNS/nurse educator for the Critical Care/Emergency Department at the Salem VAMC. Ms Hannigan also recently achieved national certification in trauma nursing.


Randall Hudspeth Elected to Board of NCSBN

National Association of Clinical Nurse Specialists member Randall Hudspeth, MS, APRN-CNS/NP, FRE, FAANP, was recently elected as director at large for the Board of the National Council of State Boards of Nursing. Randy has previously held the position as chairman of the Idaho Board of Nursing and currently serves as vice chair.


Kathleen Dunn Named ARN APN of the Year

Kathleen L. Dunn has been named the Association of Rehabilitation Nurses Advanced Practice Nurse of the Year. She will receive her award at the ARN nation conference in San Francisco in October. Ms Dunn is the CNS at the VA San Diego Healthcare System Spinal Cord Injury Center.


Kathleen L. Dunn, CNS at the VA San Diego Healthcare System Spinal Cord Injury Center, has been elected to the Spinal Cord Injury Hall of Fame. The Hall of Fame award, through the National Spinal Cord Injury Association (NSCIA), is in the category of Disability Educator. The award will be presented at the NSCIA annual conference in New Orleans in late September 2008. Ms Dunn is the first nurse to be inducted into the Spinal Cord Injury Hall of Fame since its inception in 2005. Previous honorees can be viewed on the NSCIA Web site at


News Briefs

Revolutionizing Healthcare

Christine Filipovich, chief executive officer of the National Association of Clinical Nurse Specialists, participated in a National Press Club panel discussion on September 5, 2008. Healthcare concerns are one of the primary issues that Americans are facing today, with many states considering some type of healthcare reform. The central focus of the discussion was how to make quality healthcare affordable for everyone. Panelists discussed ideas for reforming the system in ways that would better use APNs and other qualified healthcare providers and provide a spiritual component that some feel is missing from healthcare.


"Eye on America" to Feature Clinical Solutions, LLC

September 9, 2008, Deerfield Beach, Florida. The producers of "Eye on America," an innovative, educational television series, are pleased to announce that they will feature Clinical Solutions, LLC in a segment on topics, trends, and issues related to "Healthcare Solutions for the 21st Century."


With healthcare costs skyrocketing and chronic illnesses on the rise, employers desiring to control healthcare costs are looking for cost-effective solutions with immediate results. In response, companies are turning to Wise Health Decisions, a unique worksite wellness program provided by the self-care experts of Clinical Solutions, LLC, a Columbus, Indiana, company.


Founded in 1999 by 2 CNSs, Nancy E. Dayhoff, EdD, RN, and Patricia S. Moore, MSN, RN, CDE, the company developed and implemented a unique worksite wellness program called Wise Health Decisions. On the basis of the premise that an employer's greatest untapped resource for controlling healthcare costs is its employees, the program helps employees to become good self-care managers.


By coming to the worksite each month, clinical solutions professional staff of registered nurses develop ongoing relationships with individual employees through face-to-face meetings. During these meetings, they identify and work with employees at risk for chronic conditions and with employees with diagnosed chronic conditions to implement self-care management interventions. The valuable skills for self-care management include disease management, disease avoidance/delay, lifestyle behavior management, and coping skills for living with a chronic condition.


"Our clients have astounding results when they provide the Wise Health Decisions wellness program for their employees. We have an outstanding record of employee participation and retention," says Nancy Dayhoff. "Our clients have seen an overall improvement in employee health, translating into reduced claims and lower premiums," adds Patricia Moore.


It provides services to manufacturing, construction, and professional service corporations of all sizes since 2003, and its clients include major hospitals and manufacturing, construction, and professional services. In addition, the program is a registered vendor with the Indiana State Department of Health Certified Wellness Program for small businesses.


To learn more about the company and its customized Wise Health Decisions wellness program, please visit


aAcademy of Medical Surgical Nursing, American Association of Critical-Care Nurses, American Association of Neuroscience Nurses, American Association of Occupational Health Nurses, American Nephrology Nurses Association, American Psychiatric Nurses Association, American Society of PeriAnesthesia Nurses, Association of Community Health Nurse Educators, Association of Women's Health, Obstetric, and Neonatal Nurses, Association of Rehabilitation Nurses, Emergency Nurses Association, Hospice and Palliative Nurses Association, International Nurses Society on Addictions, International Society of Psychiatric-Mental Health Nurses, National Association of Clinical Nurse Specialists, National Association of Orthopaedic Nurses, National Gerontological Nursing Association, Society of Pediatric Nurses, and Society of Urologic Nurses and Associates. [Context Link]


bMedical/Surgical, Orthopaedics, Gerontology, American Association of Critical Care Nurses, National Association of Clinical Nurse Specialists. [Context Link]


cAmerican Nephrology Nurses Association, Association of Community Health Educators, Hospice and Palliative Nurses Association, International Nurses Society on Addictions, Society of Urologic Nurses, and Oncology Nursing Society. [Context Link]