1. Section Editor(s): Rust, Jo Ellen MSN, RN, Column Editor

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NAME: Angela P. Clark, PhD, RN, CNS, FAAN, FAHA

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CURRENT POSITION: Associate Professor of Nursing


CURRENT AFFILIATION(S): The University of Texas at Austin


AREA(S) OF SPECIALIZATION: Cardiopulmonary and Diabetes Care


PROFESSIONAL EDUCATION: PhD, Texas Woman's University; MSN (CNS), Texas Woman's University; BSN, Spalding College; Diploma, Ga. Baptist Hospital School of Nursing




FELLOWSHIPS: FAAN-Fellow, American Academy of Nursing; FAHA-Fellow in the American Heart Association


Dr Angela Clark received the 2008 Brenda Lyon Leadership Award from the National Association of Clinical Nurse Specialists at their annual meeting in Atlanta, Georgia. This award recognizes an individual who has attained national recognition as a clinical nurse specialist (CNS) leader. Through publications, presentations, and participation in national forums, the individual has helped improve healthcare delivery, especially as it relates to CNS practice. The individual has been successful in mentoring others to become successful leaders. Dr Angela Clark was asked to share her thoughts regarding leadership, mentorship, and CNS practice.


Describe your definition of leadership and why it is so important for clinical nurse specialist to provide leadership today in healthcare.


Leadership is the ability to influence others-it's the classic definition. It implies that the leader and others in a group have identified a goal to reach, and the leader's role is to use influence to motivate people to achieve the desired outcome. For clinical nurse specialists, influence is a critical characteristic to have and maintain. Leadership is desperately needed in healthcare today-the systems of care are broken in many places, with many underserved people. For example, obesity, cardiometabolic syndrome, and diabetes are epidemic in proportion in the US population. The costs of acute and critical care are unbelievable. When I round in critical care settings and review medical diagnoses that led to the admissions, it is so clear what is needed in our healthcare culture that can be influenced by expert CNS care. Prevention, risk factor reduction, patient and family education, as well as health and disease management programs-all of these are part of CNS educational curricula and CNS practice today and are part of solutions needed for the future.


What uniquely qualifies clinical nurse specialists to serve in this capacity?


The ability to manage complexity shows why CNS expertise is so valuable. Each CNS has the opportunity to influence the quality of healthcare in a variety of settings and to improve individual and aggregate health. We are educated to practice at an advanced level and can implement programs and maintain care that targets high cost populations. The recent national vote on tobacco regulation was influenced at a regional level by several CNS leaders in our state. Using our influence to lead is a must.


Define your view of a mentor.


A mentor is one who guides, counsels, and supports the mentee or protege who is the recipient of the nurturing. To me, it implies a professional relationship but also has elements of a personal relationship. We have a very large painting in our home of Odysseus who is clinging to a raft amid huge waves in the sea with his home Ithaca in the background where he is the King. When I researched the painting, I was surprised to find an early use of the word mentor. When Odysseus left to go fight the Trojan war, Greek mythology shows that he left his close friend Mentor in charge of his son and his palace. For over 10 years, Mentor cared for the son and the royal duties, providing counsel and nurture for the child. My own mentor was a physician colleague. I was practicing as hospital-based CNS and managed care for many of his patients. He helped me to develop as a young professional, encouraging me to go to graduate school for PhD studies, listening to me, and giving sage advice. He also gave me a door key to his medical office and provided resources, including secretarial services, a typewriter (no one had personal computers then!), a copier, and fax machine to develop some of my first manuscripts and professional papers. In thinking about the essence of what his mentoring meant to me, it was simply invaluable to my career and growth. To me, this is mentoring at its best.


What do you think it takes to mentor others to become leaders?


Support, especially at key times, and listening with reflection. Maintaining a balance between that support and empowering of the protege. Giving advice in small bites. Offering help beyond just words-when I think back to the office key provided by my mentor, it symbolizes how he guided me to succeed professionally in ways that I didn't even realize I needed at the time. The mentor must be willing to invest the time needed to help the protegee develop and achieve his/her own goals.


What do you enjoy or value most about the role of a clinical nurse specialist?


I love the CNS role! My original specialization was in cardiopulmonary care and diabetes-in the curriculum, it was a "double major" which I had to get approved by the faculty. My overarching preparation was in adult health advanced practice nursing. Given the leading causes of morbidity and mortality in the US, my CNS education covered it all! Currently, I work with patients with chronic heart failure, many of whom also have diabetes. Funding from NIH for a 3-year study on improving self-care and health outcomes in this population gave me an opportunity to use all of my skills as a CNS-teaching and mentoring my CNS students, doing meaningful clinical research, leading a research team, and giving family and patient education. My CNS preparation and expertise has served as the basis for a rich and interesting career. The opportunities I've had to practice, teach at the University level, and conduct clinical research have been amazing. I am limited only by my need to balance life in a well-rounded manner. I enjoy almost every aspect of my work.


What advice would you give a new clinical nurse specialist starting out in this role who would like to identify a mentor?


Find someone who seems to have an interest in you as a person and the role that you choose, and who is willing to invest the time in helping you develop in this professional role. Ideally, the mentor will be someone you see as wise and very ethical. Ask for help when you need it. Show appreciation continually.