1. Duffy, Melanie MSN, RN, CCRN, CCNS

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President's Message

2010! Can you believe it? A brand new year has arrived accompanied by plans for new projects, career decisions, and personal and professional goals. The new year has a different meaning for me as president of the National Association of Clinical Nurse Specialists (NACNS). This is my last column for the journal as president.


I entered this new phase of my career with excitement and a little anxiety. I was following in the footsteps of outstanding leaders with outstanding ideas and qualities. How would I ever live up to the expectation? I finally figured out that the objective wasn't to "live up" to someone's expectations, but to forge my own path and add my leadership style to the history of the organization.


The NACNS has been involved in several projects this year. Doctoral-level clinical nurse specialist (CNS) competencies were finalized and published for comment and endorsement. The Education Standards Task Force began work on CNS education and curricula. The NACNS offered comment on the draft of The Essentials of Master's Education in Nursing, published by the American Association of Colleges of Nursing. And NACNS will continue to offer comment in future meetings. We submitted testimony and garnered letters of support from nursing organizations to add the CNS as a healthcare provider in the list of standard occupational classifications. We filed a letter with the federal Drug Enforcement Agency requesting expansion of the identifying terminology used to describe midlevel practitioners to include the term clinical nurse specialist. We continue to dialogue with state boards of nursing and other professional nursing organizations regarding the purpose and implications of the Advanced Practice Regulatory Model. The NACNS presented testimony for the Forum on the Future of Nursing: Acute Care, the first public forum hosted by the Robert Wood Johnson Foundation Initiative on the Future of Nursing at the Institute of Medicine. The role of the CNS was explained, and the effect of the CNS on quality and safety was highlighted. The NACNS continues to be a resource to CNSs requesting guidance as they embark on the journey to title protection in states where CNSs are not title protected.


The NACNS has grown as an organization to more than 2,300 members. We appointed new chairs to committees and added new members. The annual conference in St Louis, Missouri, in March 2009 was a huge success. The Clinical Nurse Specialist Toolkit: A Guide for the New Clinical Nurse Specialist, published by NACNS, made its debut at the conference. As primary editor for the book, I extend my appreciation to my coeditors, Susan Dresser and Dr Janet S. Fulton, and to the authors who contributed time and effort to such a worthwhile project. And this year, I anticipate that the conference in Portland, Oregon, in March 2010 will surpass the previous years in attendance, networking, and the sharing of professional ideas.


The NACNS has been in the forefront of numerous initiatives as cited, and I know I have forgotten some. But I have saved the best for last. The undertaking I am most proud of is the establishment of the first annual National CNS Recognition Week, which occurred September 1 to 7, 2009. The week is devoted to the CNSs and acknowledges the significant impact this particular advanced practice nurse has on healthcare. The September dates were chosen in honor of the birthday of Hildegard Peplau, the founder of the concept of the CNS. She established the first master's in nursing program at Rutgers University in New Jersey in the 1950s. The focus of the program was exclusively clinical practice and the formation of a relationship between the master's-prepared nurse and the patient. This relationship continues to the present day and will continue into the future. The CNS is the driver and an active participant in the reform of the healthcare system. The CNS is the advanced practice nurse who interacts with and affects patients, families, communities, nurses, physicians, systems, and organizations. Begin to make plans now to honor and recognize your CNS colleagues for the second annual National CNS Recognition Week, September 1 to 7, 2010.


I have had an exciting, rewarding, and very eventful year as president of NACNS. I have met, talked with, and perhaps influenced decision makers at all levels of healthcare within and outside nursing. I am glad I had the opportunity to be president of an organization with such impact! I will be forever grateful to previous, current, and future leaders in the organization that have been mentors to me. And special thanks to my husband who is always there for me. Dr Patti Zuzelo will become president in March. The NACNS will thrive under her leadership and guidance.


Affiliate News

Pennsylvania Affiliate Begins!

Attention clinical nurse specialists (CNSs) in Pennsylvania, we are initiating a local affiliation of the National Association of Clinical Nurse Specialists. We would like all CNSs practicing in Pennsylvania to join us. The meetings are scheduled monthly on the third Tuesday of every month from 6:30 to 7:30 pm. The November meeting will be held at Pinnacle Health in Harrisburg. Please plan to join us; we hope to accomplish a plethora of goals such as political activism, peer education, career development, and community involvement. For more information, contact Cynthia Swartz at We look forward to meeting with everyone and developing a strong and prosperous affiliation to the National Association.


Cynthia Swartz, MSN, RN, CNS


Medical/Surgical Clinical Nurse Specialist


503 N 21st St


Camp Hill, PA 17011-2288


Oklahoma Affiliate (OACNS)

In recognition of clinical nurse specialist (CNS) week and the 100th birthday of Hildegard Peplau, the Oklahoma Association of Clinical Nurse Specialists (OACNS) celebrated during their regular quarterly meeting. Festivities included a birthday cake with party favors and balloons. The celebration was highlighted by a proclamation from Gov Brad Henry to recognize and exemplify the work of CNSs in Oklahoma. The document further establishes the week as CNS Recognition Week in the state of Oklahoma. The OACNS president, April Merrill, will represent OACNS on Oklahoma Nurses' Association House of Delegates.


Stephanie Moore, 2008 OACNS president and current immediate past president, has been appointed to a 2-year term of service, 2009 to 2011, on the National Association of Clinical Nurse Specialists (NACNS) Education Committee. Committees are a vital part of NACNS, and NACNS relies on committee members to define and achieve much of the work on behalf of CNSs nationwide.


Member News

National Association of Clinical Nurse Specialists member, Lori Grove, MS, ARPRN, GCNS-BC, took advantage of the first National CNS Week to meet with Mayor Joseph Suchanec of Kistler, Pennsylvania, to discuss the influence and contributions of Clinical Nurse Specialists (CNSs) across the nation. Ms Grove explained how CNSs are advancing nursing practice by providing interprofessional systemwide leadership and creating and evaluating cost-effective evidence-based policies, procedures, and best practice models. For example, at Alliance Impairment Management, Inc, the development of a gerontological case management division is currently under way as a direct result of hiring Grove who identified the need and has initiated new policies and processes for meeting the unique needs of the elderly in central Pennsylvania. This meeting with mayor Kistler resulted in the signing of the first proclamation in their community recognizing National CNS Week September 1 to 7. This proclamation signifies the mayor's recognition of the important work that CNSs do to rural communities all over the country.


Global Diversity Through Research, Education, and Evidence-Based Practice

Research and evidence-based practice abstracts are currently being accepted for the 21st International Nursing Research Congress of Sigma Theta Tau International. The congress meets 12-July 16, 2010, in Orlando, Florida. This event provides a forum for cutting-edge nursing research highlights and conclusions, an international assembly for nurse researchers to network and share ideas, and a discussion platform for the following topic: global diversity through research, education, and evidence-based practice. This is a perfect opportunity to clinical nurse specialist researchers to showcase the work they are doing. To submit an abstract or view suggested topics and submission guidelines, please visit the Sigma Theta Tau Web site.


The Forum on the Future of Nursing: Acute Care

The Forum on the Future of Nursing: Acute Care was held on October 19 in Los Angeles. The forum pointed up key priorities for the nursing profession, including interdisciplinary collaboration, technology, and quality and safety. The presentations and testimony from the forum will help inform the work of the Robert Wood Johnson Foundation Initiative on the Future of Nursing as the committee explores how to improve the delivery of care. A limited number of preselected individuals were given the opportunity to present testimony. The National Association of Clinical Nurse Specialists submitted written testimony for this meeting and was also accepted to present 2 minutes of "live" testimony during the meeting. Margaret Talley of our California affiliate represented the National Association of Clinical Nurse Specialists. The Initiative on the Future of Nursing is a 2-year effort of the Institute of Medicine and Robert Wood Johnson Foundation to find solutions to the continuing challenges facing the nursing profession and to build upon nursing-based solutions to improve quality and transform the way Americans receive healthcare. This was the second of 3 national forums as part of this initiative and focused on nursing across acute care health settings and included panels, discussion and outside testimony on technology, interdisciplinary collaboration in the healthcare team, and quality and safety. More than 300 nurses, public policy experts, and healthcare professionals gathered at Cedars-Sinai Medical Center to focus on improving quality care across acute care settings. The simultaneous Web cast of the event drew 220 live viewers. The archived version of the Forum on the Future of Nursing: Acute Care can now be accessed by going to this Web site:


Tools for Discussing the Role of the CNS and Healthcare Reform Now Available

The National Association of Clinical Nurse Specialists (NACNS) has developed talking points to assist members in discussing the role of the clinical nurse specialist in a healthcare delivery system as part of healthcare reform. These talking points are available on the NACNS Web site.


The NACNS has been awarded a Resourcefully Enhancing Aging in Specialty Nursing grant to fund the development of clinical nurse specialist continuing education modules addressing 7 geriatric topics.


NACNS Addresses the Department of Labor Ruling Re: Standard Occupational Categories

The National Association of Clinical Nurse Specialists (NACNS) is developing a comprehensive response to address the Office of Management and Budget's previous decision that clinical nurse specialists should be included as registered nurses in the standard occupational classifications. An overview of the issue can be found on the NACNS Web site. The NACNS research, education, and practice committees as well as the American Nurses Credentialing Center and other certifying agencies and individuals have prepared and submitted documentation supporting naming the clinical nurse specialist as a separate classification, just as the other 3 advanced practice nursing groups are.


NACNS Core Practice Doctorate CNS Competencies Completed

The National Association of Clinical Nurse Specialists, along with 18 nursing specialty organizations, has completed the first set of core practice doctorate clinical nurse specialist (CNS) competencies. These competencies have been distributed for endorsement by specialty nursing organizations. Upon completion of a practice doctorate CNS program, the graduate should possess the master's-level CNS core competencies developed by the National CNS Competency Task Force (2008) and the practice doctorate competencies. These competencies are available from the National Association of Clinical Nurse Specialists.


NACNS Requests Revision of DEA Registration Form

In response to member concerns and requests, National Association of Clinical Nurse Specialists submitted comments and letters to the DEA requesting a revision to application forms to allow clinical nurse specialists (CNSs) to register as a CNS. The current form provides only a category recognizing the nurse practitioner, forcing CNSs to register as nurse practitioners. For detailed information, see the National Association of Clinical Nurse Specialists Web site.


NACNS 2010 Conference

The 2010 Conference, CNS as Internal Consultant: Influencing Local to Global Systems, will be held March 4 to 6 at the Hilton Portland & Executive Tower, Portland, Oregon. For more information, go to