1. Fulton, Janet S. PhD, RN

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Happy New Year! As I write this message, it's November. The US House of Representatives has passed healthcare legislation. The Senate is preparing a bill for that chamber to consider. According to messages on television, the proposed changes are really good and really bad-polar opposite opinions stated with equal certitude. My e-mail is flooded with more messages enumerating the positives and lamenting the negatives. Billboards urge me to call my senators to remind them to say yes to healthcare reform; the radio messages tell me to have them say no to healthcare reform. Mr Toad's Wild Ride of healthcare reform.


Our American healthcare system will be affected by the current legislative activity. That's as far as I'm willing to go on predicting an outcome. Color me yellow. Clinical nurse specialists (CNSs) have been contemplating where we will fit in the future. Be assured that the National Association of Clinical Nurse Specialists (NACNS) is advocating for CNSs in many forums. In June 2009, NACNS held a congressional briefing, organized through the American Nurses Association, for members of Congress and their staff. According to Christine Filipovich, NACNS chief executive officer, NACNS is "participating in national dialogue and group efforts keeping advanced practice nurses in the forefront of our members of Congress." NACNS is a partner or member in many nursing coalitions and organizations working in Washington. To name a few, the NACNS is an active member of the Champion Nursing Council of American Association of Retired Persons Center for Championing Nursing. Led by Dr Brenda Cleary, a CNS, the center is engaged in a number of advocacy activities related to ensuring an adequate nursing workforce for the future. NACNS and other advanced practice groups are working with the center to identify solutions to some of the current barriers to advanced nursing practice. NACNS is also a member of the Coalition for Patient's Rights, which is addressing the public's need for choice in healthcare providers, and the Americans for Nursing Shortage Relief Coalition. Participation in these groups gives the NACNS the ability to monitor and influence the work of the groups and to join in a larger voice related to healthcare reform. NACNS participation includes advocating for appropriate language in proposed legislation, attending meetings with key policy makers, and providing testimony. For example, on October 22, Filipovich represented NACNS along with 8 other representatives of the Americans for Nursing Shortage Relief Coalition in a meeting with the director of the Division of Nursing, Health and Human Services, Health Resources and Services Administration. On November 3, Filipovich attended a special meeting convened by the American Association of Retired Persons to bring selected advanced practice nursing groups together with Donna Shalala, Linda Burnes Bolton, and Susan Hassmiller of Robert Wood Johnson Foundation (RWJF)-the group leading the RWJF Initiative on the Future of Nursing. In October 2009, NACNS member Margaret Talley made a presentation to RWJF as part of its Future of the Nursing Workforce initiative. NACNS joined with other groups to advocate for continued funding for advanced nursing education. Filipovich was 1 of 4 panelists at a National Press Club event addressing a vision for the future healthcare delivery system where she spoke about nursing's key role and in particular the contributions of CNSs to quality, safe, cost-effective care. NACNS president Melanie Duffy and other board members have traveled extensively and spent countless hours on conference calls on behalf of CNSs. The complete list of activities is too extensive to be recounted here.


Through these activities and collaborations, the NACNS continues to represent the interest of CNS practice at the national level during this time of uncertainty. If you are a CNS and want to ensure your interests are represented, be sure to renew your membership and encourage a colleague to do the same. When the dust clears from the wild ride of healthcare reform, CNSs will be present and standing.