1. Sullivan, Marie MS, RN, PCNS-BC, CPON
  2. Ouellette, Annette MA, RN, ACNS-BC
  3. Lincoln, Pam MA, RN, ACNS-BC, FNP-BC
  4. Udeen, Tracy MA, RN, ACNS-BC
  5. Wagner, Linda MA, RN, CNS
  6. Johnson, Anastasia M. BSN, RN, CNOR
  7. Roach, Diane BA, RN
  8. Runquist, Jean BA, RN

Article Content


Transitioning from an experienced registered nurse to an advanced practice nurse can be challenging. This presentation explores the journey of the clinical nurse specialist (CNS) from novice to expert. The purpose is to review a practice model utilizing CNS graduate students in the CNS intern role at a Midwestern acute care tertiary hospital and describe how the model supports advanced practice nurse (APN) role acquisition.



Novice advanced practice nurses often feel overwhelmed when stepping into the APN role. This practice model seeks to provide the CNS graduate student with situational experiences to bridge the transition to the APN role.



The history of the CNS intern program will be summarized. Due to multiple vacancies in the CNS positions at the hospital, a collaborative partnership was developed with a local college's graduate nursing program to create the intern model. The Dreyfus skill acquisition model of APN role development as described by Brykcznski serves as the theoretical underpinning of the program. The CNS spheres of influence guided the development of the CNS and CNS intern job descriptions.



The CNS intern role provides opportunity for the CNS graduate student to accrue experience in actual situations with the mentoring and support of the experienced CNS. The presentation will include examples of the CNS intern's projects and outcomes. Benefits and challenges of the model to the CNS graduate student, practicing CNSs, and the organization will be identified.



Benefits to the CNS graduate student include immediate access to mentors and meaningful work projects. The greatest challenges are the ambiguity in the CNS intern role finding balance.



The CNS intern role provides the CNS graduate student with real-time synthesis of the principles of CNS practice and increases awareness of the CNS role among hospital staff.


Implications for CNS basic and Continuing Education:

Opportunities for improvement include formalization of the CNS graduate student requirements into a competency-based format to document the CNS intern progression. Advantages of a competency format will document the accomplishments of the CNS intern and assist with role clarification.


Section Description

The 2010 National Association of Clinical Nurse Specialists (NACNS) Annual National Conference is planned for Portland, Oregon, on March 3 to 6. More than 375 clinical nurse specialists (CNSs), graduate faculty, nurse administrators, nurse researchers, and graduate students are expected to attend. This year's theme, "CNS as Internal Consultant: Influencing Local to Global Systems," demonstrates the breadth and depth of CNS practice and leadership at multiple levels in organizations and on healthcare.


A total of 142 abstracts were submitted for review, and 58 (not including student posters) were selected for either podium or poster presentations. Again, this year, there is a CNS student poster session; student abstracts will appear in a later issue of the journal. The abstracts addressed CNS practice in all 3 practice domains as described in the Spheres of Influence Framework for CNS Practice. Abstracts emphasized patient safety and quality care outcomes, leadership, CNS education, evidence-based practice, and new ways to shape CNS practice. Topics include CNS work activities incorporated into the 3 Spheres of Influence, the role of the CNS in developing clinical inquiry skills among staff nurses, use of simulation technology, strategies to maintain clinical excellence, the role of the CNS in National Database for Nursing Quality Indicators (NDNQI) activities, and many new and thoughtful ideas to support CNS education, practice, and research. Collectively, the abstracts represent the breadth, depth, and richness of the CNS's contribution to the well-being of individuals, families, and communities, as well as contributing to the advancement of the nursing profession.


The conference abstracts are published to share new knowledge with those unable to attend the conference. As you read each abstract, appreciate the intellectual talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to the health of society through improved outcomes for patients and healthcare organizations. We encourage you to contact individual presenters to network, collaborate, consult, or share your thoughts and ideas on the conference topics.


Watch for next year's call for abstracts and consider submitting for presentation at the next NACNS annual conference scheduled for March 9-12, 2011, in Baltimore, Maryland.