Year: 2015


National Nursing Organization Applauds Congress for Supporting Advanced Practice Nurses’ Practice, Workforce Development and Research

“As members of the Advanced Practice Nursing community, the National Association of Clinical Nurse Specialists is pleased by the provisions included in the new budget package that support expanding advanced practice nurses’ scope of practice and supporting nurse workforce development and nursing.

“Specifically, the package allows the Veterans Health Administration to proceed with publishing a proposed rule supporting veterans’ access to quality care through full practice authority for advanced practice registered nurses; and funds Title VIII nurse workforce development programs and nursing research.

“These provisions not only support nurses, but also health care consumers, by ensuring that nurses are able to practice to the full extent of their skills and education, and by supporting the nursing workforce and crucial research that improves health and health care.

“We want to thank the members of Congress who voted to support these crucial provisions.”


More Clinical Nurse Specialists Now Able to Practice, Prescribe Without Physician Supervision

Survey of State Laws and Regulations Reveals Clinical Nurse Specialists Authorized to Practice to Top of Education and Skills in More than Two-Thirds of U.S. States

A review of state laws and regulations reveals that since 2010, eight states have granted clinical nurse specialists (CNSs) the authority to practice without a physician’s supervision and six have given CNSs independent authority to prescribe drugs and durable medical equipment. These represent 32 percent and 40 percent increases, respectively, in the number of states that grant such authority; CNSs can now practice to the full extent of their education and training in 28 states and prescribe without supervision in 19.

An additional 13 states allow CNSs to practice with the collaboration of a physician bringing the total to 43 states (85%). CNSs have the authority to prescribe drugs and durable medical equipment with the collaboration of a physician in an additional 20 states, bringing the total to 39 states (76%).

One state (Maryland) that has recently granted full practice authority granted it only to psychiatric and mental health CNSs.

CNSs are advanced practice registered nurses who hold leadership roles in health care settings. They provide diagnosis, treatment, and ongoing management of patients. They also provide expertise and support to nurses caring for patients at the bedside, help drive practice changes throughout the organization, and ensure the use of best practices and evidence-based care to ensure the best possible patient outcomes.

In its landmark report, The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine recommended that nurses be able to practice to the full extent of their education and skills. The National Association of Clinical Nurse Specialists (NACNS) commissioned the review to determine how much progress has been made since the publication of that report. The work was done in consultation with the National Council of State Boards of Nursing.

“This is an important and exciting trend in state health care policy,” said Peggy Barksdale, MSN, RN, OCNS-C, CNS-BC, President of NACNS. “The number of people who have access to health care services has increased dramatically because of the Affordable Care Act. At the same  time, the number of people who have chronic conditions, including multiple chronic conditions is increasing. More than ever, we need to ensure that every health care provider, including the highly skilled CNS, is able to perform to the top of his or her skills, education and expertise.”

The eight states that have authorized CNSs to practice to the full extent of their education and skills since 2010 are: Alaska, Arizona, Delaware, Maryland (psychiatric mental health CNSs only), Minnesota, Nevada, North Dakota and Oregon. CNSs were able to practice independently prior to 2010 in Arkansas, Colorado, Connecticut, Washington, D.C., Hawaii, Idaho, Iowa, Kentucky, Maine, Montana, Nebraska, New Mexico, North Carolina, Oklahoma, Rhode Island, Utah, Vermont, West Virginia, Wisconsin and Wyoming.

The six states that have authorized CNSs to prescribe independently since 2010 are Alaska, Delaware, Hawaii, North Dakota, Oregon and Rhode Island. CNSs were already able to prescribe in Colorado, Connecticut, Washington, D.C., Idaho, Iowa, Maine, Minnesota, Montana, Nevada, New Mexico, Utah, Vermont and Wyoming.

Maps indicating states that have authorized CNSs to the full extent of their education and skills and that have authorized them to prescribe independently are available here.


Clinical Nurse Specialists Urge Full-Practice Authority at VHA, Streamline Services for our Nation’s Veterans

“This Veterans Day, the National Association of Clinical Nurse Specialist is urging the Veterans Health Administration (VHA) and Congress to grant full-practice authority to all advanced practice registered nurses (APRNs) employed at VHA facilities, including its clinical nurse specialists (CNSs), nurse practitioners, nurse anesthetists and nurse midwives.

Granting full-practice authority to clinical nurse specialists at VHA facilities would immediately improve access to vital health care services for our nation’s veterans by streamlining health services, eliminating redundancies and bottlenecks and alleviating delays in care delivery.

Every day across this country, CNSs provide expertise and support to nurses caring for patients at the bedside, help drive practice changes throughout their organizations, and ensure the use of best practices and evidence-based care to achieve the best possible patient outcomes. If every health care setting employed CNSs, more of the care provided would be based on research and best practices, our health care system would be more efficient, and we would all be healthier.

NACNS is proud to be a part of the APRN Workgroup, a coalition of national advanced practice registered nurse membership organizations working to improve access to health care by decreasing barriers to APRN practice, in calling for this common sense solution. We will continue to work with other nursing and health professional organizations to ensure that our veterans receive health care services as safely, timely and cost-effectively as possible.”

Peggy Barksdale, MSN, RN, OCNS-C, CNS-BC is the President of the 2015-2016 NACNS Board of Directors.


How Do Clinical Nurse Specialists Improve Health Care?

Five Facts to Know About Clinical Nurse Specialists

September 1-7 is the seventh annual National Clinical Nurse Specialist (CNS) recognition week. CNSs play a crucial role in health care and improving patient safety and quality of care.

“Now, more than ever, CNSs can and should be leaders in health care,” said NACNS Board President Peggy Barksdale, MSN, RN, OCNS-C, CNS-BC. “Every day across this country, clinical nurse specialists provide expertise and support to nurses caring for patients at the bedside, help drive practice changes throughout their organizations, and ensure the use of best practices and evidence-based care to achieve the best possible patient outcomes. If every health care setting employed CNSs, more of the care provided would be based on research and best practices, our health care system would be more efficient, and we would all be healthier.”

Here are five important facts to know about the CNS role in health care.

  1. Clinical Nurse Specialists are advanced practice registered nurses (APRNs), and have education and training in advanced nursing care, physiology, pharmacology and physical assessment.
  2. There are more than 72,000 CNSs across the United States working in hospitals and other health care settings, including private practice, and clinics.
  3. The vast majority of CNSs (85 percent) work full-time and two-thirds (66 percent) work in hospital settings. Of those, more than two in five (44 percent) have responsibility across the entire hospital system.*
  4. As a group, CNSs spend most of their time providing direct patient care (25 percent), consulting with nurses, staff and others (20 percent), teaching nurses and staff (19 percent) and leading evidence-based practice projects (14 percent).*
  5. CNSs can make a bigger difference in improving health care if more people understand the value, expertise and skills clinical nurse specialists bring to health care practice.

The National Association of Clinical Nurse Specialists (NACNS) established National CNS Recognition Week in 2009 to commemorate the contributions of Hildegard Peplau to nursing and health care. Born September 1, 1909, Dr. Peplau was a prominent nursing theorist whose landmark book, Interpersonal Relations in Nursing, emphasized the nurse-client relationship as the foundation for nursing practice and today serves as the basis of the CNS role in health care.

*Note: Data is based on NACNS’s 2014 Clinical Nurse Specialist Census findings. The Census was an online survey (conducted from June 1 to December 31, 2014) completed by 3,370 nurses who had completed or were enrolled in a CNS education program.

 


Clinical Nurse Specialists Say Approval of Flibanserin Represents Important Advance in Women’s Sexual Health

“The Food and Drug Administration’s approval of the first medication to help women suffering from sexual dysfunction represents an important advance in women’s sexual health. The FDA has approved 26 drugs to treat sexual dysfunction in men, but until now, none for women. That’s in spite of the fact than one in ten women suffers from hypoactive sexual desire disorder.

“Now, women will finally have an option for treatment that they can discuss with their health care providers. We would hope that this will help increase the focus on developing ways to help women overcome sexual dysfunction and help end the gender inequality in this important area of health care.

“There has been a lot of concern about the side effects associated with flibanserin, and as an association representing advanced practice registered nurses, we take that seriously. We also know that the majority of FDA-approved drugs have side effects. It is important that women are educated about the side effects associated with this drug and then make their own decisions, in consultation with their health care providers, about whether to use flibanserin.”

Peggy Barksdale, MSN, RN, OCNS-C, CNS-BC is the President of the 2015-2016 NACNS Board of Directors.


National Association of Clinical Nurse Specialists Endorses Requiring Doctor of Nursing Practice Degree for Clinical Nurse Specialists

Association Leadership Asserts Doctor of Nursing Practice Degree Will Help Clinical Nurse Specialists Meet Demands of an Evolving Health Care System

Washington, D.C. – The National Association of Clinical Nurse Specialists (NACNS) today announced its endorsement of the Doctor of Nursing Practice (DNP) degree as a requirement for entry into practice for clinical nurse specialists (CNS) by 2030.

Until now, the association has consistently supported either the Master of Science in Nursing (MSN) degree or the DNP as adequate preparation for a CNS.

“In recognition of the increasingly complex needs of patients, the dramatic and ongoing changes in health care, and the pivotal role that the CNS plays in ensuring high quality, evidence-based, patient-centered care, NACNS has determined that the DNP will better prepare these nurses to meet the future demands of the evolving health care system,” said NACNS President Peggy Barksdale, MSN, RN, OCNS-C, CNS-BC.

NACNS’ new position also supports the recommendations of the 2010 Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health, and the 2009 Carnegie Foundation report, Educating Nurses: A Call for Radical Transformation, to increase the number of doctorally prepared nurses.

NACNS also agrees with the IOM report’s assertion that programs that allow seamless transition to higher degrees are essential to ensuring the nation has an adequate number of doctorally prepared nurses to meet future health care needs. Post-baccalaureate and post-master’s programs are the two academic routes to the DNP. The latter must use approved CNS competencies and education standards in the curriculum to ensure graduates are prepared for CNS practice.

NACNS developed core CNS competencies and Criteria for the Evaluation of Clinical Nurse Specialist Master’s, Practice Doctorate, and Post-Graduate Certificate Educational Programs to support and guide CNS educators in developing and evaluating their curricula.

While NACNS supports the DNP as the appropriate degree for future clinical practice as a CNS, the association supports allowing CNSs who pursued other graduate education to continue to practice without having to earn a DNP, retroactively, after 2030.

The NACNS position on the DNP was developed by a DNP Task Force, which included:

  • Chair: Carol Manchester, MSN, ACNS, BC-ADM, CDE, University of Minnesota Medical Center, Minnesota;
  • Melissa Craft, PhD, APRN-CNS, AOCN, University of Oklahoma, Oklahoma;
  • Ruth Lundquist, PhD, RN, FAHA, FAAN, University of Minnesota, Minnesota;
  • Rachel Moody, MSN, RN, CNS, Franciscan Alliance, Illinois;
  • Linda Scott, PhD, RN, NEA-BC, FAAN, University of Illinois at Chicago, Illinois ;
  • Maureen Shekleton, PhD, FAAN (Staff Advisor), NACNS Consultant, Illinois; and
  • Patti Rager Zuzelo, EdD, RN, ACNS-BC, ANP-BC, CRNP, FAAN, Drexel University, Pennsylvania.

National Association of Clinical Nurse Specialists Honors Founding President, American Association of Critical-Care Nurses with President’s Award

San Diego, CA – At its 20th Anniversary Annual Conference, the National Association of Clinical Nurse Specialists (NACNS) today presented its prestigious President’s Award to a woman and a nursing organization that were instrumental to the founding of the association. Patricia Bielecki, MS, APN/CNS, RNC-OB, and the American Association of Critical-Care Nurses (AACN) were honored with the Award, which recognizes an individual or entity for extraordinary service to NACNS. It was established in 2013 to honor individuals or groups that make significant contributions toward the accomplishment of the NACNS mission.

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Atlanta Nurse Receives Award from National Nursing Association for Exemplary Work Teaching, Coaching and Mentoring Nursing Students

San Diego, CA – The National Association of Clinical Nurse Specialists (NACNS) today presented its prestigious Clinical Nurse Specialist Preceptor of the Year Award to Courtenay Wannamaker, MSN, APRN, CCNS, CCRN, PCCN, a Clinical Nurse Specialist (CNS) at Emory University Hospital. The Award was designed to nationally recognize an NACNS member for outstanding professional achievement as a CNS Preceptor. It recognizes a CNS preceptor who has demonstrated commitment to teach, coach and mentor CNS students to achieve CNS competencies. The Award was presented at NACNS’ Annual Conference.

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University of Minnesota Nurse Receives National Nursing Leadership Award

San Diego, CA – The National Association of Clinical Nurse Specialists (NACNS) today presented its prestigious Brenda Lyon Leadership Award to Carol Manchester, MSN, RN, ACNS-BC, BC-ADM, CDE, a Diabetes Clinical Nurse Specialist (CNS) at the University of Minnesota Medical Center. The Award recognizes extraordinary leadership in service to NACNS. It is named for Brenda Lyon, a founding member and the second president of NACNS, and was presented at NACNS’ Annual Conference.

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Cal State, Dominguez Hills Faculty Member Receives Clinical Nurse Specialist Educator of the Year Award

San Diego, CA – The National Association of Clinical Nurse Specialists (NACNS) today presented its prestigious Clinical Nurse Specialist (CNS) Educator of the Year Award to Terri Ares, PhD, RNC-NIC, CNS-BC, Lecturer and CNS Program Advisor at California State University, Dominguez Hills. The Award recognizes an NACNS member for outstanding professional achievement as a CNS educator. It acknowledges the recipient’s excellence and innovation in preparing CNSs and in implementing the NACNS Statement on CNS Practice and Education.

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