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National Nursing Organization Offers ‘Next Best Option’ to Certify FALS Clinical Nurse Specialists

A recent report from the National Association of Clinical Nurse Specialists (NACNS) Family Across the Lifespan (FALS) Crosswalk task force recommends allowing FALS clinical nurse specialists acquire certification for state licensure by passing both the clinical nurse specialist (CNS) adult/gerontology and pediatric certification examinations.  The NACNS Board of Directors and the task force note the recommendation is a proxy for a FALS population-specific CNS certification examination until such time that a valid and reliable FALS test and/or certification process is established.

NACNS was an active participant in developing the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education (APRN Consensus Model)  in 2008 to improve patient access to clinical nurse specialists and to enable CNSs to practice to the full extent of their education and licensure.

For CNSs and other APRNs, the APRN Consensus Model shifted accreditation from a specialty-based certification to one centered around a population, and APRNs must be educated, certified and licensed to practice in at least one of six population foci: family/individual across the lifespan, adult/gerontology (adult/gero), pediatrics, neonatal, women’s health/gender-related or psych/mental health. CNSs practice in all six population areas, but there are only three CNS certification examinations currently available for three populations: adult/gero, pediatric and neonatal.

In 2016 the NACNS Board of Directors commissioned the task force to compare the adult/gero and pediatric CNS competencies with the draft FALS CNS competencies. The task force was charged with assessing whether both the adult/gero and pediatric certification exams might be a viable option to certify a CNS to practice within the FALS population.

The task force’s report, Family Across the Lifespan: The Viability of Taking Pediatric and Adult-Gerontology Certification Examinations to Attain CNS Population Certification in Family Across the Lifespan, concludes that most of the FALS, adult/gero and pediatric competencies are equivalent. The report notes:

“A few competencies among the vast majority of competencies identified seemed to suggest a gap between the FALS competency and/or the adult/gero and/or the pediatric competency.  The task force judged these gaps to be minimal and not sufficient to preclude the possibility of using the adult/gero and pediatric certification exams as a functional, pragmatic option to certify a CNS to practice within the FALS population.  This was particularly true when considering that the measure for competency is entry-level competency.”

“In 2008 when the APRN Consensus Model was first implemented the board acknowledged that the new framework would present additional hurdles for clinical nurse specialists,” said Anne Hysong, MSN, APRN, CCNS, ACNS-BC, 2018-2019 NACNS Board President. “Until a proper certification exam is created, allowing CNSs to sit for two certifications so they can practice in their chosen population focus is the next best option for FALS CNSs working with families across the lifespan to gain licensure. Given that all APRNs are operating under the APRN Consensus Model, it is critical the nursing community consider all options which provide CNSs access to appropriate population-based certification.”

As one of the four types of advanced practice registered nurses (APRNs), clinical nurse specialists (CNSs) are required to hold graduate degrees, either a master’s or doctoral degree. CNSs have advanced education and training in advanced nursing care, physiology, pharmacology, and physical assessment. Their work includes specialized skills, performing as an independent health care provider and clinical expert with prescriptive authority, and autonomous patient management.  CNSs are licensed for prescriptive authority in 40 states.

The NACNS Family Across the Lifespan Crosswalk task force members are:

  • Lola Trudell Coke, Ph.D., ACNS-BC, RN-BC, FAHA, FPCNA with Rush University Medical Center in Chicago, Illinois;
  • Emily Dorosz, MSN, RN, CPN, CPEN with Children’s National Health System in the District of Columbia;
  • Ana-Maria Gallo, Ph.D., CNS, RNC-OB with Azusa Pacific University in San Diego, California;
  • Jerithea Tidwell, Ph.D., RN, PCNS-BC, PNP-BC with Children’s Medical Center Dallas in Dallas, Texas;
  • Terri Nally an NACNS consultant; and
  • Melinda Mercer Ray, MSN, NACNS Executive Director.

Download the full report and crosswalk here.

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Founded in 1995, The National Association of Clinical Nurse Specialists is the only association representing the clinical nurse specialist (CNS). CNSs are advanced practice registered nurses who work in a variety of specialties to ensure high-quality, evidence-based, patient-centered care. As leaders in health care settings, CNSs provide direct patient care and lead initiatives to improve care and clinical outcomes, and reduce costs. NACNS is dedicated to advancing CNS practice and education, removing certification and regulatory barriers, and assuring the public access to quality CNS services. Follow us on Facebook and Twitter.

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