Year: 2022


Ask Phee Phee Anything: What a CNS Should Bring to Work

Hello and happy CNS Week, Day 5! What a great week it’s been already, and to close this week’s special Ask Phee Phee blog series, I want to talk about the tools a CNS needs at work, and how to always come prepared for any situation that may arise.

Being a CNS means, one needs to be prepared for anything with their patients, and every day is different. A large part of being a CNS entails simply being present and available for whatever your patients need, physically, mentally, or emotionally.

Below is my list of the tools that a CNS should always bring to work to best serve our patients and communities. 

  1. A sense of humor
    A sense of humor is one of the most important things anyone in a health care role can bring to work. Between the long hours and emotionally/mentally draining work, being able to laugh and have a sense of humor can be extremely valuable in tense situations.
  2. Trust
    This tool goes two ways; you need your colleagues to be able to trust you as well as your patients. Being able to be someone that others trust should be a top priority for all health care workers.
  3. Reliability
    Stemming off being someone that people can trust, being reliable, and speaking up when others aren’t comfortable, is extremely important. Always being visible and transparent in your practice allows you to be a reliable person in the healthcare field.
  4. Teamwork
    Be open and be able to collaborate and communicate with those on a team. You can’t take yourself too seriously, but you need to be able to relate to and validate others’ feelings and situations in order to be the best CNS you can be.
  5. Empathy
    Always carry tissues, for the nurses, families, and patients. This is an emotional role and can carry a lot of stress for yourself and those around you. Be in tune with the situations around you and provide as much support as you can.
  6. Advocacy
    Set boundaries, and advocate for yourself as much as you advocate for others. Say no when you disagree with something or are put in an uncomfortable situation.
  7. Change
    Be a change advocate for nursing and your individual organizations as well as your own advanced practice. When our 3 spheres of impact are broken apart, other nurses can do one of the spheres, but we are unique when we practice all 3 spheres, in order to continue to demonstrate our value and impact as advanced practice registered nurses. We need to be able to push and expand our practice to continue to grow in healthcare.

Something I learned when I was a girl scout was to always “do a good turn daily,” and to always be prepared. As CNS, we need to not only do good deeds, but hold ourselves accountable to make sure that we are advancing our education and our practice, and most importantly have unstoppable advocacy.


Ask Phee Phee Anything: Diversity as a CNS

Hello to all my Ask Phee Phee readers, and happy day three of CNS Week! On this special Ask Phee Phee blog, as we celebrate CNS Week, we are going to be talking about the importance of diversity in the CNS role. The NACNS board recognizes that change is needed and is actively educating themselves and others through our initiatives this year and moving forward to create a more equitable workplace for all. 

What diversity initiatives does NACNS have in place for 2022-2023?

In 2022, NACNS has ramped up our DEI committee. This was initiated as a task force, and it has since grown and become more focused on making sure that nursing (specifically CNSs) is representative of the communities we serve. The DEI committee is making sure that members have equal opportunities within their role as a CNS. We released a DEI survey to hear from our members on diversity. 

The DEI committee’s first task identified with the survey was to investigate education, and training for diversity, equity, and inclusion, as well as how to make the CNS role more diverse. Starting with members on the DEI committee, we are going to not only be more aware but actively trained to address the situation. DEI Committee Board Liaison Jerithea (Jeri) Tidwell, PhD, RN, PNP-BC, PCNS-BC, FCNSI, Chair Monica Coles, DNP, RN-BC, APRN, ACNS-BC, CDP, and co-chair Beckie Kronebusch, MSN, APRN/CNS are all helping immensely in their efforts to spread awareness and grow the committee to its full potential. 

Advocacy and Diversity

However, our goal isn’t to “form” and then not follow through. We have a commitment to change, a commitment to move forward and advocate for diversity. . Advocacy is so important at every level. Continuing to advance in our advocacy is reflective of how we take care of our patients.

Like most CNSs, I am not a member of a minority group, but I will continue to educate myself to better understand those who are and the challenges they could face becoming a CNS. If those in positions of power advocate for more diversity, then we can make a difference.  We can move beyond talking about diversity and (soon) see results.

For more on diversity, and how NACNS is actively making a change, make sure to register now for the 2022 Fall Summit on Oct. 18-19. The closing keynote on diversity and racism in nursing will be given by Marcus Henderson, MSN, RN, PhD Student.


Meet Your Board of Directors: Where They Went to CNS School and the Lessons They Took Away

As CNS week begins, NACNS wants to give members and readers a look into where their board went to school to become a CNS, and what lessons they took away from their programs.

The CNS board encourages members and other readers looking for more information on CNS programs to check out the program guide on the NACNS website. If you know of any CNS programs that are new, or not listed here, please reach out to questions@nacns.org to get the program on our website!

Phyllis Whitehead PhD, APRN/CNS, ACHPN, PMGT-BC, FNAP, FAAN, President of NACNS

What CNS program did you attend? 

Radford University, Radford, VA (No longer offers a CNS track; offers a post-graduate DNP)

What is the biggest lesson you learned through becoming a CNS? 

I went into nursing to make a difference in my patients’ lives. Being a clinical nurse specialist has taught me the importance of collaboration and hard work in positively impacting my patients and their families, as well as my nursing and medical colleagues and institution. The role of the CNS offers me the versatility to do what I need in whatever the situation warrants. There is simply no other role that I prefer to have in healthcare.

 

Jan Powers, PhD, RN, CCNS, CCRN, NE-BC, FCCM, FAAN, Past President of NACNS

What CNS program did you attend? 

Indiana University School of Nursing

What is the biggest lesson you learned through becoming a CNS? 

The complexities surrounding healthcare, and how important nursing practice positively impacts patient outcomes and prevents complications. The CNS as an APRN is the guardian of nursing practice and continues to advance nursing to provide optimal patient outcomes. Advanced nursing practice is so much more than procedures and prescriptions, it is looking at the patient holistically, identifying evidence-based or innovative interventions to facilitate care so patients can reach their optimal state of wellness.

 

Mitzi Saunders, PhD, APRN, CNS-C,NACNS President-Elect

Mitzi Saunders

What CNS program did you attend? 

Oakland University, Rochester, MI – Adult Health CNS

What is the biggest lesson you learned through becoming a CNS? 

Besides it being the best APRN role, the ability to flex our skills in a variety of health care directions is my favorite part. I also think being a prescriber in my role as a CNS gave me a whole new appreciation for the art of CNS prescribing – I do believe every CNS should have some capacity in their role to be a prescriber, even if the formulary is tiny. 

 

 

Linda Thurby-Hay DNP, RN, ACNS-BC, BC-ADM, CDCES, Secretary/Treasurer of NACNS

What CNS program did you attend? 

I graduated from Virginia Commonwealth University’s Clinical Nurse Specialist program years before the release of the Consensus Model for APRN regulation.  My educational preparation was quite different from current requirements, and the conversation around full practice authority for APRNs was not underway.

What is the biggest lesson you learned through becoming a CNS? 

One lesson learned relates to the need for active engagement in the national conversation about the nursing profession. There are many stakeholders whose livelihoods are grounded in maintaining the status quo in healthcare delivery, while there is ample evidence that our model of care is ripe for innovation to better equip our people with the knowledge and tools to stay healthy, recover from illness, or die with dignity. Nursing must speak deliberately about changes in care delivery that will produce better patient outcomes, and articulate more clearly how professional nurses contribute to those outcomes. 

 


Ask Phee Phee: Keeping CNSs in Education

Happy August to all my Ask Phee Phee readers! I hope it has been a summer full of advocacy, and, getting outside to do something fun (for me, it’s been getting out on my husband’s Harley motorcycle)!

This month, we’re going to talk about CNS education, and regulations, or lack thereof, surrounding CNS education and the instructors. Check back during CNS week, September 1-7, for more Ask Phee Phee content!

Part of having continuous advocacy for all CNSs includes promoting that education and CNS programs are led by experienced CNSs. 

What are the guidelines for serving as a program director/coordinator in an academic setting? Does NACNS require or recommend that a CNS Program Director or Coordinator be a CNS in an academic setting?

This is an excellent question, and to answer in short, no, there is no requirement that a CNS educator must be a CNS, but NACNS does recommend it. This requirement can vary from state to state, so we recommend you check your state’s programs. 

It’s strongly encouraged that a CNS program has a CNS instructor, but it cannot be mandated. NACNS promotes? CNSs to be in academic settings, and on this, check out page 59 of the Clinical Nurse Specialist Statement on Education and Practice for more information.

Because the CNS role is so specific based on the area of practice, having a more generalized nurse or healthcare professional teaching CNS classes may cause the unique CNS experience to be overlooked. 

This education statement is also being updated from when it was last published in 2019. What is shown is the most recent –but it still needs to be updated. With our task force working diligently on this, it will be updated in 2024!

Can a Ph.D. or RN with a strong medical, surgical, or clinical educator/administrator background serve as a program coordinator in a CNS academic setting? 

Yes, RN and Ph.D. can teach CNS courses, but should they? Ethically this is such a specific role, CNSs need to be teaching CNSs. From a research perspective, having a Ph.D. is great for education. From the clinical perspective, they may not have the right experience. 

There is a shortage of nurses in academic settings, but also specifically clinical nurse specialists. Because we are smaller in numbers, there is already a lack of CNSs in the education field. We don’t want to lose any CNS programs and we are grateful for the nurses who are willing to teach the next generation, but we need to also advocate for programs to keep and hire CNSs in the education field.  

You can find the list of CNS programs around the country here. If there are any CNS programs you know of that are not listed here, please reach out! We want to ensure we have an accurate representation of the CNS programs currently active. If you are interested in starting or expanding a CNS program, let us know! We also have a Graduate Education Committee. Please reach out to questions@nacns.org!


Ask Phee Phee Anything: CNS Legal Issues and Scope of Practice

In case you haven’t heard yet, my name is Phyllis Whitehead, and I am the newly elected NACNS President. Phee Phee was my nickname given to me by my young nieces who couldn’t say Phyllis, and now what my grandchildren call me. So came to be my “ask anything” column. I aim to answer your questions about all things NACNS and keep a transparent dialogue going during my presidency. 

CNSs have a very specific role in the hospital within their specialty. I received a few questions regarding the legal complications surrounding being a CNS, as well as policy and practice. Let’s talk about it.

Are there any current legal complications surrounding CNS?

As with any occupation, there are legal complications with being a CNS. Now more than ever, CNSs must be aware of what is going on in both their country and their state. For example, the RaDonda Vaught case in Tennessee is a prime example of the level of responsibility that clinical nurse specialists have in ensuring best practices, as the best level of care must be given to the patient. CNSs need to be aware of varying legislation from state to state in order to best serve their patients, as well as protecting themselves by following state guidelines. 

On a federal level, the overturning of Roe v. Wade is a substantial issue that impacts women’s’ health. For the CNS members who specialize in this kind of work, finding how they can now best advocate for their patients and practice is a newly evolving matter. With any of these legal scenarios, the primary focus should be ensuring advocacies for all, and to make sure that every patient is aware of what is going on during their care, and that the nurse is safe and protected as well. Anything in the legal world that effects hospitals, also effects clinical nurse specialists. 

What is NACNS doing to advocate for policy changes to allow full practice authority for CNSs? 

NACNS fiercely encourages remaining aware of what is happening state to state, and we are forming affiliates and creating tool kits to better equip our members with information about title protection and how to protect the CNSs full practice authority.

NACNS also is proudly and loudly excited about the volunteerism for committees and task forces, as CNSs are coming together and contributing to the conversation. Remaining aware of the current conversation is super important, and we cannot accurately represent the CNS community if we don’t hear from our members, so we encourage readers to reach out and become members of NACNS. 

What is Phyllis doing to advocate for this issue? 

I am on the Lace Steering Committee for licensing and education about the consensus model – which allows me to be at the table representing CNSs and NACNS. I am constantly advocating for the CNS role and practice. 

For example, NACNS has commissioned a Certification Task Force to explore innovation in addressing CNS specialty certifications such as mental and women’s health. July 14th is the first certification task force meeting, so it is a big date for us. I strongly believe in allowing CNSs to enter meaningful CNS roles in the hospital. 

What do we anticipate in the future for CNS scope of practice?

The future for the CNS scope of practice is promising, as we are working on hearing the CNS voice, getting the NPI numbers up, and showing that we are advanced practice nurses. The CNS affiliates are doing a great job and we want to advocate for them and keep gaining affiliate members to grow NACNS even more. I always say that there should be no CNS left behind, and that NACNS is the only organization specifically dedicated to advocating for CNSs. I will continue to answer your questions to the best of my ability to ensure complete transparency, and that no CNS is left behind. 

Thank you for reading, and until next time! If you are interested in asking Phee Phee a question about anything NACNS or CNS related, please visit our website home page and scroll down to the section to submit a question.  



Ask Phee Phee Anything: NACNS and the Year of Advocacy

Ask Phee PheeIn case you haven’t heard yet, my name is Phyllis Whitehead, and I am the newly elected NACNS President. Phee Phee was my nickname given to me by my young nieces who couldn’t say Phyllis and now my grandchildren call me, and hence the name of this column where you can ask questions about all things NACNS.

One question I’m getting a lot lately is “what’s all this about advocacy and CNSs”.

Q. Why advocacy?

Part of the reason we are focusing on advocacy is because of my third-grade teacher. Mrs. Flora taught the class about nouns and verbs. She called verbs “action words” because they describe some type of activity.

Advocate is both a noun and a verb. That’s exactly what we want to do over the next few years – take action and advocate for our patients, for each other, and for ourselves. I call it “unstoppable advocacy”. Here’s what we plan to do:

First, we plan to advocate for diversity in all its forms. Not just acute care but all areas . . . Primary care/ambulatory care, LTC/subacute, HH/Hospice/Palliative. NACNS is an open, diverse, and inclusive organization.

Second, we will advocate for you:

  • Expand Professional Development Leg/Reg opportunities to promote our scope of practice and competencies
  • Launch the new LMS platform
  • Simplify the path to membership
  • Bridge the gaps between academia and practice
  • Work more closely with affiliates and CNSI

Already Underway

Finally, the CNS story has only begun to be told. It is ever-changing series of successful actions that barely registers with some of our colleagues. Maybe we are talking to the wrong people. Maybe we need to be stronger when delivering our message. Maybe both. This is what advocacy is all about – reaching the right people, at the right time with the right message.

Today, “Clinical Nurse Specialist” is a noun. Let’s make it a verb. Working together we are unstoppable. That’s why we advocate.


Establishment of a clinical nurse specialist-led, virtual aneurysm surveillance clinic

BACKGROUND: The COVID-19 pandemic has necessitated significant changes to the manner in which healthcare is delivered. Chief among these has been the need to rapidly adopt virtual, or telephone clinics as a means of reducing unnecessary patient exposure to hospitals and clinical care settings. We were greatly aided in our adoption of virtual clinics by our experience in the establishment and maintenance of a Clinical Nurse Specialist-led, virtual clinic for both abdominal aortic (AAA) and extra-aortic aneurysm (EAA) surveillance within our department since 2016. Patients undergoing surveillance for abdominal aortic aneurysm (AAA) require frequent and lifelong clinical review. Previous studies have shown that post-operative surveillance in particular is critical in prolonging survival in AAA patients and in the early detection of late complications particularly following endovascular repair (EVAR). Poor compliance with EVAR surveillance has been shown to result in worse outcomes.

AIM: The aim of this study was to evaluate the success of a nurse-led virtual clinic programme in terms of the safe management of patients undergoing AAA surveillance in a nurse-led virtual clinic.

RESULTS: Over the course of the 4-year period from 2016 to 2019, 1352 patients were enrolled in the virtual aneurysm surveillance clinic. The majority of patients each year were male, ranging from 78.2% in 2016 to 85.2% in 2017. The majority of patients encountered the service owing to pre-operative surveillance of an AAA, with this group comprising at least 65% of the total cohort of patients each year.Over the course of the 4-year period of the virtual clinic there were 1466 patient encounters. Each ambulatory day care centre (ADCC) attendance normally costs the hospital €149. Therefore, a total saving of €218,434 resulted from this initiative alone. No patient presented as an emergency with a ruptured aneurysm during the time period studied.

CONCLUSION: Patients with AAA can be safely kept under surveillance in a nurse-led virtual clinic. Our experience with this model of care proved to be particularly advantageous during the period of the early COVID-19 pandemic.

Learn more


National Association of Clinical Nurse Specialists 2022 Award Winners and New Board Announced

National Awards Recognize Clinical Nurse Specialists for Outstanding Professional Achievement 

RESTON, VA – March 23, 2022 – The National Association of Clinical Nurse Specialists (NACNS) recently unveiled its 2022 award winners, president, president-elect and new board of directors at its Annual Conference. Phyllis Whitehead, PhD, APRN/CNS, ACHPN, PMGT-BC, FNAP, FAAN was elected president and Mitzi Saunders, PhD, APRN, CNS-C. was elected president-elect of NACNS. New board members include: 

  • Rick Bassett, MSN, RN, APRN, ACNS-BC, CCRN, FCNS
  • Susan Dresser, PhD, MSN, APRN-CNS, FCNS
  • Cherrie Pullium, DNP APRN ACNS-BC, FCNS

NACNS is the national, non-profit organization representing the 89,000 clinical nurse specialists (CNS) in the United States and is dedicated to advancing the practice and education of CNSs. CNSs are one of the four Advanced Practice Registered Nurses (APRN).

Twelve CNS Award Winners Honored

The twelve award winners were honored for their professional achievements and contributions to advancing the CNS profession in the United States. Award winners were nominated and selected to receive the honors by their APRN peers. More NACNS Award Program information can be found here. 

“These twelve award winners represent everything CNSs stand for; professionalism, community, and excellence,” said Phyllis Whitehead, PhD, APRN/CNS, ACHPN, PMGT-BC, FNAP, FAAN and president, NACNS. “In 2022 we are looking forward to honoring these and more CNSs who have shown exceptional dedication to the profession.” 

2022 NACNS National Award Winners

  • Clinical Nurse Specialist of the Year: 2022 Recipient: Kathleen Hopkins, MSN, RN, ACNS-BC
  • Clinical Nurse Specialist Educator of the Year Award: 2022 Recipient: Lynn Mohr, PhD, APRN, PCNS-BC, CPN, FCNS
  • Clinical Nurse Specialist Evidence-Based Practice / Quality Improvement of the Year Award: 2022 Recipient: Lynne Brophy, MSN, PGMT-BC, APRN-CNS, AOCN
  • Armed Forces Clinical Nurse Specialist of the Year Award: 2022 Recipient: Wendy Hamilton, DNP, APRN, AGCNS-BC, RN-BC
  • Rising Star Clinical Nurse Specialist of the Year Award: 2022 Recipient: Kayla Little, MSN, APRN, AGCNS-BC, PCCN
  • Clinical Nurse Specialist Researcher of the Year Award: 2022 Recipient: Tina Mason, PhD, APRN, AOCN, AOCNS, FCNS
  • NACNS Affiliate of the Year Award: 2022 Recipient: Virginia Association of Clinical Nurse Specialists
  • Clinical Nurse Specialist Mentor of the Year Award: 2022 Recipient: Commander Karen Flanagan, ACCNS-AG, AGACNP-BC, CEN
  • Clinical Nurse Specialist Preceptor of the Year Award: 2022 Recipient: Jennie Matays, MS, RN, CNS, CCNS, CCRN
  • Sue B. Davidson Service Award: 2022 Recipient: Lynn Mohr, PhD, APRN, PCNS-BC, CPN, FCNS
  • Brenda Lyon Leadership Award: 2022 Recipient: Kimberly Elgin DNP, APRN, ACNS-BC, PCCN, CMSRN
  • President’s Award: 2022 Recipient: Sean M. Reed, PhD, APRN, ACNS-BC, ACHPN, FCNS

About The National Association of Clinical Nurse Specialists

The National Association of Clinical Nurse Specialists (NACNS) is the only national association representing the clinical nurse specialist (CNS). CNSs are the most versatile advanced practice registered nurses and work in a variety of health care specialties to ensure delivery of high-quality, evidence-based, patient-centered care. As leaders in the acute, post-acute, and ambulatory health care settings, CNSs impact direct patient care, nurses and nursing practice, and organizations and systems to optimize care and drive outstanding clinical outcomes. NACNS is dedicated to advancing CNS practice and education and removing unnecessary and limiting regulatory barriers, while assuring public access to quality CNS services. For more information or to join NACNS click here.


Get to Know Your 2022 Annual Conference Keynote Speakers

What Has The Pandemic Taught You?

Mark your calendars and get your tickets now, because the NACNS annual conference is fast approaching on March 14th-17th in Baltimore, Maryland. 

This year, the theme of the conference is the Rise of the CNS. Back in person for the first time in two years, the annual conference will feature workshops, networking opportunities, an awards presentation, and three keynote speakers. 

To get to know the keynote speakers a little better, we asked them all a question about what they’ve learned through the past two years, and how that will affect nursing in the future.  See what they had to say below. For more information on the annual conference and to register, click here!

As we enter the third year of the pandemic, what is the most important thing this situation has taught you and how will what you’ve learned inform your future decisions? 

Andrew Miller

Andrew Miller, MA Denver Health’s LGBTQ Center of Excellence

 One thing I’ve learned throughout the pandemic is the importance of flexibility and teamwork. This pandemic has been a challenge on so many different fronts for all healthcare workers and finding ways to accommodate and work together has been our saving grace, especially on some of the harder days. I am in constant awe of the incredible and brave frontline workers who I get to work with daily and their dedication to providing affirming and respectful care, even when times are scary.

Andrew Miller (he/him/his) provides training, consultation, and capacity-building assistance through the Denver Health’s LGBTQ Center of Excellence. Specializing in Transgender and Gender Expansive affirming care, Andrew provides trainings spanning across medical systems, public health departments, academic settings, and community-based non-profit programming. After graduating with a Master’s in Multicultural Clinical Counseling in 2019, Andrew combined his over ten years of national training experience with his passion for creating accessible, affirming clinical settings, and has focused his work towards medical and public health settings.

Mary Zellinger

Mary Zellinger, RN, MN, ANP-BC, CCRN-CSC, CCNS, FAAN, FCCM

 Teamwork, communication, and mentoring have always been cornerstones of successful interprofessional practice. During the pandemic, the need for effective and timely communication was especially essential. The importance of sharing information at least daily with colleagues internally in our healthcare system, and externally through list-serves, personal contacts, and organized webinars allowed all of us to learn from other’s experiences and quickly incorporate advances into our own practice.   Ensuring frequent communication with staff to provide support and share new information in a rapidly changing environment, frequent communication with patients who were unable to have family members with them, and frequent, scheduled communication with other team members and peers demonstrated to me that the impact of clear, informative, and ongoing communication prevents isolation and supports our mission of optimizing patient, staff, and community health.

Mary Zellinger RN, MN, ANP-BC, CCRN-CSC, CCNS, FAAN, FCCM was the CNS for Cardiovascular Critical Care at Emory University Hospital for over 42 years and was a collaborative faculty member of the Emory University School of Nursing in Atlanta, Georgia before retiring in November 2021.  She received her BSN from Duke University, her MN in Adult Health/Critical Care, and her Post Masters Nurse Practitioner degrees from Emory University.  

Deborah Klein

Deborah Klein, MSN, APRN, ACNS-BC, CCRN-K, FAHA, FAA

 One important thing the pandemic has taught me is that moral injury is real; nurses are tired, frustrated, and angry.  Many are retiring, traveling, or are leaving nursing resulting in dire staffing shortages. We must develop strategies that address moral distress and staffing shortages including ensuring a healthy work environment, effective communication, and meaningful recognition that creates well-being at work. My future actions will focus on developing and supporting these strategies. 

Deborah Klein, MSN, APRN, ACNS-BC, CCRN-K, FAHA, FAA recently retired as the Clinical Nurse Specialist for the Cardiac ICU, Heart Failure ICU, and Cardiac Short Stay/PACU/CARU at Cleveland Clinic in Cleveland, Ohio where she also served as Vice-Chair for the Ethics Committee. She has 45 years’ experience as a nurse and 39 years as a Clinical Nurse Specialist.

Watch the keynote speakers live at the annual conference.  For more information on the annual conference and to register, click here!