Press Room

CNS Definition Gets an Update to Foster Understanding and Visibility

Anyone who has worked with a CNS understands our value. Given the positive impact we have, however, we are much fewer in number than we should be. Part of the challenge lies in the complexity of our role, which means that healthcare systems that don’t already have CNSs on staff often don’t know what we can accomplish, and typically haven’t even heard of the role.

Solving this problem will require a multifaceted and ongoing effort. To serve as the cornerstone for future efforts to enhance CNS visibility, ensure clarity and understanding among all stakeholders, and provide a reference point for the continued evolution of the role, we need an updated definition.

A joint effort of NACNS and the Clinical Nurse Specialist Institute (CNSI) sought to create a fresh definition that clarifies the CNS role. As of November 2023, the official definition now reads:

“A Clinical Nurse Specialist (CNS) is an Advanced Practice Registered Nurse (APRN) prepared by a master’s, or doctoral, or post-graduate certificate level CNS program. CNSs diagnose, prescribe, and treat patients and specialty populations across the continuum of care. The CNS improves outcomes by providing direct patient care, leading evidence-based practice, optimizing organizational systems, and advancing nursing practice.”

We’re confident that this new definition will help engage more external stakeholders and lead to growth of our role, and better outcomes for patients, families, and healthcare systems.

Background: Reasons for Change

The idea for this initiative came about following a CNS Fellow (FCNS) town hall where the challenges of being a CNS and the opportunities we can leverage were discussed. Here are some of the key points raised:

  1. In some areas, there are plenty of CNSs doing exceptional work, but in other places, CNSs are underutilized.
  2. The scope of practice for CNSs varies from state to state.
  3. Some places have restructured job titles and eliminated the CNS designation, opting to hire non-CNS individuals for the same role.
  4. There is a lack of familiarity with and understanding of the CNS role amongst people who can have a big impact on the future of the CNS role, including chief nursing officers, other healthcare professionals including advanced practice registered nurses (APRNs), and nursing students.
  5. Due to this lack of understanding, CNSs are not utilized to their full potential, or are not hired by healthcare systems.

The Process

In February 2022, after the town hall, NACNS and the CNSI created a joint task force to find ways to highlight the significance of Clinical Nurse Specialists (CNS). Their goal was to enhance the visibility and recognition of CNSs.

Initially, they considered conducting surveys, creating a toolkit, and leveraging social media. However, they realized that the fundamental challenge was the lack of awareness about the CNS role, and specifically that the definition of the role was unclear and inconsistent. The previous definition also didn’t effectively convey the essential aspects, such as practice elements and settings, to non-CNS individuals. They then set out to craft a new, clear, and easily understandable definition, factoring in:

  • Target audiences and their messaging needs.
  • Removal of words that people who aren’t CNSs might not get (like “spheres of influence/impact”).
  • Ensuring everyone knows what APRN scope of practice means for CNSs.
  • Clearly explaining the hands-on and non-hands-on parts of what CNSs do.

At the same time, the Statement on CNS Practice and Education task force was conducting work on the 4th edition of the NACNS CNS Statement, and the two groups decided to collaborate.

The two separate task forces each developed their own definitions. After sharing and refining these versions, the best elements from each were combined to form a final definition. In November 2023, the NACNS Board of Directors made a slight modification to the final statement, stipulating that only individuals who have completed a CNS program can be officially recognized and employed as CNSs.

Highlighting the Value of CNSs

This new definition holds immense importance as it enhances understanding of the CNS role and ensures that CNSs receive the respect they deserve. The collaborative efforts of the NACNS/CNSI task force and the Statement on CNS Practice and Education task force have effectively clarified the CNS role and set the stage for the future of CNSs.

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