Year: 2026

Jackie Iseler, DNP, MSN, RN, ACNS-BC, CNE, FCNS, NACNS President

I had the wonderful opportunity to speak on a panel alongside our Advanced Practice Provider Colleagues at the University of Virginia Health (UVA) for National APP Week held September 21-25 and hosted by UVA Health this year. This year’s theme: The Pulse of Progress: APPs Powering Tomorrow.

I was joined by the following presidents:

• Valerie Fuller, American Association of Nurse Practitioners (AANP)
• David Bunnell, American Academy of Physician Associates (AAPA)
• Peter Johnson, American College of Nurse-Midwives (ACNM)
• Tracy Young, American Association of Nurse Anesthesiology (AANA)
• Emily Mycyk, American Academy of Anesthesiologist Assistants (AAAA)

We spoke about metrics and outcome measurement, and how APPs can be involved at the organizational level — understanding how healthcare at the systems level affects the care provided to the individual patient, and vice versa. What we do doesn’t stay within the four walls of where care happens; it impacts care everywhere.

One question posed to me was: which metrics and outcomes matter most when evaluating APP impact? My answer: there isn’t a single metric or outcome we should follow, and relying solely on productivity is short-sighted. We should look at it from a portfolio framework:

1. Clinical and Quality: Are our patients receiving evidence-based guideline-concordant care? Are we practicing evidence-based practice – using the best available evidence, with the resources available, within our clinical expertise, and with shared decision-making with our patients?
2. Business case: Of course, clinics and hospitals are a business that need to stay financially viable. We should track productivity, return on investment, and value on investment – data that gives our C-suite and administrators the full picture, both the financial and clinical story of the care we provide.
3. Workforce well-being: What is the level of engagement and retention rate? When APPs leave an organization, they take those years of experience and productivity with them.
4. Patient access and satisfaction: Are patients getting timely, high-quality care because an APP is available? Has access improved as a result?

I was also asked what opportunities exist for APPs to play a larger role in system-wide clinical strategy and innovation. CNSs, fortunately, understand how care at the patient level affects the organizational level—our foundation: the spheres of impact, our competencies, and what makes us indispensable in healthcare. APPs understand clinical work at a granular level; what we need to do is build the same fluency at the systems level and finance.

I shared a personal story of when I worked at Mayo Clinic, and we were moving from paper charting to electronic charting. I was one of many nurses asked to advise the clinical nurse specialist leading the charge on how we would like the electronic charting to look and feel. That is the kind of seat at the table APPs need to be claiming.

Artificial Intelligence is here; it is a tool that our organizations are implementing – from ambient listening to summarizing provider documentation. As end-users, we should be working alongside our computer scientists and informaticists to build and improve these tools. Because these are tools, they are supposed to make our work easier and safer.

I also had the opportunity to speak with the CNSs at UVA and learn about their role as APPs there. Kim Elgin asked me: what can they do to help NACNS? My reply was simple: help amplify the CNSs! Share on social media, write manuscripts, and share with your leaders and one another the work and the metrics you move.

Presidents of APP organizations.

Jackie Iseler (NACNS); David Bunnell (AAPA); Tracy Young (AANA); Peter Johnson (ACNM); Vallerie Fuller (AANP); Emily Mycyk (AAAA); and Bill Lombardi

CNSs at UVA and Bill Lombardi, Associate Chief Nursing Officer

Advocacy in Action: CNSs Make Their Presence Known

This week, NACNS leadership joined the American Nurses Association Assembly in Washington, D.C., and the message was clear: when nurses speak with a unified voice, the profession cannot be ignored.

Five hundred nurses representing 49 states descended on the nation’s capital, and NACNS was among them. Along with the NACNS President-Elect Kayla Little, we represented the CNS community at this critical national advocacy forum alongside nursing leaders who understand what is at stake when nurses show up prepared, unified, and unwilling to be overlooked.

But here is what one of the most powerful voices in the room reminded us: you do not have to be in Washington, D.C. to make a difference.

As Laura Underwood said during the assembly: “Tell them the stories only nurses can tell.”

Work with your state representative and senators. We are their constituents.

That is the truth of advocacy. Legislators hear from lobbyists every day. What they hear far less often are the real human stories from the nurses who care for their constituents in hospitals, communities, and districts. That is the voice that moves people. That is the voice only we can offer.

What We Advocated For

NACNS joined nurses from across the country in advancing four critical legislative priorities:

1. Protecting Nurses from Preventable Workplace Violence | H.R. 2531 / S. 1232 Workplace violence against nurses is not inevitable; it is preventable. This legislation would require healthcare facilities to implement comprehensive workplace violence prevention programs, ensuring that the people who care for patients are protected. CNSs, who operate across patient, nursing practice, and systems spheres, have a direct role in creating safer care environments. This bill is personal to our profession.
2. Title VIII Nursing Workforce Reauthorization | H.R. 3583 / S. 1874 Nursing is the largest healthcare profession in the United States, with more than 5 million nurses serving patients across every care setting, and for more than two decades running, nurses have been ranked the most trusted profession in America. That trust is not accidental. It is earned through education, clinical preparation, and an unwavering commitment to patients.

   Title VIII is the primary federal investment in nursing workforce development, including funding for education, scholarships, training programs, and the pipeline that brings the next generation of nurses, including CNSs, into practice. It is the backbone of a workforce that the nation depends on, and it must be protected and strengthened.

   Reauthorizing Title VIII is not just a nursing issue. It is a public health issue. A healthcare access issue. A patient safety issue. When we invest in the nursing workforce, we invest in the 5 million professionals that patients trust more than any other, and we invest in the future of care delivery for every community in this country.

   NACNS stands firmly in support of robust Title VIII funding. The CNS pathway depends on it. Our patients deserve it.

3. Improving Care and Access to Nurses (I CAN) Act | H.R. 1317 / S. 575 The I CAN Act would remove outdated barriers that prevent Advanced Practice Registered Nurses from practicing at the full extent of their education and training. For CNSs, this legislation directly advances our longstanding priority of a full scope of practice and proper recognition as APRNs. Passage of the I CAN Act would mean better access to care for patients and long-overdue recognition for CNSs across the country.
4. Nursing is a Professional Degree. The Department of Education has proposed changes that would reclassify nursing education, potentially significantly affecting student loan eligibility and forgiveness for nursing students. This is unacceptable. Nursing is a professional degree, and it must be recognized and protected as such.

The consequences of getting this wrong are not abstract. Fewer financial supports mean fewer nursing students. Fewer nursing students means fewer nurses at the bedside. And critically, it means fewer resources to sustain the nursing faculty who educate the next generation. No faculty. No pipeline. No nurses. And ultimately, patients suffer the consequences of a workforce dismantled not by a shortage of people willing to serve, but by policy decisions that failed to value the profession.

NACNS did not stand on the sidelines. NACNS is one of ten organizations that joined ANA in filing suit against these proposed changes. This is what it looks like when a professional association fights for its members, its students, its faculty, and the patients who depend on them. We took action because the stakes demand it.

That advocacy is already showing results. A federal judge recently blocked part of the Department’s rule, and as of now, students pursuing graduate nursing degrees are once again eligible for higher federal loan limits available to other professional degree programs. It is an encouraging sign, but not a finish line. The Department has been clear that it intends to keep fighting in court to restore the original rule, and a separate lawsuit from a coalition of states remains pending as well.

For students and the faculty who prepare them, the stakes could not be higher. NACNS stands firmly against any policy that undermines access to nursing education, threatens the sustainability of CNS programs, and puts patients at risk. We will continue to advocate loudly and clearly that nursing education must be protected, funded, and recognized for what it is — professional, essential, and irreplaceable.

You Don’t Have to Go to D.C.

Five hundred nurses in the capital are powerful. But 5 million nurses in their home states and continuing that conversation with their own representatives? That is how policy changes.

Your state legislators are your constituents, too. They represent your hospital, your community, your patients. A phone call, a meeting request, a letter that shares what you see at the bedside every day, that is advocacy. And it matters every bit as much as a Hill Day visit.

CNSs are uniquely equipped to tell these stories. We see the systems. We understand the evidence. We live the impact of policy decisions in ways that statistics alone can never convey. Use that.

Connect with your state representatives and senators. Share what these four priorities mean for your patients and your practice.

The work does not end in Washington. It continues wherever you are.

A divided voice is easily dismissed. A unified voice is impossible to ignore.

The work continues.

Jackie Iseler, DNP, MSN, RN, ACNS-BC, CNE, FCNS, NACNS President

It was an honor to represent NACNS at the Nursing Community Coalition to the Thank a Nurse Congressional Reception on Capitol Hill, in Washington, D.C., last week. This congressional event was held at the Rayburn House Office Building, where staffers and healthcare allies gathered to celebrate nursing, and stand strong in promoting the field during a time of challenging professional proposals.

Representative Suzanne Bonamici (D-OR), co-chair of the bipartisan Congressional Nursing Caucus, delivered heartfelt remarks praising nurses’ critical role in healthcare, sharing a personal story about a family member’s newborn who required NICU care, and the awe she felt witnessing those nurses’ compassion and expertise firsthand. Rep. Bonamici also participated in a bipartisan, bicameral resolution recognizing National Nurses Week.

Nurse advocates used the occasion to urge congressional support for:

• Reauthorization of Title VIII Nursing Workforce Development Programs
• Increased funding for Title VIII and the National Institute of Nursing Research (NINR)
• Reclassification of graduate nursing programs as professional degrees under the One Big Beautiful Bill Act (H.R. 1), expanding access to higher federal loan limits

The following day, celebrations continued with an event hosted by the Health Resources and Services Administration’s (HRSA) Bureau of Health Workforce, Division of Nursing and Public Health. The occasion marked National Nurses Month and the Division of Nursing’s 80th Anniversary, an agency that predates HRSA itself.

The theme, Advancing the Nursing Workforce: The Impact of Title VIII Investments, brought together grantees and national nursing organizations to highlight Title VIII’s lasting impact amid a projected 30% nursing shortage. Participants were also encouraged to complete the National Sample Survey of Registered Nurses. If selected at random, individual nurse responses matter.

As the president of NACNS, a clinician, educator, and innovator, I shared one of our biggest challenges: it comes from within.

Nurses have to stop working in silos. ADNs, BSNs, DNPs, PhDs, NPs, CNSs —are one profession. The competition for preceptors, the internal turf wars, and the fragmented advocacy are holding us back. Medical residents receive priority placement because hospitals receive Federal Medicare GME Funding to support their training, a financial incentive that nursing students do not benefit from. This must change.

We also need to invest in how we teach. A terminal degree is not a teaching credential. Evidence-based education matters. And every nurse deserves to practice to the full scope of their education and license.

Nurses are stronger united. It’s time to demonstrate that fact.

Under the sunny skies of San Diego, clinical nurse specialists from across the country came together for four energizing days of learning, connection, and inspiration at the NACNS 2026 Annual Conference. Centered around this year’s theme — Collaborate — the conference showcased the power of partnership in advancing patient care, strengthening healthcare systems, and elevating the CNS role. 

With 704 in-person attendees, including 336 first-time participants, the energy throughout the conference was welcoming and forward-looking. Representing 40 states and 270 organizations and schools, this year’s gathering reflected the reach and impact of the CNS community. 

From the opening sessions to the final conversations in the exhibit hall, one thing was clear: collaboration is not just a concept, it’s a catalyst for meaningful change. 

Advancing Practice Through Education and Innovation

Across sessions, attendees explored critical topics shaping today’s healthcare landscape, including workplace safety and violence prevention, sepsis recognition and management, maternal health, and early mobility initiatives. These discussions highlighted the essential role CNSs play in improving patient outcomes and leading system-level change. 

Quality improvement and evidence-based practice remained central themes throughout the conference. Sessions focused on translating evidence into action, measuring impact, and driving sustainable improvements in care delivery. Attendees gained valuable insights into how data-informed decision-making can reduce costs, enhance outcomes, and strengthen clinical practice. The program also emphasized innovation in documentation, care processes, and technology integration — offering actionable strategies to streamline workflows and improve efficiency in increasingly complex healthcare environments. 

With insights shared by 330 industry experts, the conference delivered both depth and practical value across every session. 

Supporting the Future of the CNS Role 

A strong focus on CNS education and workforce development underscored the importance of preparing the next generation of clinical leaders. Sessions explored academic-practice partnerships, preceptor development, and strategies to expand and sustain the CNS pipeline. Pharmacology and advanced clinical practice sessions reinforced the CNS’s role as a clinical expert — ensuring attendees left with both the knowledge and confidence to lead in their specialty areas. 

Research, Posters, and Shared Learning

The exhibit hall served as a vibrant hub of innovation and idea-sharing, with poster sessions highlighting the breadth of work being led by CNSs across the country. 

This year featured 44 student posters and 84 professional posters, showcasing real-world solutions, emerging evidence, and creative approaches to improving care. From student-led research to experienced clinician projects, these presentations fostered meaningful dialogue. 

Celebrating Excellence and Leadership

The conference also provided an opportunity to recognize the outstanding contributions of CNSs making an impact across healthcare. The CNSI Fellow induction and awards ceremonies honored individuals who exemplify leadership, innovation, and excellence in clinical practice. These moments of recognition served as a powerful reminder of the depth of expertise and dedication within the CNS community. 

Building Connections That Last

Beyond the sessions, the NACNS Annual Conference created space for connection—whether through networking events, informal conversations, or time spent exploring the exhibit hall. With the support of 49 partners, sponsors, and exhibitors, attendees engaged with leading organizations and industry innovators, further enriching the conference experience. This sense of community is at the heart of NACNS, and it was on full display throughout the week in San Diego. 

Continuing the Momentum

We look forward to continuing this momentum and bringing the community together again next year in Kansas City, Missouri, for the NACNS 2027 Annual Conference. With the theme Amplify, we’re excited to build on this year’s energy and further elevate the voice and impact of clinical nurse specialists. See you there!