- Intro
- Overview
- CNS Role & Definition
- Talking Points
- Outcomes
- Cost Exemplars
- CNS Job Description
- Resume & CV
- Precepting
- Social Media
- Resources
Advocating for the Clinical Nurse Specialist Role
Advocacy. What does it mean? One definition defines advocacy as “to support or argue for (a cause, policy, etc.): to plead in favor of” (Merriam-Webster). The American Nurses Association (ANA) “believes that advocacy is a pillar of nursing. Nurses instinctively advocate for their patients, in their workplaces, and in their communities; but legislative and political advocacy is no less important to advancing the profession and patient care” (American Nurses Association).
Clinical Nurse Specialists (CNS) often need to advocate for their role to administrators, colleagues, peers, staff, patients, and the community. Clinical Nurse Specialists have unprecedented opportunities to shape healthcare by tapping into individual talents to demonstrate advanced practice competencies.
The National Association of Clinical Nurse Specialists charged the Professional Development Committee to articulate the value of the clinical nurse specialist by advocating for the CNS role. An Advocacy Subcommittee led the work through the development of a toolkit for new and established CNSs to use to advocate for their role. The varying “toolkit tabs” provide information on specific topics that can contribute to and influence advocacy for the CNS role. The subcommittee hopes that individuals can easily access the information on particular topics of interest which would support their efforts in advocating for their roles. Please take the time to explore the different tabs and use the information as needed.
References
Merriam-Webster. Accessed June 29, 2022. https://www.merriam-webster.com/dictionary/advocate#other-words
American Nurses Association. Accessed June 29, 2022. https://www.nursingworld.org/practice-policy/advocacy/
NACNS Professional Development Advocacy Subcommittee Members
Pam LaBorde, DNP, APRN, CCNS- chair
Kathy Baker, PhD, APRN, ACNS-BC, FCNS, FAAN
Jennifer Davies, MSN RN-BC ACNS- BC
Cheryl Houseman, MSN, APRN, ACNS-C
Amy Shay, PhD, RN, APRN-CNS, FCNS, CCRN Alumna
Jess Viste, DNP, RN, ACNS-BC, CCTN
Jennifer Wilson, MS, APRN, ACCNS-BC, AGCNS-BC, ACHPN-BC
Advocacy Toolkit Overview
The various “toolkit tabs” provide information on specific topics that can contribute to and influence advocacy for the CNS role.
INSTRUCTIONS FOR USE:
Navigate to the tab that is of interest and review the content. Utilize the tools and templates to advocate for the role of the CNS!
Toolkit Tabs
Advocacy Overview
Basic information on topics to consider when advocating for CNS role
CNS Role Definition and Description
A Power Point with basic information on the CNS role and definitions
Talking Points
Brief bullet points to use when describing the role of the CNS
Outcomes of CNS
Literature review of CNS outcomes in the three spheres of impact
Cost Exemplars of CNS Work
Exemplars of CNS outcomes focusing on cost-effectiveness of the CNS
CNS Job Description
Template for creating a CNS job description and NACNS CNS job description example
Resumé and Curriculum Vitae
Information regarding developing a resumé and curriculum vitae (CV) and examples of each
Precepting
Tips on how to precept a CNS student
Social Media
Basic information on various social media platforms and suggestions on using these in advocating for the CNS role
Resources
Other resources to discuss the CNS role that are not specifically discussed in the previous toolkit tabs
CNS Role & Definition
Talking Points for CNS
- APRN (Master’s degree minimally), commonly doctoral degree, certification in specialty population
- Clinical expert for a population
- Finds & uses evidence-based strategies to improve quality & outcomes, patient & staff safety, decrease length of stay & readmissions
- Implements evidence-based strategies that result in cost-avoidance or cost savings
- Catalyst for change & innovation
- Supports knowledge & development of nursing staff
- Leads interdisciplinary teams to evaluate clinical care & determine evidenced-based strategies
Outcomes of CNS Work
The following table is provided to assist the Clinical Nurse Specialist in utilizing published research and evidence-based practice projects to better advocate for your desired role, project, and/or change to current practice. Locate the CNS Sphere(s) of Impact/Core Competencies you are interested in on the left side of the table and review the associated articles to determine if these can assist you moving forward.
Cost Exemplars of CNS Work
Cost Analysis Toolkit
A Business Guide for the Clinical Nurse Specialist
Today’s health care landscape is ever-changing. Initiatives to improve patient care and safety must take cost savings into account. Through their direct work with patients and families, nurses at the bedside and hospital and health system leaders, clinical nurse specialists are uniquely prepared to assess, analyze and improve the business of health care while continuing to put the patient first. The CNSs ability to translate value impact in the clinical setting is crucial.
CNS Job Description
General Summary/Description
The Clinical Nurse Specialist (CNS) is a licensed registered nurse that has graduate preparation (master’s or doctorate) in nursing as a clinical nurse specialist. CNSs are one of four categories of APRNs as identified by the APRN Consensus Model, National Council of State Boards of Nursing (NCSBN), State Boards of Nursing, American Nurses Association (ANA) and International Council of Nurses (ICN). The role of a CNS provides leadership and clinical expertise within the National Association of Clinical Nurse Specialists (NACNS) spheres of impact by utilizing unique and advanced level competencies. The CNS provides expert comprehensive nursing care directly to patients, supports and develops registered nurses at the point of care and serves as a leader in redesigning systems to improve access, quality, and safety in a cost-effective manner. The CNS improves patient care by putting the best evidence and innovations into practice while solving challenging patient care issues and monitoring patient outcomes for clinical effectiveness. (www.nacns.org)
Key Accountabilities (Based on 3 Spheres of Impact)
Direct Patient Care
- Conducts comprehensive wellness and illness assessments including development of a differential diagnosis
- Provides interventions to prevent or treat illness including identification and treatment of symptoms, functional problems, risk behaviors,
- Uses advanced communication skills to address complex situations and conversations.
- Intervenes to educate, guide and coach the patient, family, and caregiver(s) to establish a patient centered plan of care and navigate complex healthcare systems.
- Leads discovery of innovations in patient care.
Nursing/Nursing Practice
- Utilizes evidence-based practices to guide nursing practice and support patients and their families.
- Develops population profiles and conducts clinical inquiries to determine the need to change practice.
- Utilizes advanced clinical knowledge and communication skills through role modeling, consultation, and education with nurses and healthcare providers to support nursing practice and improve patient outcomes.
- Creates and develops evidence-based policies, procedures, protocols, and best practice models/guidelines using advanced clinical and specialty knowledge.
- Assists nurses and the interprofessional team to evaluate and change practice standards and ensure nursing practice is evidence-based.
Organization/Systems
- Leads systematic quality improvement and safety initiatives based on gap assessments and data analysis.
- Drives translation of best evidence into practice and facilitates integration of multiple programs and disciplines across the healthcare system to ensure positive patient outcomes.
- Collects and analyzes data while utilizing collaborative systems thinking to achieve quality, cost-effective patient care and outcomes.
- Advocates for the improvement of health care through participation in professional, private, and governmental agencies.
- Creates healthy communities and works to enhance a culture of health beyond the healthcare system.
- Utilizes expert leadership skills to influence policymakers and advocate for equitable healthcare.
- Participates as members and leaders in state/national and specialty nursing/healthcare organizations including NACNS.
Practice Setting Expectations
APRN Practice Component
- APRN practice will be defined as outlined by specific State Boards of Nursing
- The Clinical Nurse Specialist role allows for autonomy to assess, diagnose, and initiate orders for treatment and therapy to include prescriptive authority for pharmacologic and non-pharmacologic therapies. (www.nacns.org)
Job Requirements/Qualifications
Education/Certification/Licensure Requirements
- Graduation from an accredited Clinical Nurse Specialist program
- Master’s Degree; (Doctoral Degree [DNP or PhD] preferred)
- Board certification in area of specialty or population foci
- As required by State Boards of Nursing, the applicant has met all requirements to practice as a Clinical Nurse Specialist.
- Current, unrestricted (State) licensure as a registered nurse
- Current unrestricted (State) licensure as an advanced practice registered nurse as required by State Boards of Nursing.
Resumé & Curriculum Vitae (CV)
- A resumé and a curriculum vitae have different formats, content, and purposes. A CV is a representation of your full history and academic credentials. A resumé is a concise depiction of your skills and qualificationsA resumé emphasizes your skills when applying for positions in your industry. It is no longer than two pages with added page for publications and presentations if applicable for the position you are applying for
- A CV emphasizes your academic accomplishments. It is usually provided when applying for academic positions and/or grants. Its length is dependent on your experience to include your publications, presentations, and posters.
Precepting A CNS Student
Precepting Expectations
| School Expectations | Preceptor Expectations | Student Expectations |
|---|---|---|
| Establish or verify clinical agreement | Reviews course objectives | Review course objectives Share syllabus, objectives, and projects for clinical |
| Ensure student has met all requirements to participate in clinical, CPR, HIPPA training | Be present for all interactions until preceptor feels comfortable with student. | Make sure all requirements for clinical are met. i.e., CPR, paperwork, onboarding at site. |
| Make sure that students clinical experience aligns with course objectives | Facilitate a learning environment to ensure that objectives are met | Provide schedule. Work with preceptor to coordinate a reasonable schedule that works for preceptor. |
| Make sure location matches clinical and student needs | Acknowledge findings reported by student. Review student documentation in chart. | Arrive prepared for the day. Have your equipment. Have assignments completed if requested by preceptor. |
| Evaluates student’s assignments | Complete student evaluations. | Complete preceptor and clinical site evaluation. |
| Assist with student goals. | Timely communication with school and instructor if there are concerns | |
| Ask questions to the student to ensure clinical understanding | ||
| Showing the student when and how to reach out to others when help is needed. Explain the collaboration. | ||
| Provides real time feedback Gives clear and useful feedback | ||
| Thinks aloud to demonstrate critical thinking and help explain the process Talk about different situations with different outcomes. What would be different if the situation were different. | ||
| If preceptor out of office coordinate with another to help meet student’s needs or other learning opportunities as appropriate | ||
| Timely communication with school and instructor if there are concerns |
Developing Your Skills as a CNS Preceptor
This link is a resource from the NACNS webpage for a module-type program with information regarding precepting a CNS student: https://nursing.iupui.edu/development/online-courses/cns-preceptor.shtml
Resources
Link to NACNS Position Statements:
https://nacns.org/advocacy-policy/position-statements/
Link to NACNS Toolkits:
https://nacns.org/resources/toolkits-and-reports/
Link to maps NACNS website prescriptive authority by state and scope of practice:
https://nacns.org/advocacy-policy/policies-affecting-cnss/scope-of-practice/
General Information Regarding Social Media/Social Networking
Types of Social Media
Social media platforms may include (but are not limited to) the following:
Taken directly from: National Student Nurses Association, Inc. Recommendations For:
Social Media Usage and Maintaining Privacy, Confidentiality and Professionalism
Facebook
Twitter
Application of Social Media in Advancing Nursing Practice
Social Media Foci Examples of Resources, Policies, and Documents
Reference:
Barry, J., Hardiker, N., (September 30, 2012). Advancing nursing practice through social media: A global perspective. OJIN: The Online Journal of Issues in Nursing, 17(3), Manuscript 5.DOI: 10.3912/OJIN.Vol17No03Man05