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:
- 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?
- 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.
- 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.
- 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

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.
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.
That advocacy is already showing results. A
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.
It was an honor to represent NACNS at the
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.
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
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.
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.
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.
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.
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.
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!

The conference featured an impressive lineup of speakers and sessions who built on the “Innovate” theme. Opening keynote speaker Cynthia Bautista, PhD, APRN, FNCNS, FCNS, energized the crowd with a lively presentation on the power of humor in nursing — complete with a clown costume and a marshmallow fight that had the audience laughing and engaged.
The Gala Celebration & CNSI Induction Dinner was a highlight, where attendees showed off their dance moves and outstanding CNSs were recognized for their contributions to the profession.
Mark your calendar for next year’s NACNS Conference, March 9–12, 2026, in San Diego, California, at the Marriott Marquis San Diego Marina Hotel. The call for abstracts and poster presentations will open over the summer, and registration links will be available this fall. Stay tuned to our social media channels for updates.