Mitzi M. Saunders, PhD, APRN, ACNS-BC, president of the National Association of Clinical Nurse Specialists (NACNS) and the Board of Directors issued the following statement strongly opposing the American Medical Association House of Delegates (AMA HOD) recent policy that “certified nurse practitioners, certified registered nurse anesthetists, certified nurse midwives, and clinical nurse specialists shall be licensed and regulated jointly by the state medical and nursing boards.”
NACNS embraces collective decision-making based on the best available evidence, health care needs of the present and future, and respect for multiple perspectives before solutions are considered.
2 The above referenced policy
1 was thoroughly reviewed and provides no existing evidence that oversight by state medical boards at any level of nursing practice would benefit patient outcomes. Such oversight could lead to increasing health care access challenges, increasing health care disparities, and a worsening of patient outcomes created by unnecessary regulation from the boards of medicine in an attempt to govern advanced nursing practice. Professions are autonomous in regulating their own ethical standards, competencies of practice, regulations, and legal standards that align with their educational, certification, and licensure requirements. Nursing is a highly regulated and trusted profession practiced at various levels (RN and APRN) and therefore, only nursing truly understands how to effectively regulate nursing practice.
At this point in time, there is no foundational evidence to support the AMA HOD’s policy. Regulation of nursing licensure (even joint regulation) by a profession outside of nursing poses unnecessary oversight, the risk for incorrect regulation, and potential for harm to patients which must remain central in all decisions that impact nursing practice. The cost of making decisions based on opinions, emotions, beliefs, and preferences instead of evidence-informed decisions might have devastating results for patients.
NACNS Board of Directors
- Geline, R. American Medical Association House of Delegates (A-23) Report of Reference Committee B. Accessed June 23, 2023. https://www.ama-assn.org/system/files/a23-refcomm-b-annotated.pdf
- National Association of Clinical Nurse Specialists. Mission and Goals. Accessed June 23, 2023. https://nacns.org/about-us/mission-and-goals/
The Academy of Medical-Surgical Nurses (AMSN) joins the American Nurses Association (ANA), International Council of Nurses (ICN), as well as NATO, the UN, and the EU in condemning the Russian invasion of Ukraine.
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Statement of National Association of Clinical Nurse Specialists (NACNS) Board President Anne Hysong, MSN, APRN, CCNS, ACNS-BC
“Congress took a vitally important step to reduce the terrible toll our country’s opioid crisis is taking by expanding the health care providers who can treat opioid use disorder by prescribing buprenorphine. Clinical nurse specialists (CNSs) are among the advanced practice registered nurses (APRNs) added to the list of buprenorphine-prescribing providers in the legislation the conference committee reported. This is a potentially life-saving move that will allow CNSs to use their skills, expertise and clinical knowledge to help end this devastating condition.
Statement of Anne Hysong, MSN, APRN, CCNS, ACNS-BC, 2018-2019 NACNS Board President
“The National Nurses Week theme this year, that nurses inspire, innovate and influence, is the description of what Clinical Nurse Specialists (CNSs) do every day. The nation’s 72,000 CNSs are proud to be part of a profession that is on the frontlines of our country’s health care delivery system, has won the public’s trust and is improving care for patients across the country every day.
Additional Funds to Address Nursing Education, Health Research and Opioid Misuse Will Improve Health Care Workforce’s Capacity to Serve Patients, Communities
“As members of the advanced practice nursing community, the National Association of Clinical Nurse Specialists is pleased to see Congress pass and President Trump sign a spending bill that allocates more funding for health and nursing programs. This spending bill is a step in the right direction if our nation is to rise and meet the need for high-quality care.
National Nursing Leader Says CNSs Need to Be Categorized Correctly
“Sadly, yet again the Office of Management and Budget has incorrectly classified clinical nurse specialists (CNSs) as a title within the broad occupation of general registered nurses (RNs) in the federal government’s Standard Occupational Classification (SOC) System’s 2018 revision. NACNS had once again requested to be treated as other advanced practice registered nurses (APRNs) and be assigned a stand‐alone SOC broad occupational code. This decision is disappointing and problematic as clinical nurse specialists’ skills and work is sufficiently distinct to reliably collect workforce data as an SOC detailed occupation.
CNSs and Other APRNs Provide Quality Care, Says National Nursing Leader
“We are incredibly disappointed that the American Medical Association (AMA) is fanning the flames of a settled argument with their call for the creation of a national strategy to oppose legislative efforts that grant full practice authority to non-physician practitioners (Resolution 214). In an effort to create concern among their members the AMA is utilizing inflammatory language implying clinical nurse specialists (CNSs) and other advanced practice registered nurses (APRNs) are seeking to practice beyond their education and training. This is simply not true.
“Last week, President Trump took an important step to address our country’s opioid crisis by allowing public health agencies to redirect existing health resources. By declaring the crisis a public health emergency, the administration sets a tone for national discussion about addiction to opioids. By declaring the crisis a public health issue, the administration is recognizing that addiction is a chronic neurological disorder and needs to be treated as other chronic conditions are.
However, to fully combat the magnitude of this epidemic a significant financial investment is needed so that our nation can expand access to treatment, develop a national prevention strategy and broaden the pool of those eligible to prescribe medications to treat substance use disorders.
“America’s opioid epidemic claimed an appalling 64,000 lives in 2016, and just one in five patients who needed treatment received it. With the number of lives lost to opioid addiction growing, the country urgently needs Congress to pass the Addiction Treatment Access Improvement Act – badly needed legislation that can make medication-assisted addiction treatment available to many more people who are in grave danger.
“While less rigid than the American Health Care Act passed by the U.S. House of Representatives last month, the Senate’s discussion draft of the Better Care Reconciliation Act of 2017 (BCRA) still puts many Americans at-risk of having no health insurance and threatens health care affordability, access and delivery for millions of Americans.