Press Room

A Few Minutes With the 2021 CNS of the Year — Brittany Rhoades

Brittany RhoadesThis year’s CNS of the Year hails from the Lone Star State and is a clinical nurse specialist providing direct care to heart transplant and left ventricular assist device (LVAD) patients at Baylor St Luke’s Medical Center in Houston, TX. We caught up with Brittany Rhoades, Ph.D., APRN, CCNS, and she shared her thoughts on being a CNS, the CNS role, and the tip that Houston weather is excellent for gardening.

What role do you play at St. Luke’s Medical Center?

I started as a CNS for the transplant and LVAD program in an educational role for nursing and multidisciplinary staff. After a couple years, I transitioned to direct patient care practice. As a CNS, I can go from education roles to direct practice to quality or regulatory roles. The CNS role is very fluid, flexible, and necessary.

How did you become a CNS?

I started my nursing career at the University of Alabama at Birmingham. Many of the leaders in various areas of cardiology were CNSs. UAB also had a clinical nurse specialist program. That’s how I was introduced to the CNS role. It has provided me a way to become an advanced practice nurse while creating change at an organizational level.

What’s the biggest challenge facing CNSs?

Visibility and a clear understanding of the role is probably the biggest challenge. I’ve encountered individuals familiar with the CNS role who love CNSs and really know how to utilize them. But we need to educate more of our colleagues about the unique role of the CNS and how healthcare can benefit from CNSs’ expertise.

What’s the unique skill set that a CNS brings to an organization?

As an example, I’m an APRN and a Ph.D. researcher. I’m very passionate about qualitative research and learning how patients perceive things. I like to connect the two of those together. Clinicians have a particular perspective of illness and healthcare, and patients have their own unique perspectives. As a CNS, I want to bridge those perspectives to improve the healthcare experience for both patients and clinicians.

Why did you join NACNS?

I wanted to become a CNS because I wanted a broader scope than direct patient care and loved the CNS role. I quickly got involved with the Texas NACNS group as soon as I moved here. They are very encouraging, supportive and stress the importance of national membership.

It’s a great way to connect with like-minded people in the profession.

What do you do for fun?

I am a wife and mother to two beautiful girls. We enjoy gardening — Houston has terrific weather most of the year for being outside and gardening. We also appreciate the arts, museums, and theatre. We are always looking for a new place to explore.


Texas Nurse Named Clinical Nurse Specialist Of The Year

Brittany Rhoades Honored By National Association of Clinical Nurse Specialists

RESTON, VA – April 13, 2021 –The National Association of Clinical Nurse Specialists (NACNS) announced today that Brittany Rhoades, Ph.D., APRN, CCNS at CHI St. Luke’s Health Baylor St. Luke’s Medical Center, Houston, TX was named the 2021 Clinical Nurse Specialist of the Year. Rhoades was recognized for her professional achievements and contributions to advancing the clinical nurse specialists (CNS) profession in the United States.

NACNS is the national organization for the 89,000 CNSs in the United States and is dedicated to advancing the practice and education of CNSs. Rhoades was nominated and selected to receive CNS of the Year honors by her advanced practice registered nursing peers.

More NACNS Award Program information can be found:

Rhoades has over 15 years of nursing experience and is currently a clinical nurse specialist providing direct care to heart transplant and left ventricular assist device patients in the Cardiothoracic Transplant Program at Baylor St Luke’s Medical Center. She started her career as a registered nurse at the University of Alabama at Birmingham before enrolling in the clinical nurse specialist program to become an advanced practice registered nurse.

Rhoades is actively involved in the profession having served on the board of the International Transplant Nurses Society and currently serving on the International Consortium of Circulatory Assist Clinicians. She has also served the community by providing hands-on left ventricular assist device education to the Houston Fire Department captains and supervisors.

Rhoades has a Ph.D. in Nursing from The University of Texas Health Science Center at Houston and a Master of Science from the University of Alabama at Birmingham in Acute Care Clinical Nurse Specialist. She has Bachelor of Science degrees from Union University (Nursing) and Ouachita Baptist University (Biology).

About The National Association of Clinical Nurse Specialists

The National Association of Clinical Nurse Specialists (NACNS) is the only association representing the clinical nurse specialist (CNS). CNSs are advanced practice registered nurses who work in various specialties to ensure high-quality, evidence-based, patient-centered care. As leaders in health care settings, CNSs provide direct patient care and lead initiatives to improve care and clinical outcomes as well as reduce costs. NACNS is dedicated to advancing CNS practice and education, removing certification and regulatory barriers, and assuring the public access to quality CNS services. For more information or to join NACNS, click here


National Association of Clinical Nurse Specialists 2021 Award Winners Announced

National Awards Recognize Clinical Nurse Specialists for Outstanding Professional Achievement and Contributions to the Profession

RESTON, VA – May 10, 2021 – The National Association of Clinical Nurse Specialists (NACNS) unveiled its 2021 award winners at its Annual Conference recently.  The nine award winners were honored for their professional achievement and contributions to advancing the clinical nurse specialists (CNS) profession in the United States.  NACNS is the national organization for the 89,000 CNSs in the United States and is dedicated to advancing the practice and education of CNSs.  Award winners were nominated and selected to receive the honors by their advanced practice registered nursing peers.  More NACNS Award Program information can be found: https://nacns.org/about-us/awards/

“The professional success of these seven honorees embodies the spirit of the 2021 NACNS theme – ‘RISE’. ‘RISE’ signifies the ongoing growth and advancement of the CNS profession and its influence,” said Jan Powers, PhD, RN, CCNS, CCRN, NE-BC, FCCM, president, NACNS. “They were recognized for significant achievements and contributions in research, improving practice and educational opportunities as well as for raising the profile of the CNS in the profession.”

2021 NACNS National Award Winners

  • Affiliate of the Year: Central Indiana Organization of Clinical Nurse Specialists, IN
  • CNS of the Year: Brittany Rhoades, PhD, APRN, CCNS, CCTN, Baylor St. Luke’s Medical Center, Houston, TX
  • CNS Evidence-Based Practice/Quality Improvement: Geline Buenconsejo, RN MSN CNS PCCN, Sharp Chula Vista Medical Center, San Diego, CA
  • Mentor of the Year: Kimberly Pate, DNP, RN, ACCNS-AG, PCCN-K, Atrium Health’s Carolinas Medical Center, Charlotte, NC
  • Preceptor of the Year: Amy Patterson, MSN, APRN, AOCNS, BMTCN, Moffitt Cancer Center, Tampa, FL
  • Researcher of the Year: Susan Storey, PhD, RN, AOCNS, Indiana University, Bloomington, Indiana
  • Pamela Jane Nye Scholarship: F. Kay Butler, MSN, APRN, AGCNS-BC, CCRN, ACM-RM, RN the Know, LLC, Newport News, VA
  • Susan B. Davidson Service Award: Anne Hysong, MSN, APRN, CCNS, FCNS, Northside Hospital Duluth, Duluth, GA
  • Brenda Lyon Leadership Award: Vincent W. Holly, MSN, RN, CCRN, CCNS, Indiana University Health Bloomington, Bloomington, IN 

About The National Association of Clinical Nurse Specialists

The National Association of Clinical Nurse Specialists (NACNS) is the only national association representing the clinical nurse specialist (CNS). CNSs are the most versatile advanced practice registered nurses and work in a variety of health care specialties to ensure delivery of high-quality, evidence-based, patient-centered care. As leaders in the acute, post-acute, and ambulatory health care settings, CNSs impact direct patient care, nurses and nursing practice, and organizations and systems to optimize care and drive outstanding clinical outcomes. NACNS is dedicated to advancing CNS practice and education and removing unnecessary and limiting regulatory barriers, while assuring public access to quality CNS services. For more information or to join NACNS click here.


National Association of Clinical Nurse Specialists Releases Census Results

Data Shows Robust Growth With Pivot Toward New Practice Areas

RESTON, VA – May 6, 2021 – There is a trend showing a pivoting of clinical nurse specialists toward a further expansion of practice areas according to the results of The National Association of Clinical Nurse Specialists (NACNS) 2020 Census of the CNS profession released today.

An infographic based on the census data called “The Role of the CNS: Findings from the 2020 Census” shows a resurgence of the profession with CNSs working in a wide variety of practices including adult health/gerontology acute care or ambulatory care settings as well as growing practices in family, mental and women’s health. The NACNS 2020 census was sponsored by AACN Certification Corporation and Cardinal Health.

NACNS is the national organization for the 89,000 Clinical Nurse Specialists in the United States (CNS) and dedicated to advancing the practice and education of CNSs. An infographic of 2020 census results is available here.

“The data demonstrates that CNSs’ roles and responsibilities are broadening and becoming more robust,” said Lola Coke, PhD, ACNS-BC, FAHA, FPCNA, FNAP, FAAN, Census 2020 project lead and associate professor and clinical nurse specialist, acting dean, Kirkhof College of Nursing, Grand Valley State University.  “The trend is a pivoting to an expanding CNS practice beyond adult health/gerontology and pediatrics to areas such as family health, psychiatric /mental health, women’s health /gender specific and neonatal. CNSs’ responsibilities continue to range from providing direct care, managing care, leading research to nurse/patient/family education in the hospital or health system setting.”

NACNS surveys CNSs every other year collecting demographic and professional data.  Almost 3,000 CNSs responded to the 2020 survey.  CNSs are advanced practice registered nurses who have graduate preparation (Master’s or Doctorate) in nursing. Like other advanced practice registered nurses, they are trained in physiology, pharmacology and physical assessment in addition to their particular specialty areas.

What’s The Typical CNS?

According to the 2020 census, one of the 89,000 CNSs that work in the United States typically could, on average, have the following attributes:

  • Works in adult health/gerontology or pediatrics
  • Involved in direct patient care, education and/or research
  • Works fulltime in hospitals and/or health system-wide
  • $100,000 year salary
  • Master’s of Science in Nursing or Doctor of Nursing Practice degree
  • Over 80% white and female

About The National Association of Clinical Nurse Specialists

The National Association of Clinical Nurse Specialists (NACNS) is the only association representing the clinical nurse specialist (CNS). CNSs are advanced practice registered nurses who work in a variety of specialties to ensure high-quality, evidence-based, patient-centered care. As leaders in health care settings, CNSs provide direct patient care and lead initiatives to improve care and clinical outcomes as well as reduce costs. NACNS is dedicated to advancing CNS practice and education, removing certification and regulatory barriers, and assuring the public access to quality CNS services. For more information or to join NACNS click here


Virtual ceremony recognizes AFMC’s ‘best of the best’

The Air Force Materiel Command announced its 2020 Annual Excellence Awards recipients during a virtual ceremony, March 26, 2021.

“I like to think of this annual ceremony as our Academy Awards, because you are all superstars,” said Patricia Young, AFMC Executive Director, addressing the virtual attendees. “You have been selected from a portfolio of over 87,000 Airmen. You are all winners!”

Due to the pandemic, this year’s awards ceremonies were split into separate events held on the Microsoft Commercial Virtual Remove live application. Families, coworkers and friends were invited to log in to view the unique ceremony.

“A special shout out to the families of these outstanding nominees. Thank you for your service. Our Airmen can only be successful because of your support,” said Gen. Arnold W. Bunch, Jr., AFMC Commander, who hosted the event.

Nine Airmen were chosen from 59 nominees representing the total AFMC workforce at centers, wings and the command headquarters. Nominees were selected in nine categories: Airman, Non-commissioned Officer, Senior Non-commissioned officer, First sergeant, Company Grade Officer, Field Grade Officer, Civilian Category I, Civilian Category II and Civilian Category III.

The event was appropriately themed, “Growing through Challenges, Breaking through Barriers, Powering the Warfighter … Together.”

“Our ceremony looks a lot different than usual, but something that doesn’t change is the number of outstanding performers we have.” said Chief Master Sgt. Stanley C. Cadell, AFMC command chief. “Congratulations to all.”

The 2020 winners are:

AIRMAN OF THE YEAR: Senior Airman Valerie M. Graw is a Cyber Operations Controller assigned to the 88th Communications Squadron Cyber Operations Center, Wright-Patterson Air Force Base, Ohio. Her team ensures 24/7 classified and unclassified network capabilities to five major commands with 30,000 personnel. In 2020, Graw completed a deployment to Al Udeid Air Base, Qatar and an associate degree in information systems technology. She was also a distinguished graduate of the Airman Leadership School.

NON-COMMISSIONED OFFICER OF THE YEAR: Tech. Sgt. Mathew M. Footit is the Flight Chief for Environmental Management. He leads a team responsible for Occupational Health, Emergency Response and Environmental Management, achieving compliance with minimal mission impact for a selectively-manned test organization servicing two installations, eight geographically separate units and 70 remote sites. Footit was also the 2019 United States Lacrosse Coach of the Year, a 2020 distinguished graduate of the NCO Academy and the 2020 USAF Bioenvironmental Engineering NCO of the Year.

SENIOR NON-COMMISSIONED OFFICER OF THE YEAR: Senior Master Sgt. David N. Briden is the headquarters operations manager for the Air Force Installation Contracting Center, Wright-Patterson AFB, Ohio. He oversees contingency operations, battle staff duties and functional area manager actions and provides guidance for eight major commands. He has deployed in support of Operation Enduring Freedom, Iraqi Freedom and Libyan operation and also provided contracting support for U.S. Northern Command during hurricane relief efforts.

First Sergeant of the Year: Master Sgt. Mary K. Cramer is the First Sergeant for the 72nd Force Support Squadron, 72nd Comptroller Squadron, 72nd Logistics Readiness Squadron, 72nd Operations Support Squadron and the 72nd Air Base Wing Staff Agencies at Tinker Air Force Base, Florida. She oversees the health, morale and welfare of more than 1,200 Airmen. Cramer has deployed three times to bases throughout Southwest Asia. She was the 2017 Commandant Award Winner and distinguished graduate at the First Sergeant Academy, the 2018 First Sergeant of the Year for the 552nd Air Control Wing and the 2019 First Sergeant of the Year for the 72nd Air Base Wing.

COMPANY GRADE OFFICER of the Year: Capt. Joseph S. Haggberg is the Flight Commander of the Sensors and Defensive Systems Test Flight, 46th Test Squadron, 96th Cyberspace Test Group, Eglin Air Force Base, Florida. He leads a team of 50 military, civilian, and contractor personnel who perform developmental testing for a variety of aircraft and cross-service survivability and sensor technology. Haggberg holds a master’s degree in science and engineering management. He recently completed a master’s of science in flight test engineering where he flew 25 different aircraft and studied flying qualities, mission systems, and performance.

FIELD GRADE OFFICER of the Year:  Lt. Col. Brett J. Cooper serves as the Materiel Leader, Reentry Systems in the Ground Based Strategic Deterrent Systems Directorate, Hill Air Force Base, Utah. He is responsible for development, deployment, and sustainment of the reentry system for the next-generation intercontinental ballistic missile system. An engineer, Cooper has served in numerous acquisition positions in space, intelligence, and nuclear programs. While at Air Staff, he managed the Air Force’s major prototyping programs, including the adaptive turbine engine, hypersonic strike, and directed energy weapons.

CIVILIAN CATEGORY I of the Year: Aaliyah M. Patten is a Financial Analyst Specialist for the Centralized Asset Management Weapon System Sustainment division at Headquarters Air Force Materiel Command, Wright-Patterson Air Force Base, Ohio. Patten is responsible for managing the operations and maintenance sustainment execution budget of $504.4 million. Patten earned a bachelor of science in business finance and will complete her masters of business administration in May. She won the AFMC Headquarters Civilian Category I of the year in 2020.

CIVILIAN CATEGORY III of the Year: Kathy M. Williams is an Adult Health Clinical Nurse Specialist and Master Clinician at Eglin Air Force Base, Florida. As a medical-surgical expert on the Multi-Service Inpatient Flight she oversees the nurse residency program, is a key consultant for three Department of Defense working groups and chairs two medical group committees. An Air Force retiree, she sets benchmarks in clinical practice, ensuring national standards of practice are met or exceeded. She received numerous awards in 2020 at Eglin AFB including the National Association of Clinical Nurse Specialists Clinical Nurse Specialist of the Year, American Nurse Credentialing Center Certified Medical-Surgical Nurse of the Year, 96th Medical Group Nursing Service Award for Excellence and the 96th Inpatient Squadron Civilian of the Year.

Civilian Category III of the Year: Daniel M. Sanders is the Operations Group Logistics Management Lead for a unique national test facility supporting separate geographic locations, organizations, and both U.S. and foreign national customers. He provides overall logistics planning, programming, and systems support requirements for projects and larger DOD programs, modifying and adapting support requirements to fit situations and fulfil mission objectives. Sanders enlisted in the Air Force in 1985, starting his career as a Tactical Aircraft Maintenance Specialist. Upon his retirement from active duty, Sanders began his career as a Department of the Air Force civilian at Hill Air Force Base, Utah.

Congratulations to these outstanding Airmen. Winners in the Airman, Non-commissioned Officer, Senior Non-Commissioned Officer and First Sergeant categories will represent AFMC in the United States Air Force Outstanding Airmen of the Year and First Sergeant of the Year competitions held later this year.


There’s far more to the ‘white uniform and cap’

When someone wins an award, it’s usually to recognize a personal achievement. However, for Geline Buenconsejo, MSN, the award she received was in recognition for her outstanding and enduring professional achievements in developing treatments, systems and protocols that benefit many people.

Geline is a clinical nurse specialist (CNS) in acute care services at Sharp Chula Vista Medical Center. She recently was awarded the CNS Evidence-Based Practice/Quality Improvement (EBP/QI) of the Year Award from the National Association of Clinical Nurse Specialists. The award recognizes outstanding professional achievement by a CNS who has significantly impacted nursing practice, patient and family outcomes, as well as health care systems, including reducing cost.

“Geline’s commitment to the profession is laudable,” says Gabriella Malagon-Maldonado, PhD, vice president of patient care services and chief nursing officer at Sharp Chula Vista. “Because of her clinical expertise and commitment to advancing nursing, she conducted multiple evidence-based practice and process improvement projects.”

From programs to reduce pressure injuries and decrease patient falls, to improving discharge times and decreasing bloodstream infections, Geline’s efforts to improve the care she and colleagues provide and to improve systems within Sharp are exemplary, especially during a pandemic.

“Recently, Geline was instrumental in training volunteer nurse extenders to assist primary care registered nurses during the COVID-19 pandemic surge,” says Malagon-Maldonado. “She was also responsible for creating COVID-19 patient care guidelines focused on both patient and staff safety.”

Geline was born and raised in the Philippines, where she completed her Bachelor of Science in nursing. She is the mother of three children, ages 3, 6 and 9; and she is currently continuing her notable academic endeavors at the University of San Diego Hahn School of Nursing and Health Science, where she is pursuing a doctorate of philosophy in nursing research.

“My aunt inspired me to become a nurse,” Geline says. “I used to see her in her white uniform and cap, and I told myself that someday, I will be like her. It wasn’t really until I became a nurse that I realized that there is more to the white uniform and cap – it was my calling and my passion to help the sick that brought me into this profession.”

Most days, Geline spends her time working with staff and other multidisciplinary team members. She starts each morning rounding on three units of the hospital to check in with unit managers and charge nurses. She also represents Sharp Chula Vista on several Sharp HealthCare system committees.

“My favorite part of my job is the opportunity to create structures and processes that can make our patients and staff safe, while also delivering positive organizational outcomes,” she says.

At home, Geline’s focus is on her family as well as self-care. From playing board games and baking with her children to carving out time each day to “escape” on her indoor exercise bike, she has found ways to thrive throughout the pandemic while always working to ensure her colleagues are doing equally well.

“We are a year into this pandemic now, and the staff are emotionally, physically and mentally exhausted,” she says. “I need to take this into consideration when I am creating and implementing changes. I need to be someone they can turn to.”

By receiving this award, it is evident Geline is just that. Noting that such recognition is motivating and humbling, she, of course, is quick to share the achievement with her colleagues.

“Receiving this prestigious award is both a personal and professional milestone,” she says. “This award is not only for me, but also for my whole Sharp Chula Vista team who have worked so hard to achieve our cumulative goals.”


These are the most lucrative nursing careers right now

3 highest paying clinical nursing jobs today

Which nursing careers pay the highest annual salary or hourly rates? Nursing jobs vary by specialty, setting, location, degree, and certification requirements. Nurses can specialize in treating a population (geriatrics, pediatrics, etc.) or specialize in a therapeutic area (oncology, dermatology, etc.) Additionally, shifts low in supply and high in demand can cause pay rates to grow in certain types of jobs.

Below are the nursing careers that generally pay the highest salary across all locations, specialties, and clinical settings. Most of the highest-paid nursing careers are APRNs, or advanced practice registered nurses, which are registered nurses who obtain a master’s level degree and additional experience or specialization after completing their Bachelor of Science in Nursing degree and RN certification.

1. Nurse Anesthetist (CRNA) – Nurse anesthetists administer anesthesia to patients who are undergoing medical procedures in a hospital, outpatient surgery center, or medical office. With additional documented experience in ICU or surgery, plus completing an additional program and passing certification requirements, RNs can become CRNAs and earn an average of $181,040 annually, according to the Bureau of Labor Statistics. CRNAs can make up to $230,000 annually, while most CRNA salaries range between $171,130 and $205,506, according to Salary.com.

2. Nurse Practitioner (NP) – Nurse practitioners also complete additional training and education to get their NP degree which enables them to treat patients more autonomously than many other types of nurses. Some states allow NPs to practice independently and prescribe medications while other states require NPs to work with a licensed physician. As of February 2021, nurse practitioners earn an average of $109,025 annually, according to data from ZipRecruiter.com.

3. Clinical Nurse Specialist (CNS) – A clinical nurse specialist has obtained a minimum of a master’s degree, plus additional training in a specialized area of nursing practice, according to Nurse.org, which reports that the median salary for clinical nurse specialists as of May 2020 is $106,604. Clinical nurse specialists may specialize in a therapeutic area or population, and specialty certifications are available in gerontology, pediatrics, and neonatal care, according to the National Association of Clinical Nurse Specialists.

Honorable Mention – Registered Nurse (RN) – While not among the very top-paying jobs, RNs are well-paid. Additionally, becoming an RN is somewhat of the “gateway” milestone along the way to achieving higher-paying advanced practice nursing jobs. Completing an RN opens many doors and provides nurses with many more options for advanced degrees and more lucrative nursing roles. According to the Bureau of Labor Statistics, the average (mean) income for RNs nationally as of 2019 (the most recent BLS data available) is $37.24 per hour which translates to $77,460 annually, assuming a full-time schedule of about 40 hours per week.

Of the nearly three million RNs employed nationwide, the highest earners are those who work in outpatient care centers or hospital settings, with an average hourly income of $40.73 ($84,720 annually), and $38.20 per hour ($79,460 annually) respectively.

Where you work as an RN also impacts your hourly wage and annual income. California and Hawaii are the top-paying states for RNs, with hourly rates of $54.44 and 50.03, respectively, followed by Washington, D.C., Massachusetts, and Oregon as top-paying states, where the cost of living is also higher.

Other ways nurses may increase their annual income

In addition to high-paying clinical nursing careers, another way to grow your nursing career and annual income is to shift into leadership, administration, or teaching. Nurse administrators such as hospital CNOs, medical directors, etc. earn more than $100,000, and nurse instructors earn an average of $83,160 annually and up to $133,000 in the 90th percentile.

Changes in supply and demand can also factor into nursing salaries, causing pay fluctuations in either direction. For example, critical care nursing is in unusually high demand in 2020-2021 due to the coronavirus pandemic. This is causing pay rates in some areas to quadruple, as demand also grows by a reported 400-500%, multiple experts report. Switching practice areas may be a more feasible career change than obtaining a new advanced degree for some nurses.

If none of the above are an option, another way for nurses to potentially grow their annual income is to consider trying out a new part-time side-gig for a few extra hours a week. This may be a more realistic method to increase earnings for nurses who are unable to shift full-time into a new, higher-paying nursing career.


CU Nursing Students to Present at NACNS Conference

Four students in the University of Colorado College of Nursing Adult Gerontology Clinical Nurse Specialist master’s program are getting a taste of academic life by presenting research addressing commonly encountered problems in critical care settings. The students will present during the National Association of Clinical Nurse Specialists (NACNS) annual conference March 9 – 11, 2021 that is being held virtually.

An essential component of CU Nursing’s master’s program includes students identifying clinical problems where they work, finding a gap in care in their organizations, studying it, and providing evidence-based solutions for improvement. These commonly encountered problems in critical care settings become the basis for their evidence-based practice capstone project and presentation. “It’s an excellent way to put action into practice and to think critically and institute best practices while on the job,” said CU College of Nursing Professor and Clinical Nurse Specialist Program Director Mary Beth Makic, PhD. CU Nursing encourages students to present at conferences, write an article and submit for publication. “This provides our students with experience in addressing issues at their workplace and presenting solutions to management,” said Makic.

The four students tackled a variety of topics including how to reduce hospital acquired pressure injuries, catheter-associated urinary tract infections, and workplace violence through prevention training. The following outlines each student’s topic of research.

Title: Hospital Acquired Pressure Injury (HAPI) Bundle

Hanna Betts, BSN, RN, Nurse, United States Army

With the incidence of hospital acquired pressure injuries (HAPI) increasing nationally, the purpose of this quality improvement project is to measure practice change of a HAPI bundle and how it will impact HAPI rates when compared to current practice among adult medical patients in a 36-bed medical unit. The national practice guidelines identify prevention as the most essential element in combating HAPIs. Therefore, this literature supported, four-part HAPI bundle will aide in increasing communication, assessments, patient education, and interventions to combat HAPIs. Outcomes are still pending as implementation has been delayed due to the increased strain on staff secondary due to COVID-19.

Title: Evaluating the Impact of Workplace Violence Prevention Training for Graduate Nurses

Kristen Caldwell, BSN, MA, United States Air Force

Workplace violence creates a significant burden in healthcare. Consequences can include low morale, decreased productivity, increased employee turnover, loss of team cohesiveness, as well as various financial impacts for the victim and the healthcare system. Creating an effective workplace violence prevention program can help nurses better understand the scope and nature of workplace violence while learning how to apply individual strategies and develop skills for preventing and responding to workplace violence. The purpose of this evidence-based practice project was to investigate the implementation of Workplace Violence (WPV) prevention training for new graduate Registered Nurse’s (RNs) in the Nurse Residency Program (NRP) and its impact on perception and confidence towards aggression and/or violence perpetuated by the patient/family member/visitor. Thackrey’s Confidence in Coping with Patient Aggression (CCPA) tool was used to evaluate effectiveness of WPV training both prior to training and directly after training. Overall, post-training CCPA tool results showed a slight increase in confidence coping with aggressive patients (4.6/10 to 5.2/10). During the training, NRP RNs shared stories of their own experiences with WPV, desire for more support from management related to WPV prevention, and a desire to receive further training. Leadership should heed the desire and need for consistent WPV training in health care settings.

Title: Rounding and Quick Access Education to Reduce Catheter-Associated Urinary Tract Infections: An Initiative to Improve Quality and Safety in Healthcare

Danielle Garcia, MSN, RN, AGCNS-BC, Clinical Nurse Specialist, United States Army

Catheter-associated urinary tract infections (CAUTI) result in increased morbidity, longer lengths of stay, and higher healthcare costs. Quality of care can be improved by frequently assessing the need for a urinary catheter and removing those no longer indicated. When urinary catheters are needed, maintenance interventions should be implemented continuously. The project was conducted in two 25-bed inpatient surgical units. The team developed a badge buddy with a quick response code that contained educational resources on CAUTI prevention. Registered nurse CAUTI champions were assembled and educated on CAUTI prevention techniques. CAUTI champions rounded on patients, auditing CAUTI bundle adherence, and recommending catheter removal when no indication was identified. CAUTI rates, indwelling urinary catheter utilization, and maintenance bundle adherence were measured. The implementation of these strategies has shown to reduce CAUTI by up to 70%. However, more time is needed to understand the effect of the project on nursing practice and patient outcomes.

Title: Only YOU can prevent Pressure Injuries!

Kelly Wild, RN BSN CCRN, ICU Charge RN, Parker Adventist Hospital

Hospital acquired pressure injuries (HAPI) are not only an indicator of nursing quality, but a financial drain on the healthcare system and increase patient mortality when they occur. This evidence-based project developed a pressure injury prevention (PIP) plan for an ICU experiencing an increase in HAPI rates and implemented it using a variety of educational techniques meant to improve nursing attitudes towards PIP. Four months after implementation, HAPI rates on the unit have decreased 88%.


Five Clinical Nurse Specialists Elected To NACNS Leadership

Will Help Lead “Resurgence Of The CNS” For 89,000 Clinical Nurse Specialists

RESTON, VA – February 2, 2021 – The National Association of Clinical Nurse Specialists (NACNS) announced the election of its President-Elect, Secretary/Treasurer and three members of the Board of Directors today.  The NACNS’s mission is to advance and support the unique expertise and value the clinical nurse specialist (CNS) contributes to health care in the United States.

These new leaders of the national nursing association will officially assume their duties representing the 89,000 clinical nurse specialists in United States at the NACNS annual conference scheduled for March 9-11, 2021.  The conference theme is “The Resurgence of the CNS” recognizing the increasing number of nurses becoming CNSs helping the CNS role to become one of the fastest growing of the four Advanced Practice Registered Nurse (APRN) designations.

“We are in the middle of a resurgence of the CNS role in health care as we near the milestone 100,000 mark for the number of CNSs in the United States. Outstanding leadership is needed to manage an organization like NACNS and continue its growth,” said Sean M. Reed, PhD, APN, ACNS-BC, ACHPN, NACNS President.  After a competitive membership-wide election, I’m confident we’ve elected the right people to NACNS leadership roles and I’m looking forward to working with them.”

About NACNS’ New Leaders

Newly elected leadership include:

  • President-elect

Phyllis Whitehead, PhD, APRN, ACHPN, RN-BC, Clinical Nurse Specialist, Palliative Medicine/Pain Management, Carilion Roanoke Memorial Hospital; Associate Professor, Virginia Tech Carilion School of Medicine, Virginia

  • Secretary/Treasurer

Linda Thurby-Hay, DNP, APRN, ACNS-BC, ADM, CDE Adult Health Clinical Nurse Specialist, Bon Secours Mercy Health System, Richmond, Virginia

  • Members of the Board of Directors

Jennifer Manning, DNS, ACNS-BC, CNE Nurse Researcher at East Jefferson General Hospital, Louisiana, Associate Dean for Undergraduate Nursing Programs at Louisiana State University Health Sciences Center School of Nursing, Louisiana

Traci Smith, DNP, APRN, ACCNS-AG, CCRN Clinical Nurse Specialist for Critical Care and Cardiac Services, Wellstar Health System, Georgia

Jeri Tidwell, Ph.D., RN, PNP-BC, PCNS-BC, FNCSI Clinical Nurse Specialist at Children’s Medical Center, Texas

About The National Association of Clinical Nurse Specialists

The National Association of Clinical Nurse Specialists (NACNS) is the only national association representing the clinical nurse specialist (CNS). CNSs are the most versatile advanced practice registered nurses and work in a variety of health care specialties to ensure delivery of high-quality, evidence-based, patient-centered care. As leaders in the acute, post-acute, and ambulatory health care settings, CNSs impact direct patient care, nurses and nursing practice, and organizations and systems to optimize care and drive outstanding clinical outcomes. NACNS is dedicated to advancing CNS practice and education, and removing unnecessary and limiting regulatory barriers, while assuring public access to quality CNS services. For more information or to join NACNS click here.


7 lessons learned from the COVID-19 pandemic

By Sean Reed PhD, APN, ACNS-BC, ACHPN

Clinical nurse specialists share experiences on how the pandemic and social distancing are highlighting the CNS role.

The “new normal” resulting from the COVID-19 pandemic has altered the way America’s 89,000 clinical nurse specialists (CNSs) do their jobs. For example, how do CNSs perform all the tasks they have been trained to do while maintaining six feet of social distance? What information should be communicated to staff?

Four CNSs and National Association of Clinical Nurse Specialists (NACNS) members recently shared their experiences learned over the past months about how to maintain social distance while taking on new responsibilities and still be effective. Their insights go beyond wearing masks, keeping social distance, and washing hands.

Communications

1. Worry only about what you can control.

It’s an ever-changing environment, with new COVID-19 information arriving daily, frequently resulting in new healthcare policies. Early in the pandemic, the Centers for Disease Control and Prevention (CDC) changed recommendations regularly, and CNSs were responsible for disseminated them across many organizations.

“It could get exhausting with the constant changes in policy and protocol. We had no control over CDC announcements, so we just rolled with it and worked to keep everyone current,” said Julie DeVaney, CNS at UC San Diego Health. “We had daily announcements, over-communicated information, and held what we called a ‘Daily Engagement.’ The Daily Engagement was a formal, daily conversation with our leadership and the clinical CNSs so we could disseminate any new information.”

2. Overcommunicate.

Take the time to critically look at news and other information being released. Because COVID-19 is constantly evolving and new study results are being reported regularly, there is a real need to be vigilant about the types of information being shared. Learning to overcommunicate accurate information takes time and is essential.

“Initially, we dedicated a lot of time for conversations and supporting staff, trying to be sure they had accurate information; keeping them updated,” said Pat Rosier MS, RN, ACNS-BC, a surgical CNS at Berkshire Medical Center in Pittsfield, Massachusetts. “We answered questions like, ‘What was our guidance?’ and ‘What was the personal protective equipment [PPE] to use?’ So, you’re always trying to be sure the [nurses] have the accurate information. And then internally, what were our plans for which units would care for which types of patients? So, we spent, and continue to spend, time keeping staff up-to-date, calming them down, and sometimes we just listen. Listening is a form of communication.”

3. Know where and how the staff is getting their information.

Understand where and how nurses obtained new information. According to Maureen Seckel, MSN, APRN, ACNS-BC, CCNS, CCRN, FCCM, FCNS, who is CNS, acute medicine service line quality and safety and sepsis leader/coordinator at ChristianaCare in Newark, Delaware, it’s important to first locate the news sources used by staff and then check to see if the sources are credible. If the sources aren’t accurate, speak up and inform the staff, and provide sources that are credible. This will enable CNSs to prevent the spread of misinformation before it starts.

CNS Leadership

4. Persuade with evidence.

As leaders, CNSs need to communicate evidence-based information thoughtfully to staff without simply reacting to whatever new information is presented. They need to use their skill and knowledge to persuade—and back up with evidence—recommended actions. The confidence that evidence brings to new information can reduce the levels of uncertainty nurses often experience working on the frontlines of the pandemic.

“The biggest challenge CNSs had to manage was the staff’s fear,” said Seckel. “Our code words for staff were ‘fluid and flexible’ because what was common practice for COVID-19 today could change next week due to new research. We didn’t want to react before we considered the situation with other experts and leaders, so we put the right information out.”

Messaging becomes exquisitely important in this environment. Rapidly and constantly changing information makes people more fearful. It’s important for the CNS to lead and persuade by taking the time with staff and explaining the evidence.

5. Insist on a seat at the leadership table.

The pandemic led to healthcare operational leaders and clinical leaders working together more closely and communicating more as a team. It’s important to not separate operational and clinical activities from each other and to make sure everyone is working toward the same objectives. This can only happen when CNSs play a leadership role.

“Clinical leadership is imperative in a situation like this. CNSs definitely need to be a voice at the table,” said Matthew Beier MS, RN, CNS-BC, CNOR, director of advanced practice nursing at Children’s Hospital of Wisconsin in Milwaukee. “Decisions should not be made strictly from an operational perspective. Clinical leadership through a CNS, and clinical educator is absolutely 100% needed in a situation like this. We need to make our voices heard and advocate for the clinical needs of the organization, not just the operational needs.”

6. Train, train, train.

All training is welcome but, in particular, pandemic surge training had the unexpected benefit of calming nurses’ nerves and creating an even more collegial environment. DeVaney helped train more than 300 nurses to manage a surge that required moving toward a team-nursing model at UC San Diego Health. DeVaney believes that the pandemic has been enlightening in that it forced her team to learn new ways of getting the job done better.

“The surge training helped calm nerves because it provided a clear idea of what may be expected of nurses,” said DeVaney. “They realized it wasn’t going to be as scary as they thought. Training is helpful in that it sets expectations and helps staff maintain focus.”

Patient Visitation

7. Maintain social distance but be socially inclusive.

Social distancing between family and patient—restricting access—is the hardest part of the job. It’s wonderful when the patients are awake and alert and want to talk to their family using various media platforms. At the same time, it’s difficult to watch patients with COVID-19 having to FaceTime family members. There is no physical contact with the family. The lack of intimacy can be incredibly sad and heart wrenching.

Nurses can become emotionally drained in this environment. These situations require a lot of discussion with staff in the form of providing care for the caregivers.

8. Master technology and use it.

“Our infection prevention team has been involved from the very beginning dictating a lot of our practices when it comes to entering patient rooms,” said Beier. “We definitely rapidly ramped up our telehealth capabilities doing a lot of work with the nurses using telehealth right on the patient care unit. Specifically, with patients who were positive early on in the crisis, we allowed nurses to stay out of the patient room, only entering for critical needs or necessary assessments and interventions. Other conversing and interactions are done by iPad and other similar devices.”

Necessity as the mother of invention has been visible in many adaptive behaviors, especially when it comes to using technology and bundling care to facilitate patient visits. During the pandemic, CNSs are helping lead efforts to improvise communications channels. All the CNSs interviewed highlighted the importance of technology to help family members communicate with their loved ones in the hospital. From acting as an intermediary between the patient and family on a mobile phone to using Facetime and iPads, CNSs have helped institute a number of communications solutions for their patients. This was especially true in instances where family members were unfamiliar with technology.

Resurgence of the CNS

Maintaining social distance while performing the role of a CNS during a pandemic—aptly categorized as a “roller coaster ride”—is challenging, yet CNSs everywhere have stepped up to lead practice changes needed. CNSs around the country are successfully modifying and strengthening their communications, taking on more leadership roles, and adapting existing systems and procedures for this new normal. Processes like the lessons learned and shared in this article have helped save lives, comforted patients, supported nurses and sparked a growing resurgence of the CNS role in organizations across the country.

Sean Reed is president of the National Association of Clinical Nurse Specialists.

8 lessons learned from the COVID-19 pandemic