The National Association of Clinical Nurse Specialists (NACNS) held the 12th Annual Clinical Nurse Specialist Summit on July 23, 2013, in Washington, DC. This year' event drew faculty from graduate-level clinical nurse specialist (CNS) programs, nursing leaders of specialty organizations with CNS interests, nursing leaders of other professional nursing organizations, and some members at large. The purpose of the summit was to highlight issues faced by the CNS with healthcare reform and the implementation of the Affordable Care Act as well as the Advanced Practice Registered Nurse Consensus Model. More than 50 persons were in attendance! The day was filled with rich discussions, an exchange of ideas and thoughts, and the expression of concerns and questions that remain.
If you have not read the discussion summary of the meeting on the NACNS Web site, I would encourage you to do so. Joan Stanley, senior director for education policy, the American Association of Colleges of Nursing, and Patti Zuzelo, past president, NACNS, presented "Preparing the Population-Based Clinical Nurse Specialist for Specialty Practice." One of the key issues identified related to implementation of the model for the CNS is grandfathering. At this time, the recommendations to the National Council of State Boards of Nursing have been embargoed by their board of directors. The expectation is that more discussion and evaluation will need to take place related to this issue, particularly in reference to individuals wishing to relocate to a different state, before model language will be released and recommended. Another key issue relates to the preparation of the CNS for specialty in addition to population and role within the graduate curriculum. At this time, the NACNS is finalizing a position statement on specialty and the CNS role. Carol Hartigan from the American Association of Critical Care Nurses Certification Corporation and Diane Thompkins from the American Nurses Credentialing Center presented requirements for certification as described in the Advanced Practice Registered Nurse Consensus Model. Each reminded faculty and practitioners of the changes to CNS certifications. Peggy Barksdale, vice president of the NACNS, provided an overview of the development of the Family Across the Lifespan competencies. She reported that a crosswalk of the pediatric and adult/gerontology competencies will need to be completed as a next step for this work to move forward. Catherine Ruhl, Association of Women's Health, Obstetrics, and Neonatal Nursing, discussed the CNS role in women's health, the lack of an examination for certification, and the work of the Validation Panel for the competencies that have been developed. The day concluded with an awareness of challenges that must be resolved as the 2015 target date draws near.
In addition to the summit, I would like to provide you with an update on the work of our task forces. The establishment of the Board Task Forces was new for our organization. We maintain the traditional committee structure, which is outlined in our bylaws. As with many organizations, we needed a mechanism to gather ideas and feedback on important issues in a timely fashion. Therefore, the task force model was established.
The Psych/Mental Health Task Force was established to review the role of the psychiatric CNS in the current mental health environment. The board wanted to explore the unintended consequences of the elimination of the psychiatric CNS role in its purest sense and the blending of the psychiatric CNS/nurse practitioner roles and educational programs. The Task Force report has been received, and more will be forthcoming regarding this.
The Cost Savings and Outcomes Task Force presented an excellent report to the board. Currently, a paper is underway that reviews the literature on outcomes and cost savings related to CNS practice, with a goal of its release by the end of 2013. The task force is now entering phase 2 of its work, with anticipation of tools available to members in 2014.
The Transitions of Care Task Force also has completed its initial report to the board and will soon begin additional work. They have reviewed the trends related to transitional care and the role of the CNS. A key recommendation is that the CNS is uniquely qualified and positioned to coordinate care transitions. The competencies of the CNS support the centrality of the function of care coordination within the role.
Full details of this valuable work will be released later this year. In the meantime, a call for members to volunteer for a new task force on Alarm Fatigue will be released soon. The NACNS Board of Directors will be meeting face-to-face on October 11 and 12, with strategic planning as a significant part of the agenda. The board is carefully scanning the healthcare landscape to determine priorities for the work that must be addressed by the NACNS.
NACNS NEWS
In August 2013, the National Association of Clinical Nurse Specialists (NACNS) Board of Directors reviewed the association's 2012-2014 Strategic Plan and begin to collect information and develop a process to engage in strategic planning for the 5-year window of 2015-2020. A strategic planning was held at the NACNS Board of Directors face-to-face meeting in October 2013. Be alert for blast e-mails that ask for membership input on this process!
The NACNS 2013 Summit was held on July 23, 2013, in Washington, DC. The focus: implantation issues with the APRN Consensus Model, particularly grandfathering of current clinical nurse specialists (CNSs), and the need for population-based certification exam/examinations for licensure. The issue and importance of maintenance of specialty were discussed as well. Information from the summit and a general synopsis of the meeting will be posted on the NACNS Web site.
NACNS Continues Position Against National Nurse Legislation
The idea for creation of a position for a national nurse was introduced in a May 2005 New York Times op-ed authored by Teri Mills, MS, RN, ANP, a faculty member at Portland Community College. The op-ed generated the third highest number of e-mails in response to all stories published in the Times that day and was subsequently published in the Oregonian and read into the Congressional Record. In response, Representative Lois Capps introduced the National Nurse Act of 2006 (HR 4903), which would amend the Public Health Service Act to establish an Office of the National Nurse. The 2006 Congress took no action as the bill was administratively referred to a committee. The bill has been reintroduced in the current Congress as the National Nurse Act of 2013 (HR 485) by Congresswoman Eddie Bernice Johnson (D-Texas) and Congressman Peter King (R-New York) on February 4, 2013. This legislation is steadily garnering support and cosponsorships in the 113th Congress. After review of the proposed legislation in 2011, the NACNS Board took a position in opposition to the proposal. Today, the current NACNS Board has reaffirmed this position and agreed to support the nursing community's position to oppose this legislation. Several nursing community organizations have been contacted and urged to support the legislation by Teri Mills, who is leading the effort to create the Office of National Nurse. Although there are some nursing community organizations that support this legislation, many member organizations, including the public healthy focused members, do not.
The concerns underlying its genesis are valid as is the intent of shifting American healthcare toward a preventive model. What it does not address is how this proposal would affect the current structure and function of the public Health Service and existing state and local health department initiatives and whether limited resources would be shifted away from the country's already weakened public health infrastructure to support implementation should the bill become law. Concerns being expressed with the nursing community include the intent of the legislation, including that it is ambiguous, creates unmandated funding, and dilutes the title and role of the chief nursing officer for the Public Health Service. Key groups are calling for support of the existing Public Health Service including strengthening the role of the chief nurse officer, acknowledging the key role public health nurses already play in health promotion and prevention, strengthening the public health nursing workforce, and funding for public health education efforts that go beyond simple messages to incorporate population-sensitive, evidence-based interventions.
AFFILIATE NEWS
California Association of Clinical Nurse Specialists
The California Association of Clinical Nurse Specialists held its annual conference "Changing Healthcare One CNS at a Time" on October 26 at Northbay HealthCare, Fairfield, California.
Cheryl Mercurio recently passed the ANCC examination and is certified for PMHCHS.
Betty Halvorson, MSN, RN, ACNS-BC, MMGT, in the Transitional Care Unit at Torrance Memorial Medical Center, presented a poster entitled "Cultivating a Safe Patient Handling Culture in a Community Hospital" at the upcoming second Bi-Annual Nursing Research & EBP Symposium at Torrance Memorial Medical Center September 27, 2013.
Paddy Garvin-Higgins, MN, RN, CRRN, CNS, was recently elected to the Board of Directors for the Association of Rehabilitation Nurses. Paddy has been a rehabilitation CNS for over 15 years and currently works at Memorial Care Rehabilitation Institute in Long Beach, California. She also presented her abstract "Improving Discharge Medication Safety and the Patient Experience Through Interdisciplinary Partnerships" at the Annual CALNOC Conference in Seattle, Washington, October 29, 2013.
Lianna A Klemp, MSN, RN, Frailty CNS at Cedars-Sinai Medical Center, presented a poster entitled "Fall Reduction on an Orthopedic Medical-Surgical Unit Using the Lean Process" at the upcoming second Bi-Annual Nursing Research & EBP Symposium at Torrance Memorial Medical Center held for staff on September 27, 2013.
Patti Radovich PhD, RN, CNS, FCCM, recently completed her PhD in nursing from Azuza Pacific University. She also presented a poster at Fulbright Academy of Science and Technology Global Summit 2013 Montego Jamaica and a podium presentation at American Public Health Association 141st annual conference in Boston, Massachusetts, November 2-6, 2013.
Lisa Refuerzo, MSN, RN, ACNS-BC (medical-surgical CNS); Lianne Teruya, MSN, RN, CNS (orthopedic CNS); Michelle Martires, BSN, RN; Daniel Palma, RN (manager) will be presenting a poster entitled "Implementation of a Multimodal Pain Management Regimen in the Total Knee and Hip Arthroplasty Patients" at the second Bi-Annual Nursing Research & EBP Symposium at Torrance Memorial Medical Center, in September 2013. Their poster presentation also won first place for clinical practice at the National Association of Orthopedic Nursing Conference, 2013.
Stella F. Riddell, MSN, RN, CNS, RNC-NIC, published the leadership abstract "Moving Forward by Looking Back: Bringing Bubble CPAP to the NICU" in Advances in Neonatal Care August 2013 issue.
Lisa Walker-Vischer, RN, CNS, Peds/PICU, received the 2013 Nursing Excellence award from Santa Clara Valley Medical Center.
Submitted by Diane Barkas, MSN, RN, ACNS-BC, CCRN
Georgia Association of Clinical Nurse Specialist
The Heart of Georgia NACNS Affiliate would like to congratulate CNS postgraduate student and affiliate member Noreen O'Connor Peyatt, MSN ED, RN-BC, LNC, pain management and sedation nurse coordinator at the Medical Center of Central Georgia, Macon, as the 2013 recipient of the American Society of Pain Management Nurses Clinical Practice Award.
Submitted by Amanda Hudson Lucas, MSN, APRN-CNS, ACNS-BC, CCRN, ACHPN
Central Indiana Organization of Clinical Nurse Specialists
The Central Indiana affiliate of the NACNS has formally organized and is recognized as The Central Indiana Organization of Clinical Nurse Specialists, Inc (CIO-CNS, Inc), as a 501(c)(6), not-for-profit organization. This formalization process began at the end of 2012 and came to completion in June this year with the inaugural election of a board of directors and adoption of bylaws. Congratulations to the newly elected board!
The mission of CIO-CNS, Inc, is aligned with NACNS. CIO-CNS, Inc, exists to enhance and promote the unique, high-value contribution of the CNS to the health and well-being of individuals, families, groups, and communities and to promote and advance the practice of nursing in Central Indiana.
Submitted by Jennifer Woodard, MSN, RN-BC, ACNS-BC
Virginia Association of Clinical Nurse Specialists
The Virginia Association of Clinical Nurse Specialists has embarked on a journey to showcase the effectiveness of CNSs' work and move regulation of CNS practice into alignment with the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education.
We are a young organization started by our colleagues in the Roanoke Valley in 2010, including Donna Bond, Phyllis Whitehead, Sheila Delp, Jackie Martin, Nancy Altice, Stephanie Baynton, Jill Bass, Leigh Pollard, Ellen Harvey, Cathy Jennings, Kim Hall, and Charmaine Hall. This group grew to include 28 members who drafted a petition to the Virginia Board of Nursing to "examine (the regulations) governing the practice of CNS[horizontal ellipsis] (for its) consistency and congruency with the National Council of State Boards of Nursing's Consensus Model." You will find the original petition on our Web site, http://www.vacns.weebly.com. The Virginia Board of Nursing responded to the petition, suggesting we (1) differentiate CNS practice from the practice of registered nurses and (2) engage key stakeholders as licensure would require legislative action before moving forward with the petition.
Since May 2012, I have had the privilege of leading this organization and am committed to engaging as many practicing CNSs as possible. But finding you is not an easy task! Sarah Conner, a Liberty University CNS student at the time, and I developed a survey to locate the CNSs in our own organization, Virginia Commonwealth University Health System (VCUHS) in the summer of 2012. We found 59 nurses, educated as CNSs, in the VCUHS Nursing community. We were amazed at the sheer numbers and are eager to find the rest of you. Becky Bowers-Lanier orchestrated our inclusion on the agenda of the Virginia Organization of Nurse Executives in October of 2012 to garner their support in our efforts to change CNS regulation and locate more CNSs; this group suggested we find CNSs through Virginia Nurses Today, the publication that reaches all Virginia nurses.
The theme of creating relationships with other groups vested in CNSs continued when the leaders of Virginia's nursing programs (VACN) heard our concern for continuation of CNS programs at the American Association of Colleges of Nursing meeting in Washington, DC, in late October. This group graciously agreed to create a consortium to share faculty resources in support of CNS education. Old Dominion University shared the restart of their CNS program because of employer demand for our skill set. VaCNS agreed to provide the nursing schools with preceptors for CNS students. As a result of that meeting, VaCNS was invited to an afternoon tea at George Mason University to discuss future directions of their advanced practice nursing program. Kim Nelson and I shared our thoughts regarding the pursuit of the BSN to DNP and the MSN to DNP educational options.
The Virginia Action Coalition has been organized to address major issues outlined in the Future of Nursing Campaign for Action initiative. Phyllis Whitehead has represented us on the Access to Care workgroup. Several VaCNS members attended the 2012 Annual Roundtable held in June 2012. A professional video production has been produced that showcases all the advanced practice registered nursing roles and is intended to assist in the effort to educate the public about advanced practice nursing. You may view the final product on the VaCNS Web site. Kim Nelson has been involved in the "Educational Progression" workgroup, whose directive is to streamline the process for nurses to further their education, making it seamless. Emphasis is being placed on nurses with an associate degree who want to earn a bachelor degree. Donna Bond has participated in the Workforce Data workgroup, which has developed a document outlining the infrastructure needed to collect data on all categories of nursing.
Finally, the legislative task force of VaCNS met in Lynchburg in June of this year to forge an action plan to prepare for the General Assembly 2014. Becky Bowers-Lanier has agreed to be our lobbyist and assisted us in establishing a timeline. The focus will be on changing the language in the Nursing Code to recognize CNSs as advanced practice registered nurses.
Join us as we tackle the challenges of today's healthcare environment together. We want to highlight your work and the effectiveness of the CNS role, as we move to align regulation with the Consensus Model for APRN Regulation. We meet by videoconference call on the second Monday of each month at 5 PM. Check out our Web site and contact the leadership to get involved. We want YOU!
Submitted by: Linda Thurby Hay, MS, RN, ACNS BC, BC-ADM
VIRTUAL VA NATIONSWIDE CLINICAL NURSE SPECIALIST GROUP
Ann Herbage Busch, MS, RN, CWOCN, ACNS-BC, CNS-PP, FAAN, liver transplant CNS was reappointed to the National VA Transplant Surgery Advisory Board. Ms Busch will serve a 3-year term within the National Surgery Office.
Linda Parker, Oncology CNS, and Sandra Dukes, Post-operative CNS at the Atlanta (GA) VAMC led the implementation of a new process for remote telemetry for all the inpatient areas with the exclusion of MICU and SICU. The program started in June, 2013.
Mary L. Thomas, Hematology CNS at the VA Palo Alto VAMC reports the following publications and presentations:
Gold JI, Douglas MM, Thomas ML, Elliott JE, Rao S, Miaskowski C. The Relationship Between Posttraumatic Stress Disorder, Mood States, Functional Status, and Quality of Life in Oncology Outpatients. Journal of Pain and Symptom Management, 44(4), 520-531. PMID: 22743157 "On the Road to Basing Practice on Evidence", "Travelling Through the EBP Process", Establishing an EBP Fellows Program (Invited Lecturer) at Paving the Road for Evidence-Based Practice, 5th Annual Nursing Evidence-Based Practice Conference, April 1-2, 2013, Southern Arizona VA Health Care System, Tucson, AZ.
Mary Theresa Lau, Nutrition Support/Venous Access CSN at the Hines (IL) VAMCI was a contributor the latest edition of Brunner & Suddarth's 13th Ed. Medial Surgical Nursing textbook, writing the section on Parenteral Nutrition for the chapter on Enteral and Parenteral Nutrition. The book is in press with publication anticipated Fall, 2013.
Submitted by Kathleen L. Dunn, MS, RN, CRRN, CNS-BC
MEMBERS NEWS
Lt Col Diane Doty has been selected for the position of Chief Consultant to Nursing Services and will be stationed out of the Pentagon starting fourth quarter 2013. She will be advising the Surgeon General and the Air Force Chief Nurse on evidence-based practice and how best to train the Air Force Nurse Corps.
CALL FOR NEWS ITEMS
If you have information you want to share about yourself, your NACNS peers, or your affiliate/affiliate peers, please send the news item to Tanya D. Williams at mailto:[email protected].