Purpose:
To demonstrate the usefulness of a comprehensive orientation and promotion program for clinical nurse specialists (CNSs).
Significance:
The dynamic clinical environment demands successful solutions to the complex problem of recruiting and retaining CNS staff. To foster a robust CNS group, solutions and strategies must be versatile enough to recruit internal candidates from experienced clinical staff and also attract external candidates. Lack of universal title protection contributes to role diffusion, contributing to fragmented influence and interpretation of domains of practice.
Design:
In May 2005, a critical appraisal of the current orientation and recruitment process led to several strategies. Three levels of competency were delineated and linked to established outcome measures. Levels included master's degree-prepared CNSs, both new to practice and experienced, and experienced clinical nurses enrolled in graduate study.
Methods:
A programmatic curriculum was developed using advanced mentorship, peer strategizing processes, formal didactic presentations, and learning opportunities. Lectures and peer consultation supported role development formation and institutional cohesiveness. Understanding of the foundations and domains of CNS practice and departmental imperatives were promoted. Professional development activities were extensive. A yearly retreat relied on the group's emerging authentic leadership to direct the group's next set of goals.
Findings:
Results of the focused efforts among the CNS group led to the development of 15 quality initiatives, all serving to provide a comprehensive influence, improving the utilization of evidence based practice and quality of care. As a result of the emergence of the clinical leadership of the CNS, 6 evidence based champion groups formed to foster the development of new practices, improve current practice, and mentor clinical staff into the role of EBP practitioner.
Conclusions:
Developing a comprehensive plan for CNS orientation and professional development greatly enhances the influence and leadership of the entire group while also providing direction and development for individual CNSs with varied backgrounds and levels of experience.
Implications for Practice:
A comprehensive orientation and development program strengthens recruitment and retention of CNSs. Competency delineation, along with outcome measures, fosters the use of data to document the effectiveness of the CNS role.