Purpose:
This session demonstrated the lessons learned from implementing a clinical nurse specialist (CNS) intern program in a 1,000-bed tertiary care center.
Significance:
Several open positions for CNS remained unfilled after 1 year of intensive recruiting by the Department of Nurse Recruitment. Due to an increased demand by nurses entering graduate studies for nurse practitioner education and less demand for CNS education, many of the local universities and colleges no longer offered CNS programs or offered CNS/nurse practitioner curriculum. The shift in graduate education demand resulted in a decreased supply of CNSs locally.
Design:
Concerns about the increased length of stay and patient complexity coupled with the changes in the nurse employee profile prompted the director of Nursing Education and Professional Practice Development to seek an innovative solution to fill the open positions. This position required that the applicants be accepted into a CNS program, attend graduate school full time, and commit to remain in the CNS role at the organization for 4 years after graduation. In return, the organization would assume the total cost of tuition and afford flexibility in both work schedule and productivity.
Methods:
A new position was created that permitted qualified candidates to function in the role of clinical instructor in their first year in graduate school and CNS intern during their second year at the program. The role of CNS intern afforded the graduate students the opportunity to transfer skills they were learning in the classroom immediately into their clinical area. In addition, the CNS interns were encouraged to select class projects that would also meet work expectations. Each CNS intern was assigned a CNS mentor who provided consultation and assisted with role modeling and problem solving.
Findings:
Five CNS interns completed graduate school and are credentialed as CNSs. They all assumed the CNS role with confidence and have exceeded role expectations particularly in the areas of educator and consultant. One individual is completing her first year as a clinical instructor and will be transitioning to the role of CNS intern. One CNS intern resigned from the position. Five additional CNS intern positions have been created, and candidates are currently being interviewed for those positions.
Conclusions:
The CNS intern program is an innovative program that fosters professional growth and development. It provides additional support to individuals who are attempting to balance work, school, and family demands. It supplies the CNS intern with the skills to immediately meet the challenge of providing care and consultation to patients with complex unpatternable care needs.
Implications for Practice:
The increase in chronic disease, uninsured, and aging population coupled with the nursing shortage requires that nurses be educated at an advanced level to manage the ever-increasing complexity, challenge the status quo, and create processes that will provide safe, comprehensive, and patient-centered care. The CNS intern program is one innovation that does just that.