The role of the clinical nurse specialist (CNS) was weakened earlier this decade when institutions attempted to control costs by downsizing. Institutions that eliminated the CNS role are now refilling those positions. It is up to each CNS to keep that trend headed in the right direction, Thomas S. Ahrens,
RN, DNSc, CCRN, CS, and Anne Wojner, RN, MSN, CCRN, told participants at the first Advanced Practice Institute, scheduled in conjunction with the 1998 National Teaching Institute™ in Los Angeles.
The CNS role consists of four subroles—expert clinician, clinical researcher, educator, and consultant. Research has revealed that CNSs in the past have tended to function primarily in the educator role, rarely involving themselves with research. Yet, the impact of the CNS role can be measured only through a program of research.
Ahrens and Wojner pointed out that the power of the CNS role lies in the recognition of a hierarchy within the subroles. Powerful CNSs spend most of their time functioning in the expert clinician and clinical researcher roles. The educator and consultant roles should serve as an extension of these two top-priority roles. In other words, education or consultation provided by a CNS should be driven by his or her clinical expertise and program of research.
“Clinical nurse specialists must learn how to put real, practical value into their role so that it is measurable and so that other people can see it,” Ahrens said. “It is important to patient care to be able to recognize the value of the CNS.
“We have the time and education to do things a normal staff person wouldn’t do. It is important for administrators and physicians as well as fellow nurses to be able to see this.”
Ahrens and Wojner emphasized that CNSs are change agents. Their clinical expertise, coupled with their ability to synthesize and apply relevant research findings support the delivery of best practice.
Ahrens is a CNS at Barnes-Jewish Hospital in St. Louis, Mo. He is a member of the AACN Board of Directors. Wojner is assistant professor of clinical nursing at the University of Texas-Houston School of Nursing. She is president-election of the AACN Board of Directors.