The bright future for clinical nurse specialist practice.

This article discusses the past, present and future of Clinical Nurse Specialist (CNS) practice and education and identifies how 4 major shifts will impact CNS practice: 1) the APRN Consensus Paper, 2) the Affordable Care Act, 3) the Institute of Medicine's 'Future of Nursing' paper, and finally 4) the journey to Magnet status for many institutions. Each of these documents and/or themes has had, and will continue to have, a major impact on the future of CNS practice. The future is bright for CNSs as the role has an extremely important part to play in ensuring high quality patient outcomes.

A nurse practitioner residency pilot program: a journey of learning.

A collaborative team developed a year long residency experience for a staff nurse transitioning to a nurse practitioner role in the Veterans Affairs system. To assist others desiring to provide support, networking, and infrastructure to those transitioning into new roles, the authors discuss strengths and weaknesses of the pilot and lessons learned related to defining trainee versus resident, credentialing and privileging, and specific mentoring needed for the role of the nurse practitioner.

Confusion, concern, or complimentary function: the overlapping roles of the clinical nurse specialist and the clinical nurse leader.

Within the practice environment there are many demands to meet and many conflicting perspectives. The most recent example of this conflict is the polarity caused by the confusion and overlap between the established role of the clinical nurse specialist and the emerging role of the clinical nurse leader. The issues surrounding the confusion, concern, and potential for complimentary function are explored. The intent is to inform nursing leaders and provide points to use in making decisions regarding the roles and the focus on patient outcomes.

Credentialing and certification: issues for clinical nurse specialists.

This article will provide a brief overview of the concepts of credentialing and certification and will identify some of the issues around certification and credentialing for clinical nurse specialists (CNSs). The article will also describe some of the misconceptions about certification and licensure that cause problems to CNSs, identify the current questions on the debated regulation of CNSs, and outline some of the proactive steps that can be taken to stay ahead of the current wave of change anticipated with the suggested changes in the forthcoming regulation of CNSs. Information provided is pertinent for new graduates and seasoned CNSs and provides an opportunity for both to gain a better understanding of certification and credentialing.

The economics of standardized patient education materials with veteran patients.

With an increasing number of veterans seeking care, it becomes imperative that the resources within the system are used efficiently and effectively and in a manner that maintains access, safety, and quality of care. Veterans who are able to manage their own care may utilize provider services less frequently, thereby increasing access for others who require more care. The objective of this quality improvement study was to determine the effectiveness of providing a standardized self-management textbook of health information with the intent that it would decrease demand on primary care providers' time for minor health care issues. This initial quality improvement study clearly demonstrated the potential of the return on investment and the subsequent potential for increased access for veteran patients, appropriate use of limited resources, and improved patient outcomes. It also clearly demonstrated the value of interaction with the veterans to educate them about their care and the increased satisfaction individualized attention to their needs creates. That finding alone has a greater value than just economics.

Exploring educational needs of multiple sclerosis care providers: Results of a care-provider survey.

Our objective was to survey experienced multiple sclerosis (MS) care providers, determine their ongoing professional educational needs, and develop future education programs. We asked providers across a variety of disciplines to identify the areas in which clinical consultation and continuing medical education (CME) would most improve their ability to provide care to individuals with MS; their preferred education modalities; and their confidence in providing care related to disease-modifying agents (DMAs), fatigue, depression, spasticity, and bladder management. At a national meeting of MS professionals, 152 MS care providers completed a self-report survey that was designed for this cross-sectional cohort study. Areas of greatest interest for clinical consultation and CME were identical and included cognition, fatigue, DMA use, spasticity, pain, sex, diagnosis of MS, and depression. Participants expressed a preference for live and interactive CME modalities. Confidence in providing specific disease-related care sometimes differed between Veterans Health Administration (VHA) and non-VHA providers. The results indicate that clinical consultations and CME should be targeted to the topics of greatest interest identified by providers and delivered in a live or interactive modality whenever possible.

Succession planning and individual development.

The authors present a framework for a succession planning and individual development initiative implemented in a Veterans Health Administration facility. Foundational strategic goals and a conceptual framework in the Veterans Affairs system provide the structure for the 3 facility-level succession planning and individual development programs. Outcomes of the programs are promising with 2 of 3 programs demonstrating clear succession planning outcomes and the other one showing positive preliminary results.

A challenge to meet the future: nursing education in Oregon, 2010.

Nursing leadership in Oregon has united behind a plan to address the nursing shortage, setting forth five strategic goals. Two of these are specific to nursing education--to double enrollment by 2004 and redesign nursing education to more directly meet the changing health care needs of Oregonians. This article describes the Oregon Nursing Leadership Council plan and the processes used to develop it. Controversial issues, challenges, and future directions also are discussed.

A description of clinical nurse specialist programs in the United States.

Changes have occurred in clinical nurse specialist educational requirements in recent years, and it is not known how programs have responded. The purpose of this descriptive survey was to identify the number of clinical nurse specialist programs in the United States, describe curricula, and examine enrollment and employment trends. This report contains data from 157 separate clinical nurse specialist programs/majors representing 139 different schools. The mean number of credit hours for semester- and quarter-based programs was 41.4 and 52.2, respectively. The mean number of clinical/practical clock hours was 416.2. Approximately half of the respondents (56%) used the National Association of Clinical Nurse Specialists to guide curricula. Nearly 66% of the programs had from 1 to 10 applicants during the previous year. The majority (68%) indicated that their graduates do not have difficulty finding employment after graduating. These findings indicate that efforts to revise curricula and clarify the CNS role must continue.

Negligence in nursing education.

Nursing faculty members should be aware that they are at risk for litigation if found negligent in failing to protect students from injury. Although student contributory negligence and willing assumption of risk are frequent defenses against negligence, the courts have determined that educators have a responsibility to determine foreseeable risks and to instruct students on how to maintain safety. The purpose of this article is to describe legal cases involving negligence in education and to discuss ways educators can reduce the risk of injury to students and potential litigation charging educational negligence