Introduction
In the United States, a CNS is an advanced practice registered nurse (APRN) trained in graduate school (earning a master’s or doctoral degree) from a program that prepares CNSs. The National Association of Nurse Specialists (NACNS) announced in July 2015 its endorsement of the Doctor of Nurse Practice (DNP) proposals as a required degree for the introduction of CNS into practice by 2030. According to the consensus model for APRN regulation, the CNS has a unique APRN role in bringing care together on a continuum and through three spheres of influence: patient, nurse, and system (Joel, 2018). The three spheres overlap and are interrelated, but each sphere has a distinct focus. Within each sphere of influence, the primary goal of the CNS is to improve patient and nursing outcomes continually. Despite this distant prospect, New York has already budgeted for CNS development this year. This indicates that this method of learning and practical application of knowledge is already considered essential and in need of development. In connection with this, the restrictions that would have prevented the development of this area have also been removed. This also demonstrates the determination to develop and support it shortly.
Discussion
Key elements of CNS practice are creating an environment through mentoring and systemic change that allows nurses to develop caring, evidence-based practices to alleviate patient suffering, promote ethical decision-making, and respond to diversity. CNSs are responsible for the diagnosis and treatment of health conditions/diseases, disease case management, health promotion, and prevention of disease and risk behaviors among individuals, families, groups, and communities (Tracy & O’Grady, 2019). CNSs are clinical experts in the specialized area of nursing practice and the delivery of evidence-based nursing interventions.
The American Association of Colleges of Nursing (AACN) has facilitated the process of developing these consensus-based competencies, including a national expert panel and external review process. Key to the full practice of CNSs in the United States, as envisioned by the implementation of the APRN consensus model, is the inclusion of the vital role of prescribing medications and durable medical equipment in the core competencies of clinical nurses.
This approach is underdeveloped at this time and requires a large number of financial investments and specialists who could be responsible for its development. It mainly comes down to sponsors who can support the project not only financially but also find the necessary and qualified personnel to develop it fully. At the moment, such projects are underdeveloped, but one cannot ignore their potential development of them in the future (Ko et al., 2019). Since the plans provide for full coverage of the labor protection market by 2030, one can conclude that the project has a future, as it is an essential component for the entire field of medicine as a whole.
It is expected that this project will have an impact not only on specific groups of people but also on medicine in general, as the new approach considers a higher level of observation and treatment of patients. One can already see the development in various countries of the world and the need for it in the fields of medicine of multiple countries (Hassmiller, 2020). Historically in North America, the role of the CNS has developed in the emergency (hospital) setting.
Conclusion
Nowadays, in addition to traditional emergency departments, CNSs are practiced in a variety of non-emergency settings. In the Australian health care system, however, clinical nurse specialist means advancement, not qualification. These core competencies are now expected to be used in all educational programs and will be revised in the coming years to remain relevant and reflective of practice. The revision of the adult gerontological clinical nurse specialist core competencies over the past several years reflects the work of a national expert panel representing both adult and gerontological clinical nurse educators and practitioners.
References
Hassmiller, S. (2020). Advanced practice nursing leadership: A global perspective. Springer.
Joel, L. A. (2018). Advanced practice nursing : Essentials for role development (4th ed.). F.A. Davis Company.
Ko, A., Burson, R., & Mianecki, T. (2019). Advanced nursing practice roles.Nursing Management (Springhouse), 50(3), 26–36.
Tracy, M. F., & O’Grady, E. T. (2019). Advanced practice nursing: An integrative approach (6th ed.). Elsevier Saunders.