A Specialized Look at the Role and the Position Essay Example

the case with South Carolina and Mississippi. South Carolina's Nurse Practice Act from 1976 acknowledges CNSs as advanced practice nurses (APNs), and necessitates that they are certified in specific specialties and licensed as RNs. CNSs in South Carolina must have obtained a minimum of a Master's degree, and are authorized to execute delegated medical actions under physician supervision as well as administer prescribed medication (South Carolina Nurse Practice Act, 1976).

According to Mississippi's Nursing Practice Law of 1972, CNSs in the state must hold a Master's Degree or higher to provide expert care as licensed RNs. However, Mississippi does not recognize the CNS as an Advanced Practice Nurse (APN). The National Association of Clinical Nurse Specialists (NACNS) is advocating for changes to certain state regulations governing this role. The NACNS contends that requirements for CNSs to hold a second license to practice should be eliminated unless they want prescriptive rights or perform duties beyond those of an RN.

The NACNS disagrees with the idea that APNs should be required to take specialty area examinations in order to obtain certification. They are concerned that state guidelines may limit the scope of practice for CNS roles and create obstacles, as noted by Lyon (2003). Hamric's early work on a conceptual framework for advanced nursing heavily emphasized the CNS role. With some revisions from Spross and Hanson, Hamric proposed a framework that could be applied to all APN specialties, which consisted of three primary criteria and seven fundamental competencies. The first criterion is graduate education, certification in a chosen specialty, and high focus on patient and family care.

Hamric's Integrative Model of Advanced Practice Nursing encompasses all the competencies required

to perform different roles of the CNS, which are the adequate research skills, clinical leadership, collaboration, decision-making skills, adept coaching, guidance, and consultation, forming the second realm. Failing to fulfill these competencies would leave a CNS susceptible to environmental factors that could impact APNs as well (Hamric, et al., 2009).

According to Spross and Lawson (2009), the fundamental competencies for advanced nursing professions include direct clinical practice, consultation, collaboration, expert coaching skills (including guidance), advanced research skills (including utilization and evaluation), skills in ethical decision-making, clinical and professional leadership, and proficiency as a change agent. These competencies are essential for all CNSs. Using Hamric's model, CNSs can communicate the value of their profession, emphasizing their competencies in clinical, professional, consultative, and collaborative leadership.

According to Sparacino ; Cartwright (2009), the primary skill in Hamric's model is providing direct care to patients and their families. All other competencies are assessed based on this skill. The practice of a Clinical Nurse Specialist (CNS) involves combining clinical work with long-term planning to enhance patient care. Direct care is emphasized in Hamric's model as it has a positive impact on patient care and the overall healthcare process. The CNS assumes the role of case management during their practice, and Hamric's model can assist them in organizing a practice's resources and services.

Creating a standard for quality care among staff nurses is crucial as it serves as a guide to manage costs and achieve impactful roles in healthcare practice and managed care. Additionally, the CNS's role in educating patients, staff, and the community is important.

Effective nursing arises from the development of skills, understanding of change, expansion of knowledge, and trustworthiness. This sequence

leads to better medical outcomes, improved professional nursing self-image, and overall job satisfaction. Integrating Hamric's model into practice empowers CNS professionals to effect positive transformation in healthcare practice. The American Association of Colleges of Nursing (AACN) aims to make the Doctorate of Nursing Practice (DNP) the entry degree for APNs by 2015. This proposal is justified by advances in technology, complexities in healthcare, and the need for increased knowledge.

According to the AACN, the increase in coursework and clinical requirements for Master's prepared programs justifies the consistency with a higher level degree. The organization believes that the implementation of the DNP will bring nursing in line with other healthcare professions and ultimately lead to better patient outcomes. The AACN emphasizes various areas of focus for DNP preparation, including quality improvement, framework for advance practice, evidence-based practice, policy development, technology, and interdisciplinary client care (Position Statement Practice Doctorate, 2004, p. 10).

The NACNS Board of Directors in 2005 raised concerns about a proposal that will pose challenges and prompt questions. This proposal lacks evidence of its contribution to patient safety, and its implementation cost has not been fully assessed. The NACNS also questions the impact on Master's prepared APNs and the ongoing CNS shortage. Nevertheless, CNSs bring significant value to the healthcare team as specialists in delivering high-quality care.

The role of CNS is crucial in advanced nursing care, and Hamric's model plays a crucial role in ensuring successful nursing practice and patient outcomes. The AACN and NACNS are dedicated to advocating for CNSs in the ever-changing healthcare system, ensuring their preparation and support for their roles in the healthcare team's future. (Chitty, K., Black, B., 2007)

The fifth

edition of "Professional Nursing Concepts and Challenges" by A. Hamric is published by Saunders in St. Louis, MO.

Hanson, C., and Spross, J. published a book titled "Advanced Practice Nursing" in 2009.

The book called "4th ed." was published by Saunders in St. Louis, MO.

Lyon, B. L. provided testimony to the Federal Trade Commission about the regulatory barriers affecting clinical nurse specialists, including those related to credentialing. Lyon holds a DNS, RN, CNS, and FAAN designation.

The source for archived PowerPoint Slides can be found at http://www.nacns.org/html/archives.php.The Mississippi Nursing Practice Law, Section 15 (1972), can be accessed at http://www.msbn.state.The website ms.us contains a publication regarding the rules of the Board of Directors of the National Association of Clinical Nurse Specialists, which can be found at publication.htm#rules.The 2005 White Paper on the Nursing Practice Doctorate is available online in PDF format at http://www.nacns.org/docs/PaperOnNPDoctorate.pdf.The retrieved source at http://www.aacn.nche is a position statement on the practice doctorate in nursing from 2004.

edu/dnp/position-statement. Sparacino, P.S., and Cartwright, C.

The text within the HTML tag states: "In 2009, as written by A.B. Hamric and J."

A. Spross and C. H. Hanson serve as editors of this text.

The book "The Clinical Nurse Specialist" is referenced with page numbers (4th ed., pp. 349-379) and published by St. within a

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Saunders.Spross, J.A., and Lawson, M. are authors based in St. Louis, MO.

T. (2009) is cited in A.B. Hamric and J.A.

The book titled "Conceptualizations of advanced practice nursing" edited by C. H. Hanson and Spross is a 4th edition, with a range of pages from 33 to 74.

Saunders in St. Louis, MO.