Perceptions of head nurses, clinical nurse specialists, nursing educators, and nursing office personnel regarding performance of selected nursing activities.
Explore the source record for details and available documents.
Administrative Personnel↗
SEARCH · Search PubMed
Results for “Specialist nurses”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
The clinical nurse specialist, clinical nurse specialist/nurse practitioner and other titled nurse in Ontario.
This study examines the preparation, employment and functions of nurses with titles of clinical nurse specialist, nurse practitioner, and others whose scope of practice exceeds that of the staff nurse. Two established categories of nurses were identified, the Clinical Nurse Specialist (CNS) and the Clinical Nurse Specialist/Nurse Practitioner (CNS/NP). A third category was called Other Titled Nurse (OTN) because of the lack of uniformity in the position descriptions. Surveys were distributed to 379 health service agencies, 33 educational institutions and 204 members of the RNAO Clinical Nurse Specialist Interest Group. This article is based on the responses from the health service agencies and discusses issues pertaining to advanced practice nursing from an administrative perspective.
Humans↗
A demystification of the clinical nurse specialist role: perceptions of clinical nurse specialists and nurse administrators.
Differences of nurse administrators and clinical nurse specialists regarding components of the clinical specialist role were investigated. To be effective in facilitating the maximum use of the abilities of the clinical specialist, it is essential that nurse educators establish a data base about the clinical nurse specialist role from the perspective of employers and the clinical nurse specialists themselves. Subjects were 54 nurse administrators and 35 clinical specialists from a large metropolitan area. The results indicated that, generally, both groups were in agreement except for the research component. Administrators placed a higher value on research than did the clinical specialists. Both groups valued the clinical practice component with the clinical specialists tending to see themselves more heavily committed to direct specialized patient care than did the administrators. The educational component was also valued with the consultant function receiving the highest rating of all the functions surveyed. The administration component was valued least highly of all the components. It is recommended that nurse educators evaluate their educational endeavors in preparation of clinical specialists especially for research functions, and, also, consultation and those functions supportive of nursing staff.
Administrative Personnel↗
Role-evaluation packs for specialist nurses.
Specialist nurses need to demonstrate the value of their interventions. Both qualitative and quantitative information is needed for a complete picture. Information on the role's value should be circulated as widely as possible.
Employee Performance Appraisal↗
The clinical nurse specialist and nurse practitioner: core curriculum survey results.
The fall 1986 newsletters of the Council of Clinical Nurse Specialists (CCNS) and the Council of Primary Health Care Nurse Practitioners (CPHCNP) featured an editorial examining the similarities and differences between the advanced practice roles of the nurse practitioner and the clinical nurse specialist. The article, entitled "Editorial on Specialization in Advanced Nursing Practice" and written by Patricia Sparacino, MS, RN, chairperson CCNS, and Barbara A. Durand, EdD, RN, FAAN, of the CPHCNP appeared in Momentum, Volume 4, Number 2/1986, and Newsletter, Volume 9, Number 2/1986. This initial exploration into advanced practice roles in nursing elicited a wide variety of responses from affiliates of both councils which, in turn, prompted the executive committees of both groups to convene a joint meeting. In the spring of 1987 the executive committees of the CCNS and the CPHCNP met to review affiliate response to the editioral, further explore concerns, and plan futher action. At that time it was decided to survey all nursing programs in the United States which provide graduate education for one or both of the advanced practice roles. It was hoped that the information gained from such a survey would provide a basis for future determinations. Survey data was compiled and presented to another joint meeting of the executive committees of the CCNS and the CPHCNP on October 3, 1989. This article reports the data, findings, and reactions of the executive committees of the councils in order to obtain feedback from our colleagues.
Curriculum↗
Clinical nurse specialist and nurse practitioner core curricula survey results.
The American Nurses' Association's Council of Clinical Nurse Specialists and Council of Primary Health Care Nurse Practitioners conducted a survey of all graduate nursing programs in the United States that prepare nurse practitioners and/or clinical nurse specialists. One hundred eight schools responded (73.5 percent), yielding data on 317 programs that could be further analyzed. For the 60 NP and 195 CNS programs analyzed, information was obtained on the following: required courses, number of hours of the required courses, students' clinical training settings and graduates' employment settings. Findings revealed marked similarity between the core curricula of NP and CNS graduate programs. The only significant differences found were that NP programs placed greater emphasis on pharmacology, primary care, physical assessment, health promotion, nutrition and history-taking in their curricula. In both the student clinical settings and graduate employment settings, NPs focused on primary care settings while CNSs focused on secondary or tertiary care settings. Based on the marked similarities between the core curricula of NP and CNS graduate programs, it is suggested that further investigations be conducted to determine whether objectives and/or teaching methods differ, and to further investigate the effects of practice setting on role development. Further, it is suggested that NPs and CNSs continue to interact through forums and conferences to continue the evolution and definition of graduate nursing education and advanced practice.
Curriculum↗
Clinical nurse specialists and nurse practitioners: complementary roles for infectious disease and infection control.
BACKGROUND: The escalation of infectious diseases worldwide heralds an unprecedented need for nurses with advanced practice graduate preparation. OBJECTIVE: To describe how a graduate program prepares clinical nurse specialists and nurse practitioners in infectious diseases or infection control to provide distinct yet complementary care for patients with contagious disease and potentially antimicrobial-resistant infections. RESULTS: The University of Washington School of Nursing launched a new master of nursing program for infectious disease and infection control to reduce the threat of infectious diseases and multiple-resistant organisms.
Communicable Diseases↗
Advanced practice nursing: merging the clinical nurse specialist and nurse practitioner roles.
Advanced practice nursing has taken a preeminent role in the recent reform of health care by fostering a perception of leadership, accountability, and responsibility in areas involving access to care, quality of care, and the cost of care. Despite this opportunity for recognition and advancement in the current healthcare system, variations in educational preparation, public confusion about the various roles and titles within advanced practice nursing, and differing professional certifications plague the opportunity for an elevated status of advanced practice nursing. In this article, the author addresses the issues related to merging the clinical nurse specialist and nurse practitioner roles. A review of the historical development of advanced practice nursing along with current practice issues and future needs is also presented.
Health Services Needs and Demand↗
Qualitative distinctions and similarities in the practice of clinical nurse specialists and nurse practitioners.
Current debate over whether clinical nurse specialist (CNS) and nurse practitioner (NP) roles should be combined or remain separate are largely theoretical. Minimal research has been conducted comparing these roles. Most studies to date consist of graduate follow-up surveys and comparisons of curricula. Interpretive results of Fenton's investigation of the practice of CNSs and Brykczynski's study describing the practice of NPs were compared to highlight the commonalities and distinctions between the two roles. This comparison is significant in that it explores the actual practice of CNSs and NPs. Both studies were modeled after Benner's research exploring the development of clinical expertise and produced adaptations of Benner's domains and competencies of nursing practice specifically for CNSs and NPs. Participant observations and small group interviews were the data-gathering methods used in these interpretive research studies. The interpretive approach is described as a situational, contextual, or narrative research method for understanding the knowledge and meanings in everyday (naturalistic) settings. Comparative analysis of results of the CNS and NP studies showed a shared core of advanced practice competencies as well as distinct differences between the practice roles. These findings have implications for curriculum development in advanced nursing practice.
Clinical Competence↗
A comparison of practice domains of clinical nurse specialists and nurse practitioners.
This qualitative study was carried out to add empirical data to the discussion of the essentials of advanced practice graduate nursing education. Study participants were 15 nurse practitioners (NPs) whose original preparation was as clinical nurse specialists (CNSs). These nurses subsequently completed post-master's preparation as NPs at a midwest US school of nursing. The nurses were interviewed regarding similarities and differences between the NP and CNS roles based on their own experiences. They stated that their 1-year post-master's NP educational program broadened their knowledge base and increased their skills of direct data collection in history taking and physical examination. They described increased NP role autonomy and clinical decision making. Comparison of study results with the six practice domains of the National Association of Nurse Practitioner Faculties (NONPF) Curriculum Guidelines appeared to verify the NONPF domains as being operant in advanced nursing practice. Each role had distinct expression of the NONPF practice domains, particularly in two areas: management of client health-illness states and the professional role. Results suggest that advanced practice graduate nursing curricular content needs to be explicit regarding CNS and NP role domains to retain the respective strengths of each. A "hybrid" CNS/NP curriculum faces the danger of lacking both the depth and specificity of knowledge that has resulted in the roles' past successes.
Attitude of Health Personnel↗
Case management: clinical nurse specialist and nurse practitioner, converging roles.
In nursing there is discussion about the commonalities and differences among nurses in advanced practice. This article compares the roles of the clinical nurse specialist and the nurse practitioner. A case management model integrating the two roles is described.
Humans↗
The effects of master's degree education on the role choices, role flexibility, and practice settings of clinical nurse specialists and nurse practitioners.
Master's degree education that explores advanced practice nursing (APN) roles in multiple settings may increase APN roles and practice viability in ever-changing health care environments. This descriptive, comparative study investigated differences in role choices, role flexibility, and practice settings among master's prepared clinical nurse specialists (CNSs) and nurse practitioners (NPs) educated in specialized and combined programs using multivariate analysis of variance. Role theory delineates activities in specific societal roles that are recognized as activities practiced always, sometimes, or never by all, some, or none of its members. Role specialization is determined by the amount and frequency that activities are performed by others in similar roles. Significant differences were found between groups on actual and preferred percentage of time spent in APN roles. The CNS group spent more time in acute care and mental health settings, and the NP and Combined groups spent more time in clinic and primary care settings.
Career Mobility↗
Collaboration between oncology clinical nurse specialists and nursing administrators.
Collaboration between oncology clinical nurse specialists (OCNSs) and nurse administrators (NAs) is built upon mutual respect, commitment, and shared skills and responsibilities. The current emphasis on cost containment, national healthcare priorities, and social issues is changing the environment in which OCNSs and NAs practice. Within this changing environment, OCNSs can exert a powerful and positive influence on nursing practice and quality patient care. When OCNSs and NAs share a common vision of desired patient care outcomes, a collaborative relationship between the two will effectively support the implementation of that vision in practice. As a result, the positions of the OCNS and the NA are strengthened, and organizational goals are realized.
Forecasting↗
Advanced practice models: a comparison of clinical nurse specialist and nurse practitioner activities.
The purposes of this article are to present advanced practice nursing models, explore similarities and differences in roles of clinical nurse specialists (CNSs) and nurse practitioners (NPs) in South Carolina, and relate findings to the advanced practice nursing models. A questionnaire was mailed to advanced practice nurses (APNs) listed with the board of nursing, which yielded a convenience sample of 228 nurses; sixty-two percent were classified as CNSs and 30% as NPs. CNSs spent significantly less time in direct practice and more time in education, consultation, research, and administration than did NPs. Satisfaction was high for both CNSs and NPs and was related to the quality of perceived support for the role and to relationships with key staff. Respondents were engaged in a variety of revenue-generating activities and provided additional suggestions for ways in which APNs could generate additional revenue. Results support previous literature suggesting greater ambiguity in the CNS role as compared with the NP, but also suggest that differences in role are primarily related to relative emphasis on direct practice. Findings tend to support viewing CNS and NP roles as dual pathways to advanced practice or as overlapping roles, with areas of shared and unique activity.
Humans↗
Unit-based clinical nurse specialist: redesigning nursing services.
At the Johns Hopkins Hospital, the Medical Nursing Services redesigned its delivery of direct patient care to include nurse managers, staff nurses, nursing support technicians, and unit-based clinical nurse specialists (CNSs). The CNS role proved efficacious to both nursing staff and nurse managers.
Baltimore↗
Do clinical nurse specialists and nursing unit managers believe that the provision of quality care is important?
The nursing profession has a long tradition of evaluating the quality of its product in order to ensure that the best possible care can be given. However, in the climate of economic rationalism which prevails worldwide, it is possible that the emphasis on fiscal restraint has distracted nurses from their previous focus on quality. This paper discusses the findings of two research studies designed to determine the competencies expected of nursing unit managers and clinical nurse specialists. Discussion focuses specifically on their roles in the provision of quality care.
Clinical Competence↗
Colorectal cancer. Part 4: Specialist nurse roles.
The key nurse specialists involved in the management of colorectal cancer include the colorectal nurse specialist, the stoma therapist and the chemotherapy nurse specialist. The specialist nurse must integrate management, consultation, research and education functions alongside the clinical role. The specialist nurse provides expert advice and information and support and helps the person to live with their diagnosis of cancer.
Adaptation, Psychological↗
Role overlap between clinical nurse specialists and nursing unit managers.
Role ambiguity is a serious and costly phenomenon that the healthcare delivery system can ill afford. Classically, it results from a lack of clarity or information concerning the expectations of a role, and it often results in several staff members undertaking the same activities. The resultant inefficiencies are costly to the organization because job satisfaction decreases and the number and quality of applicants for positions decline because people are unsure about the role and its functions. The authors describe an example of role ambiguity that resulted when the new classifications of nursing unit manager and clinical nurse specialist were introduced in New South Wales, Australia, in 1986.
Hospital Units↗