Clinical Nurse Specialist: A Critical Member of the ICU Team

Objectives To describe the role of the clinical nurse specialist, an advanced practice registered nurse in the intensive care setting. The value and impact of the clinical nurse specialist role as a member of the ICU is presented along with a review of clinical nurse specialist education, licensure, and certification requirements as well as a description of the clinical nurse specialist role, scope of practice, and competencies. In addition, a selected review of clinical nurse specialist–led quality improvement and research that resulted in improved patient outcomes is provided. Data sources Review of published medical and nursing literature and expert opinion guidance from a collaborative effort between the Society of Critical Care Medicine, American Association of Critical-Care Nurses, and National Association of Clinical Nurse Specialists. Study selection Not applicable. Data extraction Not applicable. Data synthesis Not applicable. Conclusions The utilization of a clinical nurse specialist, an advanced practice role, in the ICU is a unique and valuable approach for organizations who strive to move evidence into sustainable practice and drive quality through an interprofessional approach. The valuable contributions made by the clinical nurse specialist efficiently and effectively meet the needs of patients, clinicians, and organizations while improving patient outcomes and optimizing cost avoidance strategies, which further lower economic demands on the healthcare system.

Informing and Supporting the New Clinical Nurse Specialist Prescriber

Advanced practice registered nurses (APRNs) in the United States are trained to diagnose and treat disease and illness, hence, to prescribe. Of the APRN roles, the clinical nurse specialist (CNS) is the least likely to prescribe. Prescribing is one of many advanced care interventions performed by CNSs, but the statutes regarding prescriptive authority are constantly changing. The purpose of this article is to inform and support the new CNS prescriber. The article reviews CNS prescribing, credentialing and privileging, safety strategies, and educational considerations that influence CNS prescribing and offers current recommendations for new CNS prescribers. Clinical nurse specialist prescribing can enhance the patient care experience and fill unmet prescriptive needs for patients. Overall, more reports on the outcomes of CNS prescribing are urgently needed, specifically, publications on CNS prescribing in acute care, where most CNSs practice.

Implementing a surgical first assistant role into that of a clinical nurse specialist at an orthopaedic specialist hospital

Background: Clinical nurse specialists (CNSs) are experienced senior nurses with advanced clinical knowledge, communication and leadership skills and commonly take on extended roles to optimise care delivery within health and social care. Aim: To critically explore the experience of one clinical nurse specialist who undertook an enhanced qualification to become a surgical first assistant. Methods: A case-study approach based on Gibbs' reflective model is used to reflect on the experience, its benefits to patient care and the challenges and facilitators related to taking on advanced surgical roles. Findings: Long-term benefits can be achieved by investing in CNSs educated to hold the enhanced surgical first assistant qualification. Advanced roles enhance evidence-based service delivery, while also benefitting the clinical nurse specialist, the patient and the trust.