Looking Back at Clinical Nurse Specialists
Anniversaries are about reminiscence and renewal, and this year is the 25th anniversary of the journal, Clinical Nurse Specialist. By way of a look back at the history and development of the clinical nurse specialist (CNS) role, are posting and providing links to several historical articles from CNS and the American Journal of Nursing which were instrumental in shaping the CNS role as we know it today.
In Reiter's article, you will see the debate around a need for a clinical expert in nursing practice. Peplau's article argues for advanced clinical nurses to span the boundary between new scientific findings and emerging health concerns. Johnson, Wilcox and Moidel provide a great example of the vision of the CNS as clinical expert with expanded authority and responsibility. In Georgopoulos and Christman's work, you see the emergence of the scope of CNS practice, now called the "Spheres of Influence" practice framework.
Faculty, consider adding a discussion about CNS history to your class! NACNS members and affiliates, how about including a discussion about CNS history at your next local meeting? With health care reform upon us, a better understanding of history can often illuminate the path to the future.
Here are some reflective questions for considering our CNS history.
1. What influences lead to the recognized need for academically prepared clinical experts in nursing.
2. Clinical expertise in nursing practice is central to the emergence of the CNS role. How has the notion of "clinical expert" changed over the years?
3. Define specialization in nursing practice according to Peplau’s 1965 publication. Is this definition applicable today? Explain why or why not.
4. How does specialization at the “generalist” level differ from specialization at the “advanced” level?
5. What role do CNSs have in assuring that the nursing profession meets its social mandate?
Follow this link for AJN's CNS collection.