The CNS Communiqué is an electronic publication of the National Association of Clinical Nurse Specialists. The purpose of this publication is to keep our members updated on the NACNS headquarters news; connect our members with fast-breaking clinical news; and update clinical nurse specialists on state and federal legislative actions. If you have any questions or wish to advertise in this publication – please contact Jason Harbonic at firstname.lastname@example.org.
Special Jobs Issue
NACNS is now offering a periodic “Special Jobs Issue” of the CNS Communique to inform NACNS members of job opportunities around the country. These and other employers also advertise on NACNS’ Job posting website.
Federal and State Policy News
Mission Health (www.mission-health.org) is Western North Carolina‘s only not-for-profit, independent community hospital system and the only health system in the nation to receive Truven Health/Thomson Reuters’s Top 15 Health System recognition for the last four years consecutively (2012-2015). Mission is located in beautiful, picturesque Asheville, North Carolina – named the Happiest Place to Live in the US!
We currently have several CNS opportunities available on our growing team in ICU/Heart Services, Oncology and Behavioral Health. As a CNS at Mission Health, you will report directly to the Associate Chief Nursing Officer and will receive a high level of autonomy to practice and innovate!
Clinical Nurse Specialist Responsibilities:
Clinical Nurse Specialist Requirements:
Psychiatric Clinical Nurse Specialist
The CNS is the clinical leader for a program or specialty area of nursing practice. The advanced knowledge and skills required for this role includes clinical expertise in a focus area, evidence-based practice, collaboration, consultation, education and mentoring. Working in partnership with Nursing Leadership, the CNS serves as a change agent for bedside nursing practice. The CNS should be able to demonstrate the ability to utilize evidence to develop, teach, guide, and implement practice standards and policies.
The Psychiatric Clinical Nurse Specialist will:
This is a full-time position working 8:00 AM - 5:00 PM. Weekend requirements as needed.
For more information and to apply, please visit us online at jobs.wakemed.org and reference job ID: 19253. EOE
Children’s Health – Children’s Medical Center is seeking a full-time Clinical Nurse Specialist to join the Heart Center – Inpatient Cardiology Services
Children’s Medical Center, a Magnet designated facility, is the primary pediatric teaching facility for the University of Texas Southwestern Medical Center at Dallas. Children’s is the only academic hospital in North Texas dedicated exclusively to the comprehensive care of neonates and children from birth to age 18.
In this role, the CNS will:
For more information please visit www.childrens.com
Continuing the 14-year winning streak, nurses were again rated the highest - meaning the most trusted profession, according to Gallup’s December 21, 2015 news release. Nurses have topped Gallup's honesty and ethics ranking every year but one since they were added to the list in 1999. Understandably, the year that nurses were rated below #1 was 2001, where firefighters took the lead, shortly after the September 11th terrorist attacks.
The 2015 Gallup poll on honesty and ethics rates nurses at an impressive 85%. The second and third place slots went to pharmacists (68%) and physicians (67%). Honesty and ethics rating -- tying their high point -- nurses have no serious competition atop the Gallup ranking this year. Pharmacists and medical doctors constitute the next tier, with about two-thirds of Americans viewing each highly, followed by high school teachers at 60% and police officers at 56%.
Less than half of Americans consider clergy (45%), funeral directors (44%) or accountants (39%) to be highly ethical. Still, Americans are much more likely to view these professions positively than negatively.In contrast, there are three professions that rank the lowest on the honesty and ethics poll. According to the survey, the majority of people give Congress, telemarketers and lobbyists low or very low scores for honesty and ethics.
Face-to-face meeting for 2016 – The Board determined that the 2016-2017 Board of Directors would hold its second face-to-face meeting in July 2016 to coincide with the Educator’s Forum and NACNS Summit. A task force has been appointed to start planning for the 2016 Educator’s Forum and Summit. These meetings will provide an important opportunity to discuss policy issues facing the CNS.
DNP position statement – To address some questions about the July 2015 NACNS Board Position Statement on the Doctorate of Nursing Practice (DNP) the NACNS’ Board added a phrase clarifying that the position will apply to the new graduate CNS as of 2030.
PhD position statement – The Board reviewed a first draft of a PhD Position Statement prepared by the DNP Position Statement Review Task Force and returned it to the committee for additional work. Once this Task Force addresses the Board’s questions, the Board will again review the position statement. Before it is considered for approval by the Board, it will be posted on the NACN website for membership comment. Members will receive an email notifying them about the two week comment period during which comments can be provided via a survey monkey tool. Please watch for this blast email so that you can provide any comments you have on the draft position statement.Appointment of new task force and committee – The Board has voted to establish a 2015-2016 Research Priorities Task Force. The NACNS president is currently reviewing the applicants. Those appointed to the task force will be informed by the end of January 2016.
In December 2015, NACNS appointed Kathy A. Baker, PhD, RN, ACNS-BC, FAAN to be the organization’s representative on AACN’s Competency-Based Education for Doctoral-Prepared APRNs Work Group. The goals of this work group are to:
We are excited to announce that the NACNS Webinar Series is being revised to include more webinars for NACNS members and advanced practice registered nurses. The theme for 2016-2017 will be pharmacology and technology. We have increased the frequency of the webinars so that they will be monthly. These webinars will provide CE at a reduced price of $25.00 for members.
Periodically, NACNS will offer free webinars to update the membership on key issues and projects the association is working on. These webinars will be announced via blast email..
*First session will be held in March 2016.*This activity has been submitted for approval for contact hours by the Alabama State Nurses Association. The Alabama State Nurses Association is accredited as an approver of continuing education by the American Nurses Credentialing Center’s Commission on Accreditation.
We are excited to announce that NACNS, in collaboration with Indiana University School of Nursing, is developing a member requested continuing education course designed to support CNS preceptors. This online course will be available to CNSs interested in becoming CNS student preceptors as well as experienced CNSs looking for new ideas. Academic programs seeking options for preparing CNS preceptors may also find this program quite useful. This course is slated to debut in spring, 2016!
Here’s how you can help! The planning team is seeking stories to illustrate “in the field” perspectives – examples providing insight for future preceptors. Below is a list of suggested topical areas where exemplars/stories are requested.
Thank you for considering this opportunity for sharing!
Preceptor Course Planning Committee:
Across the United States, CNSs are making a difference in the lives of patients they serve as well as improving care delivery in hospitals and healthcare systems. NACNS is collecting these stories.
In an effort to educate policymakers, the public and leaders in the health care system about the important contribution of the CNS, NACNS is looking for stories from you about how you have made a difference in patient care, patient outcomes, systems and more! Whether it is decreasing length of stay for a patient population, decreasing the rate of wound infection, implementing new guidelines or regulations or organizing care to address a unique patient care need, you are working in collaborative teams or as individual change agents to enhance the patient care experience and improve outcomes. And we want to hear about it!
NACNS will collect your stories about innovative practice projects and initiatives and use them in a variety of ways to illustrate the contribution of the CNS to improving health care. If you have a story to share, please send it (it only need be a couple of paragraphs long) to email@example.com.
It is not necessary to address the following questions, but they might provide a good guideline for your submission.
Please make sure that you do not use personal identifiable information related to patients in your story.Submit your stories to: firstname.lastname@example.org. Please put "innovative story" in the subject line.
The Future is today: Entering a World of New Practice Challenges for the Clinical Nurse Specialist
NACNS is excited to welcome you to Philadelphia, PA for the NACNS Annual Meeting! In case you haven’t been to Philadelphia, here are some fun facts about the historic city:
For more information on Philadelphia, visit http://www.discoverphl.com/visit/.
Registration is now open for the 2016 NACNS Annual Meeting. The NACNS website has detailed information on this exciting Annual Meeting. Go to http://www.nacns.org/html/conf-2016.php.
The planning committee is happy to announce the following keynote speakers: Ann B. Hamric, PhD, RN, FAAN, Associate Dean of Academic Programs, Professor, School of Nursing, Virginia Commonwealth University, Regina Cunningham, PhD, RN, AOCN, FAAN, Chief Nurse Executive, Associate Executive Director, Hospital of the University of Pennsylvania, Assistant Dean for Clinical Practice, Adjunct Professor of Nursing, University of Pennsylvania School of Nursing, and Michelle Larkin, JD, MS, RN, Interim Vice President, Robert Wood Johnson Foundation.
Attendees who register for the pharmacology preconference session will have the opportunity to earn up to 6 CE pharmacology credits. There will be additional options for earning pharmacology CE credits during the Annual Meeting Preconference. We will provide pharmacology CE for a number of sessions at the meeting as well.
The meeting will be held at the Loews, Philadelphia, which is right downtown, a short walk from key attractions such as City Hall, the Reading Terminal Market and lots of unique and high-quality restaurants. Philadelphia is steeped in history and is a melting pot of cultures. While you are in town, consider adding a day to see the Liberty Bell, or the Declaration of Independence or visit the yearly Philadelphia Flower Show. Details will be posted on the NACNS website – www.nacns.org.
Gifts to Purchase – The Celebration Continues
NACNS logo note cards – pack of 10 NACNS postcard-style logo note cards and envelopes - $5.00 per pack – buy 10 or more packs for $4.00 each. (Plus shipping and handling)
NACNS silver logo pen with stylus – single pens are $5.00 each. 10 or more - $4.00 each. 25 or more $3.50 each. (Plus shipping and handling)
On January 21, 2016 NACNS member Jennifer Bright, MSN, RN-BC, ANCS-BC, FGNLA, and Susan Fowler, PhD, RN, CNRN, FAHA, joined NACNS’ Executive Director Melinda M. Ray MSN, RN at the HHS External Opioid Working Group Meeting in the Old Executive Office Building, Washington, DC. This meeting brought representatives from numerous health professional groups to the table. The nursing groups in attendance in addition to NACNS were: ANA, AWHONN, AACN, AANP, and APNA, The agenda was designed to allow attending organizations to report on their activities to decrease opioid over use and abuse. In addition to sharing the role of a CNS, NACNS representatives were able to discuss the publication of information on opioid use as well as the many educational opportunities we are allotting to this important issue in our webinar series and at our annual meeting.
On December 1, the American Association of Colleges of Nursing and the American Nurses Association jointly hosted a meeting of stakeholders to review and discuss the progress that has been made in state adoption of the Consensus Model for APRN Regulation (Consensus Model). NACNS was a member of the planning committee and NACNS Executive Director, Melinda Mercer Ray facilitated a session and presented on a panel.
The purpose of the meeting was to identify where the Consensus Model has been successful and where there are continuing issues and/or unintended consequences that need to be addressed. NACNS representatives and other CNS attendees at the meeting raised these key concerns:
It has been almost two years since the start of the 2014 Ebola epidemic in West Africa, the first in history. The first case was reported in Guinea in March 2014, and the disease spread to the neighboring countries of Liberia and Sierra Leone. Over the span of a year, there were more than ten times as many cases of Ebola reported than the combined total of all those reported in previous Ebola outbreaks. As the outbreak became more widespread, travel-associated cases appeared in Nigeria, Mali, Senegal, and even countries outside Africa, including the United States. A report, The Road to Zero: CDC’s Response to the 2014 Ebola Epidemic outlines the CDC’s response and its analysis of the effectiveness of its work.
The U.S. Food and Drug Administration today approved a new indication for the Integra Omnigraft Dermal Regeneration Matrix (Omnigraft) to treat certain diabetic foot ulcers. The matrix device, which is made of silicone, cow collagen, and shark cartilage, is placed over the ulcer and provides an environment for new skin and tissue to regenerate and heal the wound.
An estimated 29 million people in the United States have been diagnosed with diabetes, according to the Centers for Disease Control and Prevention, and about 25 percent of them will experience a foot ulcer during their lifetime. Chronic diabetic foot ulcers are associated with tissue and bone infections and result in 50,000 amputations each year.
The FDA first approved Integra Dermal Regeneration Template (which the company now also calls Omnigraft) in 1996 for the treatment of life threatening burn injuries when the use of a patient’s own skin for a graft was not possible. In 2002, Integra Dermal Regeneration Template was approved for a new indication to treat patients undergoing reconstructive surgery for burn scars when they cannot have skin grafts. Now, Omnigraft is approved to treat certain diabetic foot ulcers that last for longer than six weeks and do not involve exposure of the joint capsule, tendon or bone, when used in conjunction with standard diabetic ulcer care.
Omnigraft’s new indication is based on a clinical study that demonstrated that the matrix device improved ulcer healing compared to standard diabetic foot ulcer care, which includes cleaning and covering the wound with a surgical bandage and keeping weight off of the foot with the ulcer. In the study, 51 percent of patients treated with Omnigraft had healed ulcers after 16 weeks compared to 32 percent of patients treated with standard diabetic foot ulcer care alone. Adverse events observed in the clinical trial included infections, increased pain, swelling, nausea, and new or worsening ulcers.Omnigraft should not be used in patients with allergies to cow (bovine) collagen or chondroitin (cartilage from any source) since serious allergic reactions may occur. Omnigraft should also not be used on infected wounds.
Federal and State Policy
13. NACNS Legislative and Regulatory Committee to Track State Activity on CNS Practice Legislation and Regulation
The NACNS Legislative and Regulatory Committee chaired by Melanie Duffy is interested in hearing from you! As the state legislative sessions get underway in 2016, the Committee wants to keep track of legislative and regulatory activity that has an impact on CNS practice and licensure. NACNS can provide some information for states who are engaged in advocacy for the CNS. At the end of 2015, NACNS wrote a letter to the Arizona legislature in support of the CNS role, and sent a letter concerning proposed changes to public health regulations in Illinois.
“We are encountering increased awareness of the CNS role which is both good and challenging in the legislative and regulatory community. For many years, the CNS has been grouped with other APRNs such as NPs and been able to achieve advances in independent practice and prescriptive authority. Of late, opponents, such as the American Medical Association and some state medical associations have begun to specifically target the CNS and attempt to restrict our scope of practice,” stated Peggy Barksdale, NACNS 2016 President. Because of the increased pressure on states to open their practice acts to accommodate the Consensus Model for APRN Regulation, we anticipate a great deal of state legislative and regulatory activity in 2016. NACNS’ Legislative and Regulatory Committee and the NACNS Board are happy to share the information resources they have with state affiliates to support their hard work in advocating for the CNS role.To inform the NACNS Legislative and Regulatory Committee of anticipated and/or ongoing legislative and regulatory issues in your state, please email – email@example.com. Please put state legislation/regulation in the subject line so your email can be forwarded to the Committee.
The concerns about the national trends of use and abuse of opioids has led to federal efforts to provide more information and resources to the public and to health care providers related to the best approaches in the use of opioids.
Opioids are a class of prescription pain medications that includes hydrocodone, oxycodone, morphine, and methadone. Health care providers wrote 259 million prescriptions for opioid pain medications in 2012 – enough for every American adult to have a bottle of pills.Commenting on the role of the CNS in the management of patients with pain, including prescribing pain relief measures, NACNS provided comments on the Draft CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. If you would like to read NACNS comments, please go to www.nacns.org.
President Obama delivered his final State of the Union address on January 12, 2016. This year, instead of laying out proposals for policies , he spoke about his views and opinions on the future. The speech was organized around four “big questions” that President Obama asked the country to answer –
First, how do we give everyone a fair shot at opportunity and security in this new economy?
Second, how do we make technology work for us, and not against us – especially when it comes to solving urgent challenges like climate change?
Third, how do we keep America safe and lead the world without becoming its policeman?
And finally, how can we make our politics reflect what’s best in us, and not what’s worst?
The full text of the State of the Union speech is widely available online, including on Medium, Facebook notes, and go.wh.gov/SOTU. These digital platforms also include charts and infographics on key areas and a way to provide feedback.
"We live in a time of extraordinary change – change that’s reshaping the way we live, the way we work, our planet and our place in the world. It’s change that promises amazing medical breakthroughs, but also economic disruptions that strain working families. …Our unique strengths as a nation – our optimism and work ethic, our spirit of discovery and innovation, our diversity and commitment to the rule of law – these things give us everything we need to ensure prosperity and security for generations to come." – President Obama, January 12, 2016
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The CNS Communiqué is an electronic publication of the National Association of Clinical Nurse Specialists.