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 jharbonic@fernley.com.

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.

Job Postings

Featured Headlines

  1. Gallup Poll Again Shows Public Sees Nurses as Most Honest and Ethical Professionals

Headquarters News

  1. Board Highlights
  2. NACNS Appoints Member to AACN’s Competency-Based Education for Doctoral-Prepared APRN Work Group
  3. 2016-2017 Webinar Series to Launch in March 2016
  4. Preceptor Partnership Seeks Your Input
  5. Help Get the Word Out - NACNS Seeking Innovative Stories
  6. Plan Now for 2016 Annual Conference – Important Dates
  7. NACNS Merchandise
  8. NACNS Attends HHS External Opioid Working Group Meeting

Association News

  1. December 1, 2015 AACN/ANA Consensus Model for APRN Regulation Meeting

Clinical News

  1. CDC Ebola Response
  2. New Graft Product for Diabetic Ulcers

Federal and State Policy News

  1. NACNS Legislative and Regulatory Task Force
  2. NACNS Comments on CDC’s Draft Opioid Prescribing Guidelines
  3. President Obama’s State of the Union Address

Job Postings

Mission Health, North Carolina

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:

  • Manage complex patient and family care by demonstrating clinical expertise through collaboration, advanced skills, knowledge, specialty competencies, and practice integration.
  • Introduce and utilize evidence-based practice, standards of care, and research to transform workforce and organization practice enhancing quality, cost effectiveness and efficiency.
  • Facilitate diverse change sensitive to the internal and external organizational needs.
  • Generate positive patient outcomes by fostering professional performance and influencing healthcare initiatives.
  • Uphold NCOB professional nursing practice standards
  • Exemplify Mission Health and the Department of Nursing’s Practice, Education and Research mission.

Clinical Nurse Specialist Requirements:
Master's Degree in Nursing (MSN), North Carolina Board of Nursing CNS recognition; national CNS certification; experience in emergency medicine, behavioral health, cardiac/CV services, oncology or intensive care. Current North Carolina Registered Nurse (RN) licensure, five (5) years minimum of recent clinical nursing experience in a related specialty. Must be an effective speaker before large and small groups and have a proven ability to work autonomously and in collaboration with other health care providers, students, instructors, and leaders.


For immediate and confidential consideration, please email your resume to jill@np-hc.com. or apply via our website at http://www.mission-health.org/become-a-caregiver.php.

WakeMed Health & Hospitals, North Carolina

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:

  • Collaborate with all members of the health care team to design, implement, and measure safe, cost-effective, evidence-based care strategies.
  • Maintain current professional knowledge and competencies and contribute to the advancement of the practice of nursing at the unit/system, local, state, and/or national and international level.

Qualifications:

  • Minimum of five years clinical nursing experience in an acute care setting and/or related experience in behavioral health.
  • National certification as a Clinical Nurse Specialist required.
  • Psychiatric CNS or an Adult Geriatric CNS with experience preferred.
  • Graduate of an accredited university with preparation at the Masters or Doctoral level.
  • Current RN license and recognition by the NC Board of nursing as a Clinical Nurse Specialist.

This is a full-time position working 8:00 AM - 5:00 PM. Weekend requirements as needed.

WakeMed is headquartered in Raleigh, NC, which is ranked nationally as one of the top ten best places to live for quality of life, and is located just two hours from the beach andr three from the mountains. The area has been named one of the fastest growing areas in the country and is located just minutes from the famous Research Triangle Park.

For more information and to apply, please visit us online at jobs.wakemed.org and reference job ID: 19253. EOE

Children’s Medical Center, Texas

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:

  • Assist in developing staff-driven research study/evidence-based practice projects at the unit level.
  • Support current process improvement initiatives.
  • Collaborate with the leadership to address identified opportunities for improvement related to nurse-sensitive indicators, hospital-acquired conditions and patient satisfaction.
  • Collaborate with clinical educator to address learning needs of the staff.
  • Serve as a clinical resource to staff and leadership to address patient care needs of a high acuity/complex population.

Requirements:

  • Master's degree in Nursing.
  • Current RN license (or eligible) in the State of Texas.
  • Recognition as a Clinical Nurse Specialist (or eligible) by the Texas Board of Nursing.
  • Current American Heart Association CPR/BLS for the Healthcare Provider, and current PALS certification.
  • Previous pediatric cardiology experience.

For more information please visit www.childrens.com

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Featured Headlines

11. Gallup Finds Nurses Still No. 1

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.

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Headquarters News

2. Board Highlights:

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.

3. NACNS Appoints Member to AACN’s Competency-Based Education for Doctoral-Prepared APRN Work Group

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:

  • Establish a common language or taxonomy by adopting definitions for competence, competencies, and competency framework that are recognized by APRN organizations and other health professions.
  • Identify common, measurable APRN doctoral-level competencies that cross all four roles and build on the expected outcomes for the APRN core courses: advanced physiology/pathophysiology, advanced health assessment, and advanced pharmacology).
  • Identify and describe progression of competence or milestones across each of the common competencies. These milestones may vary for each of the four roles; however, the goal will be to reach consensus on two milestones: competence prior to entry into clinical experiences and at end of program. 
Dr. Baker will be reporting on the progress of this Work Group to the NACNS Board of Directors. She isAssociate Professor, Division Director, Graduate Nursing Studies & Scholarship at the Harris College of Nursing & Health Sciences of Texas Christian University. She is also Deputy Director, Center for Evidence Based Practice & Research: A Collaborating Center of The Joanna Briggs Institute.

4. NACNS 2016 - 2017 Webinar Series *

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..

All webinars have been archived for later viewing.

Webinar Cost:
Single Webinar

Members $25
Non-Members $60
Student $30

 

 

 

*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.

5. NACNS and Indiana University School of Nursing Collaborate to Address Preceptoring

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.

  • Negotiating a clinical experience with a student – Getting started on the right foot!
  • Orienting a student to the unit(s)/agency – Avoiding deer-in-the-headlights.
  • Communicating with faculty – Who, what, when where, how.
  • Providing feedback to students – What and how often! 
  • Learning activities –Helping students achieve practice competencies. 
  • Evaluating competency achievement – Beginners, over achievers and everything in-between.
  • Debriefing – Why it’s important for the student to know what’s in your head.
  • Dealing with challenging situations – If only everything went as planned!
  • Fostering collegiality – Easing students into a larger professional community.
  • Precepting as professional development – Achieving Win-Win!

Thank you for considering this opportunity for sharing!
If you have a story to share, please click the link below for further information and submission instructions. There is no monetary compensation for volunteering your story, but we know that CNS preceptors would benefit from hearing about the experiences of others! To submit your story, please go to: https://www.surveymonkey.com/r/6MVFGJK. If you have questions, email Lisa Wages at lwagnes@iu.edu.

Preceptor Course Planning Committee:
Sharron Coffee, MSN, RN, CNS-BC, Milwaukee, WI; Julie Dramedy, PhD, RN, ACNS-BC, Milwaukee, WI; Janet Fulton, PhD, RN, ACNS-BC, ANEF, FAAN, Indianapolis, IN; Jennifer Kitchens, MSN, RN, ACNS-BC, Indianapolis, IN, 2014 NACNS Preceptor of the Year; Francesca Levitt, MSN, Indianapolis, IN, 2012 NACNS Preceptor of the Year; Deb Sips-Fears, MSN, RN, CCRN, Indianapolis, IN; Lisa Wages, MSN, RN, Indianapolis, IN

36. NACNS Seeking CNS Innovation Stories

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 info@nacns.org.

It is not necessary to address the following questions, but they might provide a good guideline for your submission.

  • What problem were you trying to solve/address?
  • What solution/innovation did you implement?
  • Who did you engage in this solution/innovation?
  • What spheres of influence did your solution/innovation address (patient/family; nurse; systems)?
  • What outcomes have you seen?
  • If you can, please estimate or cost out any savings that you have seen.

Please make sure that you do not use personal identifiable information related to patients in your story. 

Submit your stories to: info@nacns.org. Please put "innovative story" in the subject line.

 

7. Save the Date for NACNS’ Annual Meeting - March 3 – 5, 2016, Philadelphia, PA

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:

  • Fairmount Park is the largest city park with over 8,000 acres.
  • Philadelphia has more public art than any city in the country.
  • The Walnut Street Theater is the oldest continually operating theater in the US.
  • Philadelphia was recently named America’s first World Heritage 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.

8. NACNS Merchandise

Gifts to Purchase – The Celebration Continues
This year, NACNS was pleased to offer products for you to purchase for yourself or another CNS in honor of CNS Week. We had such a great response, we thought we would continue to offer these products until the end of 2016!

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)

9. NACNS Attends HHS External Opioid Working Group Meeting

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.

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Association News

110. December 1, 2015 AACN/ANA Consensus Model for APRN Regulation 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:

  • Lack of available certification exams for licensure for CNSs in all of the populations. There was much discussion of the lack of a national licensure exam for women’s health.
  • The need for a transition plan for the CNS for licensure where no national certification exam exists.
  • The potential to consider another model for licensure in the event that there are not sufficient numbers of individuals to develop and maintain an accredited national certification exam.
  • The range of states’ interpretations of grandfathering.
At the conclusion of the meeting, it was determined that AACN/ANA would make the speaker slides available and the speakers would collaborate on the writing of a short report about the meeting. When the materials are ready, NACNS will post information about how to obtain them on the NACNS website –www.nacns.org.

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Clinical News

11. Ebola Epidemic Response Review

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.

12. U.S. Food and Drug Administration (FDA) Approves Graft for Diabetic Foot Ulcers

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.

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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 – info@nacns.org. Please put state legislation/regulation in the subject line so your email can be forwarded to the Committee.

14. CDC Publishes For Comment - Opioid Prescribing Guidelines for Primary Care Providers

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.

15. President Obama’s Last State of the Union Address

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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This is a publication of the National Association of Clinical Nurse Specialists. You are receiving this publication because you are identified as holding a membership in NACNS. If you wish to unsubscribe from this publication, please email info@nacns.org. Please note, if you unsubscribe, this will remove you from all email communications from NACNS.
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The CNS Communiqué is an electronic publication of the National Association of Clinical Nurse Specialists.
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