The Commission on Nurse Certification (CNC) is now accepting applications for the 2021 CNL Innovative Project Award. -Aydelotte, M.K. The CNS: b) Assessing, analyzing, identifying priorities evaluating and creating plans for highly complex situations with clients and other caregivers. Develops and evaluates innovative approaches and programs for complex practice issues. 2. The award application process is open to CNLs, faculty, and practice … Participates and provides leadership on internal and external committees relating to care delivery, policy and procedure development, research, education and professional development. -Theory – A theory is a set of statements that tentatively describe, explain, or predict relationships between concepts that have been systematically selected and organized as an abstract representation of some phenomenon. 4. For example, a low risk birthing centre in a community hospital, or a short term psychiatric unit in a general hospital or community-based ambulatory care centre. Over 1,000 questions covering every BCNS study domain. The purpose of this document is to articulate Standards of Practice of the Clinical Nurse Specialist (CNS) within an evolving health care system. Care is provided to clients with varying levels of acuity in highly variable work settings. The quality of nursing care and/or worklife is evaluated and improved by the CNS’s research activities. 15. 4. Internal/external committees benefit from CNS representation. Get the latest public health information from CDC: It has an identity defined by a shared domain of interest. Questions were written & improved by a team of real-life CNS exam takers who hold graduate degrees & practice in the field of nutrition. 4. as per the Authorization and Proctoring’ system Experience Three (3) years of clinical experience after registration as RGN. The CNS: Outcome 4. The core CNS competencies are comprehensive, entry-level competencies and behaviors expected of graduates of master’s and post-master’s programs that prepare CNSs. Environmental Support for Research 7. Practice within the CNS’s domain of responsibility is positively influenced by research findings.   5. • Reference List 2. The CNS strives to optimize client(s) involvement to the extent possible within cognitive and developmental abilities. New York: McGraw Hill. 2. 8. 3. Using a set of criteria, the standards define the uniqueness of the Clinical Nurse Specialist by addressing five domains of practice. The Regulation on Advanced Nursing Practice. 1. The standards enable the quality of advanced practice, consultation, education, research and leadership to be judged. This mean engaging in practice and/or planning care for complex situations or complex client needs. Please enable it to take advantage of the complete set of features! They practice in collaboration with other health care professionals to promote health, prevent disease and to diagnose, access and manage health needs. 3. There are three domains of CNS practice, known as the three spheres of influence (Mayo, et al,2017; NACNS 2004): Patient; Nursing personnel; System (healthcare system) The three spheres are overlapping and interrelated, but each sphere possesses a distinctive focus. • Domain of Research 3. Like other APNs, (nurse practitioner, nurse midwife, and certified registered nurse anesthetist) the CNS is educationally prepared with either a master’s or doctoral degree. Environmental Supports (2) the evaluation of long-term illness that requires hospitalization to determine any needed change in treatment. c) Referring the care of the client to appropriate health care professional when the client’s health situations outside the CNS’s scope of practice or clinical competence. While the other APNs function primarily as providers, the CNS role encompasses a multitude of healthcare practices. 12. Supports clients in decision-making regarding health care by: 3. 6. In the case of private/independent practice, the CNS may be responsible for both domains of practice and environmental support. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. The role of the CNS includes five inter-related domains: advanced practice, education, research, leadership, and consultation. 1.  |  The organizational placement and position description of the CNS facilitates formal and informal consultations. The CNS is an advanced practitioner who holds a Masters or Doctoral degree from a nursing program and has expertise in a clinical nursing specialty. 4.   For example, transplant units. Chaska, The Nursing Profession: A Time to Speak. The employing system allows flexibility of work hours for both learners and educators to meet the learning needs of staff on varying work schedules. Collaborates in the development of nursing roles within a changing health care system. 3. The focus of the consultation may be at the individual, group, program, or systems level. 7. (1990). Ottawa: Canadian Nurses Association. Stimulates others to read and interpret research findings in health care literature. Expectation of collaborative relationships with nurse leaders and others. Implications: Resources are available and accessible to education which recognizes variability of learning styles. Facilitates the implementation of planned learning experiences. -Canadian Nurses Association (1986).  |  2008 May-Jun;22(3):143-8. doi: 10.1097/01.NUR.0000311694.69791.e9. The master's-level EBP competencies can be transposed on a crosswalk of the ACE Star Model and the 5 CNS practice domains to form a matrix representing the influence that CNSs can have over the EBP process. Demonstrates ability to function as an external reviewer for research proposals. It is expected that a CNS is able to meet and exceed all of the requirements of a RN as identified in the professional standards of practice. In addition, CNS core competencies communicate the expectations of CNS practice to healthcare organizations using CNSs. Clients will benefit from the application of current theory and research based practice. The Clinical Nurse / Midwife Consultant develops, facilitates implementation and evaluates care management plans for … The competencies of the specialist include the ability to assess, conceptualize, and analyze complex problems related to health, and make appropriate recommendations and/or complement a plan of care (Adapted from National Council of State Board of Nursing, Inc., 1986). Introduction 9. The CNS helps nurses in meeting the current and future needs of individuals, families, communities, populations and the profession by sharing current knowledge. 4. The CNS's practice can be organized around 5 domains: expert practitioner, researcher, consultant, educator, and leader. d) Demonstrating skills and ability to practice when following clients across settings. Master's-level EBP competencies based on these 5 steps were established by a national consensus panel. The first position paper by Canadian Nurses Association (CNA) on the role of the CNS was accepted in 1973. 3. 6. 5. 5. The CNS … 6.   -Role Model – The demonstration of the behaviour associated with a particular position or profession that serves as an example for others. NLM 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. The CNS can advocate for environmental supports but it is an administrative responsibility to provide them. (1990). 6. Membership therefore implies a commitment to the domain, and therefore a shared competence that distinguishes members from other people. The consultee demonstrates an enhanced understanding of the issues. Employing systems facilitate research activities including material and non-material support. Negotiates with consultee a process for follow up. View CNL FAQs . Society of Trauma Nurses position statement on the role of the clinical nurse specialist in trauma. • Domain of Advanced Practice The domain of advanced practice is the foundation of the Clinical Nurse Specialist role. News & Announcements. Demonstrates advanced understanding and synthesis of the role of the CNS within the nursing profession and the health care system. Consultation with care providers allows the CNS to influence the plan of care for clients/families and provide learning to the consultee which can be applied to future situations. The study of nursing science and related arts and sciences provides a basis for advanced practice. Specialization in CNS practice includes application of a broad range of theories and research to particular client situations that are within the domain of nursing. 10. Demonstrates advanced knowledge and synthesis of teaching and learning theories for individuals and groups. Demonstrates knowledge of qualitative and quantitative research methods. Environmental supports involve elements that are generally a joint responsibility of the CNS and administration. J Trauma Nurs. A "hybrid" CNS/NP curriculum faces the danger of lacking both the depth … Clients experience care which is client-centered, innovative, and satisfying. 4. 2. The future health care delivery system in the United States. 1. Washington, D.C.: Author. 10. Domain of Advanced Practice concussion. Developing an empirical base for clinical nurse specialist education. 1. -Advanced Practice - the practice of nursing at a level which requires in depth theoretical knowledge at a graduate level in nursing. Practice domains were more strongly influenced by the predictors of nursing position and professional career ladder. Newbury Park, Califoria: Sage Publications. Consultation may be requested by nurses, other health professionals, clients, families, or groups. Performance Standards • Domain of Education Plans, recommends and collaborates with the consultee. J Athl Train. a) continuously assessing clients’ capabilities to participate in decision-making and use appropriate decision-makers when necessary. The role of the CNS includes five inter-related domains: advanced practice, education, research, leadership, and consultation. 4. Negotiates the type and duration of involvement. Ottawa: Canadian Nurses Association. The Clinical Practice Pillar can be further developed to reflect particular requirements of speciality groups. The Clinical Nurse Specialist provides care or plans care for clients with highly complex needs in selected practice situations. Share knowledge of client’s perspectives during policy development and planning. 1. -Advocate - an agent who acts on behalf of vulnerable people. 2. 11. Environmental Support for Consultation CNSs are expert nurses who work within a specific area of practice incorporating advanced knowledge and skills. • Glossary Clinical Nurse Specialist (CNS) as the pinnacle in point of care nursing practice. Epub 2013 Feb 20. 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. relationship development, problem solving, critical thinking, clinical skills, etc). (1983). Opportunity for participating in key clinical and nursing decisions. A system exists for the documentation and communication of CNS consultations. Prepare with our CNS Study Guide and Practice Questions. Standards were developed through consultation from across Canada. CNS domains of practice are within nursing's scope of practice. Progressive change is evident within the CNS’s domain of responsibility. Since the 1970’s, the Clinical Nurse Specialist role has become well established in hospital, community and independent practice. 14. The scope of advanced practice nursing is distinguished by autonomy to practice at the edges of the expanding boundaries of nursings’ scope of practice (ANA,1995). 3. Determines the focus of the consultation with the consultee. Get the latest research from NIH: The purpose of this article is to describe master's-level evidence-based practice (EBP) competencies as determined by a national consensus panel and present an EBP matrix that illustrates the influence that the clinical nurse specialist (CNS) practice can have on driving EBP change. 3. The nurse as change agent. -Clinical Nurse Specialist – an expert advanced practitioner who provides direct care to clients and services as a role model and consultant to practicing nurses and others. The employing agency/system ensures that mechanisms are in place for documentation and communication. Demonstrates the ability and knowledge to participate on research committees. Human, material and organizational resources are positively influenced. 2. 5. CNS practice is within the domain authorized by state-regulated initial RN licensure (nursing's autonomous domain and responsibilities implicit in … • Assumptions (3) the provision of counseling and therapy that can not be provided in a primary care centre (Aydelotte, 1983). 11. The practice of the clinical nurse specialist is based on in-depth knowledge of nursing and behavioural and biological sciences. 5. 8. Assures ethical and legal practices in the conduction of research. Demonstrates knowledge and skills in managing organizations and environments. Evidence-based practice is a growing and necessary paradigm for nursing care. b) Involving clients in decisions related to their care. 2. The Dictionary of Nursing Theory and Research. 7. 2. The recommendations in this article are for the installation of Windows 2000 Server or Windows Server 2003 environments where there is no previously defined DNS infrastructure. 7. Each role had distinct expression of the NONPF practice domains, particularly in two areas: management of client health-illness states and the professional role. Nurses and others will identify and utilize the CNS as a resource in meeting learning needs. -Performance Standards – authoritative statements with measurement criteria which describe a competent level of behaviour in the clinical nurse specialist role regardless of specialty or practice setting. Assumptions The employing agency/system supports the advanced practice of the CNS by promoting flexible time arrangements and protected time for the provision of direct care. This license should either be issued by an official body in the United States or by a legally recognized licensing body elsewhere. Participates in employee recruitment, selection, career development and performance appraisal. Environmental Support for Education The leadership occurs at multiple systems levels. Acts as a role model and clinical expert in the area of clinical specialty. Environmental Support for Leadership There was widespread variability in the level of practice both within and between the CNC grades as well as significant differences in job content. 1. Systems exist for the CNS to receive formal and informal consultations. Chicago: National Council of State Board of Nursing, Inc. -Powers, B.A., & Knapp, T.R. Original product version: Windows Server 2012 R2 Original KB number: 825036. 3. Certified Nutrition Specialists practice science-based personalized nutrition therapy to power people to health. 2. In N.I. 2. This article describes best practices for the configuration of Domain Name System (DNS) client settings. Critically analyzes socio/political issues and contributes to the political process to influence health outcomes. The advanced practitioner may work in areas of primary, secondary, tertiary and quadertiary care, in health care agencies, or in an independent practice. Supports nurses in professional development and career planning in furthering their educational qualifications. Study Design ORGANIZING FRAMEWORK Research regarding master's-level role domains and competencies by Fenton and Brykczynski (1993) led them to develop a model to guide CNS and NP CNS/NP PRACTICE DOMAIN COMPARISON 283 curriculum development. Policy planning and development demonstrates intersectorial representation. is means that nurses hav e to seek out knowl-edge from all of these sectors to apply in clinical . Administrative structure facilitates consultation to the CNS by nursing staff, other health professionals, clients, families, and communities. 3. 3. These Standards of Practice for CNS’s identify the additional minimum expectations for CNSs. Primary What? Find NCBI SARS-CoV-2 literature, sequence, and clinical content: Documents analysis, findings, and recommendations. Assists in the skill development of nurses (e.g. CNSs provide leadership for other nurses, clinical programs, research programs, and client care. Anticipates future changes (needs, technology, changing system, professional development) and recommends appropriate changes/implications. Placement in organization systems at level appropriate to impact across individual programs/units/sectors. The consultations may be informal or formal. This will occur organisationally in Tuesday@2 ceremonies in April and October of each year. Timely access to relevant clinical and system information. Nursing knowledge is constantly evolving and increasing in complexity. The CNS’s leadership subrole may take place in a number of different ways in different systems. HHS tributions of CNS practice to the health and welfare of the public. 1. 2007 Oct-Dec;30(4):165-82. doi: 10.1080/01460860701738336. • Introduction Secondary care include (1) the treatment of temporary dysfunctions that requires hospitalization but not highly skilled services and high risk interventions. Get started today! 3. 4. They work in partnership with individuals, families and communities and the multidisciplinary care team. Implementation of Best Practices Based on Evidence; Quality Improvement; Learn more about the CNL . Their work modified Ben- ner's domains of expert nursing practice (1984). b) Facilitating the process of clients’ decision-making about health choices. -Change Agent – an individual who facilitates in problem-solving, strategic planning, and change projects (Kaplan, 1990). References Communicates the importance of nursing research to clinical practice and theory development. Prepare for the exam efficiently & effectively with our up-to-date questions & helpful explanations. 8. Evaluates outcomes of policy decisions and communicates findings. International Nursing Review, 32 (6), 175-176, 180. Develops a collaborative relationship with the consultee. The CNS facilitates others understanding and application of research. The nurse participates in research to improve the quality of nursing care and communicates and uses research findings. 8. J Nurs Manag. College of Nurses of Ontario. This site needs JavaScript to work properly. Advocates for client-focused decision-making within the health care deliver system by: Applies relevant research and a broad-range of theories to clinical practice using critical thinking and analysis. Regardless of where the CNS works, it is always in context of work with others. Domain of Education Performance Standards Performance Standards CNS Vital Signs tests and auto-scored results provide the clinician with a broader spectrum of clinical domains and the sensitivity to assessing neurocognitive function is such that they often reveal abnormality in the absence of positive findings in CT and MRI scans e.g. 5. Mechanisms exist for communication and documentation of research activity. The Clinical Practice Pillar also contains common elements of practice which are applicable to all practitioners. Nursing knowledge is validated or generated. 5. Domain of Research c) Expanding other caregivers’ understanding of the subjective experience of clients. 2008 Jul-Sep;15(3):91-3. doi: 10.1097/01.JTN.0000337148.21926.71.   Domain of Consultation Nurses practice in diverse and complex environments and may require consultation with a CNS. Evidence-based practice: a primer for action. CNS role descriptions include research activity. J Athl Train. CNS’ may demonstrate leadership … The CNS is an agent of change who brings value to clients, practice settings and organizations to improve safety, promote positive health outcomes and reduce costs. The consultee is able to generalize and apply the new knowledge to other situations. 4. Each role had distinct expression of the NONPF practice domains, particularly in two areas: management of client health-illness states and the professional role. Evaluates the effects of educational experiences on nurses’ behaviour, and client and system outcomes. a) Providing clients with the information required to make health care choices regarding care, treatment, and participation in clinical research. practice. Leadership is required to advance nursing practice and to promote quality client care. • Environmental Supports Pediatric Nursing, 16(6), 603-618. Identifies human, material and organizational system needs. Clin Nurse Spec. 1. 2011 Sep-Oct;46(5):514-22. doi: 10.4085/1062-6050-46.5.514. The role of the clinical nurse specialist includes the following components: practitioner, leader, consultant, educator and researcher. Purpose: Demonstrates advanced knowledge and synthesis of therapeutic counselling modalities. -Secondary Care – involves preventing complications of disease conditions. 7. This mean engaging in practice and/or planning care for complex situations or complex client needs. Hold a current license as a registered nurse (RN). Demonstrates advanced health assessment and clinical decision-making within a clinical specialty. Position Paper on Advanced Clinical Nursing Practice. 6. Outcome Identifies and/or creates resources for learning. Clipboard, Search History, and several other advanced features are temporarily unavailable. The clinical nurse specialist (CNS) is an advanced practice nurse (APN) who serves as a clinical expert within a specialty population. Agreements: CNS is to have a collaborative practice agreement with one or more licensed physicians; this agreement designates the scope of practice/amount of autonomy specific to prescribing, monitoring, and managing drugs. The Clinical Nurse Specialist is a nurse with a Masters or Doctorate degree from a nursing program, with a clinical specialty area who functions in the sub-roles of practitioner, leader, consultant, educator, and researcher (Canadian Nurses Association, 1993). Nurse practitioner educators' perceived knowledge, beliefs, and teaching strategies regarding evidence-based practice: implications for accelerating the integration of evidence-based practice into graduate programs. 9. Client care is evidenced and reflects current knowledge. 1. 5. It implies the delivery of a complex set of services and the assumption of responsibility for obtaining special services as required by the patient, in a manner that is responsive to patients’ needs and cultural values (Smith, Forchuk, & martin, 1985). 8. Disseminates recent innovations and research findings relevant to nursing practice and client outcomes. Nursing research is integral to the development of nursing theory and nursing practice. -Criteria – a standard or principle by which a thing is judged. Glossary The CNS may clarify, recommend and/or educate. The domains of practice include advanced practice, consultation, education, research and leadership. Identifies individuals and systems facilitators and barriers to professional education. Perceptions of approved clinical instructors: barriers in the implementation of evidence-based practice. Domain of Leadership (You could belong to the same network as someone and never know it.) Clinical nurse specialists engage in three domains of practice, known as the three spheres of influence: 1. Outcome The employing system supports the identification of nurses’ learning needs APN focuses on the clinical domain in a wide array of practice settings.  |  There was widespread variability in the level of practice both within and between the CNC grades as well as significant differences in job content. Melnyk BM, Fineout-Overholt E, Feinstein NF, Sadler LS, Green-Hernandez C. J Prof Nurs. The master's-level EBP competencies can be transposed on a crosswalk of the ACE Star Model and the 5 CNS practice domains to form a matrix representing the influence that CNSs can have over the EBP process. 9. -Specialty – a defined area of clinical or functional nursing practice requiring a narrowed focus and in-depth knowledge and skills to meet the full range of client needs in that area of nursing (College of Nurses of Ontario, 1987). While providing direct care, the CNS may consult with other nurses and modify a plan of care to conform to evidence-based recommendations within each specialized nursing practice. Demonstrates advanced knowledge and synthesis of theory related to consultation for individuals, groups and systems. What is the CNS credential? The employing agency/system supports the identification and referral of clients with complex needs. Several provincial Interest Groups drafted standards for the sub-roles. July 1, 2020. Maintains membership in provincial, federal and/or international professional associations. The CNS: 9. 4. The CNS provides linkages between systems and transcends traditional boundaries. Collaborates in the development of strategic and program planning and evaluation to foster innovation. Demonstrates advanced knowledge and synthesis of advanced nursing practice within a clinical specialty. The emphasis on each Pillar at a particular level of the framework will vary according to specific roles e.g. The CNS contributes to the research process through application of research findings and may develop and implement research projects. 6. Identifies learning issues and problems, and assists nurses in strategizing and solving problems related to learning. The role of the Clinical Nurse Specialist as an advanced practitioner is based on autonomy of practice, in-depth theoretical nursing knowledge, clinical experience, and research application. Demonstrates advanced knowledge and synthesis of negotiation and conflict resolution. 6. The CNS may work independently with other nurses or in collaboration with other disciplines or caregivers. -Smith, R.H., Forchuk, C., & Martin, M-L. (1985). 2. Nurses and others will demonstrate the acquisition of knowledge and skills in their clinical practice. The Clinical Nurse / Midwife Consultant provides expert clinical advice to patients, carers and other health care professionals within a defined specialty. For example, client services received from a family practice agency or public health service. • Domain of Leadership May participate in research projects. 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. Guaranteed to raise your score. 2. 1. NIH Position Paper on the Clinical Nurse Specialist. Each competency falls well within the practice domains of the CNS, making the CNS an ideal person to lead the EBP movement forward, providing tangible outcomes to further demonstrate the need for the CNS role. -Primary Care – the first level of contact and maintenance within the health care system. 2013 May-Jun;48(3):382-93. doi: 10.4085/1062-6050-48.1.18. Influences the quality of nursing practice. Issues Compr Pediatr Nurs. 10. New CNL Innovative Project Award. The domains of practice did not appear to have played a central role in the design of these CNC roles despite being defined in the industrial legislation and linked to a pay structure. 13. All other domains of practice draw upon advanced practice. 3. Overcoming barriers to implementation of evidence-based practice concepts in athletic training education: perceptions of select educators. Fenton (1984, 1985) studied CNSs, whereas Brykczyn- ski … 1. Clinical practice includes both direct client care and indirect ... the CNS and NP. May be appointed or cross-appointed to a university or college. 1. Promotes an intra-and inter-disciplinary collaborative approach in clinical decision-making by: Clarifies different perceptions of stakeholders. May develop collaborative research proposals in his/her clinical nursing specialty, as a primary investigator or co-investigator. 1. The ACE Star Model conceptualizes the knowledge transformation that must occur in an EBP environment as 5 distinct points: discovery, summary, translation, integration, and evaluation. Although there are variations in the implementation of the subroles, this implementation always includes the practitioner subrole. 6. Fundamental to these competencies is that the CNS maintains clinical CNS Domains of Practice COVID-19 is an emerging, rapidly evolving situation. Due to the wide range of specialties in which CNSs practice, these competencies reflect CNS practice across all specialties, populations, and settings. Check out one of our sample CNS practice tests, absolutely free. These two roles evolved from different roots. • Domain of Consultation Although there are variations in the implementation of the subroles, this implementation always includes the practitioner subrole. 2. -National Council of State Board of Nursing, Inc. (1986). 2008 Jan-Feb;24(1):7-13. doi: 10.1016/j.profnurs.2007.06.023. These drafts were revised through national consultation. -Quadertiary Care – a highly complex health care available only in a few centres. Environmental Support for Advanced Practice Background: CNSs first emerged in the 1970s as client care grew more complex. -College of Nurses of Ontario (1987). 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. The CNS: practice domain, and the enviro nment domain. Patient/Client SphereWithin the patient/client sphere, the clinical nurse specialist engages in direct patient care in a variety of settings, including acute care, private practice, or community clinics. The employing agency/system shares accountability for inter- and intra-professional communication and planning for optimal health care. Nursing’s Social Policy Statement. The Clinical Nurse Specialist role was introduced to the Canadian health care system in the early 1970’s. 2. -Kaplan, S.M. Clinical Nurse Specialists work within complex systems. Print or eBook. The domains of practice did not appear to have played a central role in the design of these CNC roles despite being defined in the industrial legislation and linked to a pay structure. a) Demonstrating interpersonal communication and leadership skills to promote collaborative care among various disciplines in hospital and/or community. -Canadian Nurses Association (1994). Performance Standards Clients demonstrate optimum health In RCH we plan to shine a light on CNS within teams and organisationally. The Certified Nutrition Specialist® credential (CNS®) is the most advanced certification for personalized nutrition practitioners. Participates in learning needs assessment related to the professional development of nurses and others. 1.   - American Nurses Association (1995). Clients may be individuals, groups, families, communities, or populations. Navigating the evidence-based practice maze. This guide provides NUM and applicants with clear organisational expectations of the CNS role. 2008 May;16(4):409-16. doi: 10.1111/j.1365-2834.2008.00860.x. The environmental supports required for optimal enactment of each domain of practice are listed below: Demonstrates and promotes critical thinking which leads to the formulation of research questions and hypotheses. The practice setting promotes ongoing learning of nurses. Presents rounds and/or workshops on areas of expertise at local, regional, provincial, national and/or international forums. 1. Certification Program: An Information Booklet. -Advanced Practitioner - one who exhibits in-depth expert competency and in-depth knowledge of nursing and related sciences to provide quality nursing care to individuals, families, groups and community. The CNS uses advanced knowledge and skills to assist in clarifying issues, exploring options, facilitating change, creating new possibilities. Advanced Practice Nursing Roles Clinical Nurse Specialist vs Nurse Practitioner …How to decide the right role for you… Clinical Nurse Specialist (CNS) Nurse Practitioner (NP) What is… A Clinical Nurse Specialist (CNS) is an expert clinician who works in a specialized area of nursing practice. 7. 4. 8. The domain: A community of practice is not merely a club of friends or a network of connections between people. 7. 5. The Clinical Nurse Specialist facilitates the empowerment of clients related to public policy issues. The CNS's practice can be organized around 5 domains: expert practitioner, researcher, consultant, educator, and leader. Expands the scientific base of nursing practice by utilizing, facilitating, and conducting research in nursing and other disciplines. A clinical nurse specialist is a registered nurse who holds at least a masters degree in nursing and has expertise in a clinical nursing specialty (Canadian Nurses Association, 1986). Acts as a role model demonstrating advanced nursing practice. Flexibility in job description to capitalize on opportunities for leadership. CNS: A CNS is registered nurse with advanced nursing knowledge and skills in making complex decisions who holds a master’s or doctoral degree in nursing with expertise in a clinical nursing specialty. Performance Standards -Client – an individual, group, family, or community who receives the services of another who is qualified to provide this service. -Domains of Practice – (advanced practice, consultation, education, research, and leadership) are an organizing framework for the description of clinical nurse specialist performance. -Tertiary Care – complex health care available only in specialized health care agencies.