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Clinical Nurse Specialists: Guardians of Nursing Practice


Powers, Jan PhD, RN, CCNS, CCRN, NE-BC, FCCM, FAAN

doi: 10.1097/NUR.0000000000000651


The importance of nursing practice for improving patient outcomes has never been more evident. The integral role of the Clinical Nurse Specialist (CNS) in advancing nursing practice and ensuring high-quality care continues to be essential. The CNS has always focused on advancing nursing science and practice. We have often heard reference to CNSs as the guardians of nursing practice.

Many factors are at play that will change the nature of nursing. Hospital nurses have typically worked 12-hour shifts, three days a week. Physician providers might be on service for a week and then not again for several weeks. These schedules are not necessarily congruent with ensuring continuity and consistency with patient care. There is a reckoning that must take place. Who better to lead a meaningful discussion on this role than a CNS?

Even before the pandemic, many nurses were leaving the bedside. The Covid-19 pandemic has caused many experienced nurses to depart the workforce for retirement or to find new vocations. This exodus has resulted in fewer new nurses at the bedside and fewer mentors to guide that smaller number. We have also seen an exponential increase in traveling nurses, registry or other transient nurses in the workforce. As we anticipate ongoing workforce challenges in nursing, there is an even greater need for CNSs to ensure high-quality, evidence-based care is delivered. CNSs are in a unique position to have a unit or population-level focus, essentially becoming the nurse intensivist or hospitalist who can round on patients, provide direct patient care, ensure evidence-based guidelines are being followed, and verify consistency and continuity of nursing care. A CNS can provide micro and macro perspectives to organizations. They provide individual complex care, making sure patients receive high-quality care in addition to developing system-level, evidence-based care standards. CNSs must verify that patient care is not compromised as a result of our changing workforce. CNSs are the APRN role focusing on nursing care and nursing science. In so doing, we can rise and continue to demonstrate the importance of nursing practice and the value of the CNS role.










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Thank you so much for an amazing conference in Wellington, awesome speakers, fabulous colleagues and great memories.

hopefully we can keep the channels of communication between us all open and active, it would be amazing to hear from others working in the same area to hear about all the fabulous things are happening around the regions

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Hi Lucy thx for the fab feedback, we were blown away how it all turned out! Elly is sending out a survery monkey feedback form early next week and we will put results on website. Thx for your support Tracey CNSSNZ committe

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