I support the Virginia Association of Clinical Nurse Specialists petition to revise the regulations governing Clinical Nurse Specialist (CNS) registration and practice. I’m a fairly new adult-gerontology CNS, and it has been extremely challenging to find a CNS position due to Virginia’s limited scope of CNS practice. In my opinion, this limitation in CNS scope of practice is directly linked to the lack of CNS positions and employer awareness about the CNS role. As a result, this forces some of us to continue to work in our RN roles or take CNS like positions that pay at a RN level, which is very frustrating because we can’t work to our full potential or get paid to function close to a CNS. Other CNSs that are lucky to work in CNS roles in Virginia don’t have prescription authority, which also limits their practice.

CNSs are advanced practice nurses with advanced education and training in their selected patient populations (adult-gerontology, pediatrics, etc.). CNSs engage in three domains of influence: patient, nursing, and system/organization. CNSs use advanced nursing knowledge and skills to oversee their patients’ care. This allows for appropriate recommendations to be made that improve the patients’ health as well as develop interventions that can be implemented to bridge gaps in their care. The CNSs functions are as follows: provide education to nursing staff and patients/family; provide evidence-based recommendations by consultation and coaching of nursing staff and other healthcare professionals; collaborate with an interprofessional team about the care of patients while keeping the principles of ethics in mind. CNSs have advanced knowledge that allows them to be change agents in their organizations by reducing readmissions and organization costs as well as improve the patients care, health, and quality of life.

Unfortunately, limited CNS practice limits what we can do for Virginians as well as limits their access to care. With the recent drop in primary care providers the demand for providers will increase and there will be more challenges with caring for a patient population that is living longer with complex medical conditions. However, if we were allowed to practice to our full scope it will help mitigate these challenges in the near future.