As a Clinical Nurse Specialist (CNS) in Virginia, I am in support of changes petitioned to the Board of Nursing to recognize CNSs as Advanced Practice Registered Nurses (ARRN) in Virginia and grant licensure rather than registration. Recognition of the CNS as an APRN is consitstent with the American Nurses Credentialing Center's (ANCC) support of the position. CNS practice in Virginia is inconsistent with other states across the nation. The Institute of Medicine (IOM) report: The Future of Nursing: Leading Change, Advancing Health supports APRNs nationwide to practice to the fullest extent of their education, which is not currently happening in Virginia. As health care reform becomes a reality, rapid change will need to take place. With millions of Americans entering the health care system for the first time, we will see a shortage of nurses and providers in the near future. Those willing and able to provide care to will require support from their peers within the healthcare industry as well as from our government officials in order to meet the demands that will be required.

I am in support of the changes requested on this petition.

As a Clinical Nurse Specialist (CNS) in Virginia, I am in support of changes petitioned to the Board of Nursing to recognize CNSs as Advanced Practice Registered Nurses (ARRN) in Virginia and grant licensure rather than registration. Recognition of the CNS as an APRN is consitstent with the American Nurses Credentialing Center's (ANCC) support of the position. CNS practice in Virginia is inconsistent with other states across the nation. The Institute of Medicine (IOM) report: The Future of Nursing: Leading Change, Advancing Health supports APRNs nationwide to practice to the fullest extent of their education, which is not currently happening in Virginia. As health care reform becomes a reality, rapid change will need to take place. With millions of Americans entering the health care system for the first time, we will see a shortage of nurses and providers in the near future. Those willing and able to provide care to will require support from their peers within the healthcare industry as well as from our government officials in order to meet the demands that will be required.

I am in support of the changes requested on this petition.

My clinical practice as a CNS has targeted older adults across all settings for over 20 years. Currenty, I see patients who have early memory loss or early dementia. I have worked with older adults in the hospital, in long-term care, in adult day care, and now in an outpatient setting. Physicians and APNs refer to me regularly, but most of my referrals come from patients themselves. I am Medicare reimbursed and would see more patients if the CNS licensure in Virginia allowed that. My services are poorly reimbursed due to licensure issues, but because the service for older adults is so needed, and because I am a respected provider, the Carilion Clinic Center for Healthy Aging, continues to support the service I provide. As a graduate of a DNP (Doctor of Nursing Practice) program, I am also teaching undergraduate and master's nursing students. There are more requests to work with me in my clinic than I can honor. Yet the need for more nurses with geriatric training will continue to increase as Baby Boomers turn 65 this year and for the next 20 years. I am willing to serve but our great state of Virginia restricts my practice outside of the CNS role in most other states. I urge support of this regulation.

As an educator in Virginia, I support the changes petitioned to the Board of Nursing to recognize CNSs as Advanced Practice Registered Nurses (ARRN) in Virginia and grant licensure rather than registration. Recognition of the CNS as an APRN is consisttent with the American Nurses Credentialing Center's (ANCC) recommendations for CNS. CNS practice in Virginia is obsolete and prohibits CNS nurses to practice to the full scope of their education; described by the Institute of Medicine (IOM) report: The Future of Nursing: Leading Change, Advancing Health, which supports APRNs nationwide. I am in support of the changes requested on this petition.

As a Family and Geriatric Nurse Practitioner, I am in support of the changes petitioned to the Board of Nursing to recognize CNSs as Advanced Practice Registered Nurses (APRN) in Virginia and grant licensure rather than registration. Recognition of the CNS as an APRN is consitstent with the American Nurses Credentialing Center's (ANCC) support of the position. NP and CNS practice in Virginia is inconsistent with other states across the nation. The Institute of Medicine (IOM) report: The Future of Nursing: Leading Change, Advancing Health supports APRNs nationwide to practice to the fullest extent of their education, which is not currently happening in Virginia. As health care reform becomes a reality, rapid change will need to take place. With millions of Americans entering the health care system for the first time, we will see a shortage of nurses and providers in the near future. Those willing and able to provide care will require support from their peers within the healthcare industry as well as from our government officials in order to meet the demands that will be required.

I am in support of the changes requested on this petition

As a CNS with the underserved population of children with mental illness, I am able improve outcomes of patients and families.  I am limited in my scope of practice in this state because of regulations inconsistent with those of the majority of states.  I can not recommend more highly the approval of this petition, most especially in light of the national and statewide shortage of child mental health service providers.

As a Clinical Nurse Specialist (CNS) in Virginia who has practiced for over 25 years , I am in support of changes petitioned to the Board of Nursing to recognize CNSs as Advanced Practice Registered Nurses (ARRN) in Virginia and grant licensure rather than registration. Recognition of the CNS as an APRN is consitstent with the American Nurses Credentialing Center's (ANCC) support of the position. CNS practice in Virginia is inconsistent with other states across the nation. The Institute of Medicine (IOM) report: The Future of Nursing: Leading Change, Advancing Health supports APRNs nationwide to practice to the fullest extent of their education, which is not currently happening in Virginia. As health care reform becomes a reality, rapid change will need to take place, this is one of those changes required.

I have been practicing in the CNS role since 1990.  I am in support of the petition to recognize Clinical Nurses Specialists as an Advanced Practice Role (APRN) and grant licensure instead of regulation in the state of Virginia.  It is imperative that Virginia make this change in preparation for the looming healthcare changes in our country.

The State of Virginia recognizes with licensure several advanced practice nurses (APN's).  All APN's are BSRN's who have taken further studies to at least obtain a Master's Degree, often to become a Nurse Practictioner (NP).  In Virginia, Nurse Practitioners are licensed such that they can exam patients, diagnose diseases, and prescribe medications.  With the continued evolution of America's health care system, there will be a heavier demand for Nurse Practitioners, both in primary care and in the subspecialties.

However, Virginia will not license a Clinical Nurse Specialist, despite their advanced degree and despite their receving training very similar to the more common NP.  It seems odd to me and inappropriate that Virginia would license one variety of APN but not another, despite nearly identical skill sets and background training for the two different APN's.  Clinical Nurse specilatists should be able to function in the field as does an NP.

Therefore, I strongly support the petition that would expand the scope of practice and allow licensure  for Clinical Nurse Specialists, and I urge a favorable ruling on this petition.

38 states recognise CNS's as APRN's and I am sad to admit VA is not one of those states.  This needs to change, especially w/ the evolving health care crisis and the emphasis on mid-level providers.

Tiffany Clark MSN, RN, ACNS-BC, OCN

As a Clinical Nurse Specialist (CNS) in Virginia, I am in support of changes petitioned to the Board of Nursing to recognize CNSs as Advanced Practice Registered Nurses (ARRN) in Virginia and grant licensure rather than registration. Recognition of the CNS as an APRN is consistent with the American Nurses Credentialing Center's (ANCC) support of the position. CNS practice in Virginia is inconsistent with other states across the nation. The Institute of Medicine (IOM) report: The Future of Nursing: Leading Change, Advancing Health supports APRNs nationwide to practice to the fullest extent of their education, which is not currently happening in Virginia. As health care reform becomes a reality, rapid change will need to take place. With millions of Americans entering the health care system for the first time, we will see a shortage of nurses and providers in the near future. Those willing and able to provide care to will require support from their peers within the healthcare industry as well as from our government officials in order to meet the demands that will be required.

I am in support of the changes requested on this petition.

As a trained Clinical Nurse Specialist (CNS) , I am in support of changes petitioned to the Board of Nursing to recognize CNSs as Advanced Practice Registered Nurses (ARRN) in Virginia and grant licensure rather than registration. Recognition of the CNS as an APRN is consitstent with the American Nurses Credentialing Center's (ANCC) support of the position. Please follow the lead of the 36 states that support the CNS as an advanced practice nurse able to lbe a leader in managing the care of patients in the Commonwealth. 

I am in support of the proposed changes to recognize Clinical Nurse Specialist as Advance Practice Nurses.  With their education they in my opinion definately fall in that category.

I strongly support the petition that would expand the scope of practice and allow licensure for Clinical Nurse Specialists.

I support the petition for CNS's in Virginia to be recognized as Advanced practice nurses.

My Masters program prepared me as a CNS in critical care/trauma nursing. I was amazed to find, on moving to VA, that the CNS role is not licensed here, nor is it recognized to have APRN status. The formidable (and exciting) changes pending in healthcare suggest that it is a favorable time to examine and approve this role designation, already existing in many states to the benefit of our patients and colleagues.

I strongly support the VaCNS recently submitted petition to the Virginia State Board of Health to review the regulations regarding CNS practice in Virginia. The state's interpretation of CNS practice as being covered in nurse licensure would suggest that an associate degree nurse has the requisite skill sets to perform the duties of an advanced practice nurse: CNS as recognized by ANCC and the IOM. The changing population and the acuity of illness dictate advanced academic and clinical experience to meet the challenges ahead in the healthcare delivery system. The constituents/citizens of Virginia deserve the care of the CNS as an APRN. Thank you for consideration on this high priority need for the Commonwealth of Virginia.

As a Respiratory Therapist, I am in support of the changes petitioned to the Board of Nursing to recognize CNSs as Advanced Practice Registered Nurses (APRN) in Virginia and grant licensure rather than registration. Recognition of the CNS as an APRN is consitstent with the American Nurses Credentialing Center's (ANCC) support of the position. NP and CNS practice in Virginia is inconsistent with other states across the nation. The Institute of Medicine (IOM) report: The Future of Nursing: Leading Change, Advancing Health supports APRNs nationwide to practice to the fullest extent of their education, which is not currently happening in Virginia. 

I have personally seen CNSs make a valuable contribution in patient outcomes and the quality of care we are able to provide.

I am in support of the changes requested on this petition

As a Clinical Nurse Specialist (CNS) in Virginia, I am in support of changes petitioned to the Board of Nursing to recognize CNSs as Advanced Practice Registered Nurses (ARRN) in Virginia and grant licensure rather than registration. Recognition of the CNS as an APRN is consitstent with the American Nurses Credentialing Center's (ANCC) support of the position. CNS practice in Virginia is inconsistent with other states across the nation. The Institute of Medicine (IOM) report: The Future of Nursing: Leading Change, Advancing Health supports APRNs nationwide to practice to the fullest extent of their education and training. As health care reform becomes a reality, rapid change will need to take place to meet the growing health care needs of Virginians. With millions of Americans entering the health care system for the first time, we will see a shortage of nurses and providers in the near future. CNSs have a long and consistent history of providing high quality care and improved outcomes across patient populations and healthcare systems. The scope of practice for the CNS in the Commonwealth of Virginia is severely restricting and does not support the health care needs of our citizens.

I am in support of the changes requested on this petition.

I support the petition for CNS in the state of VA to be recognized as APRN.

I support the petition for CNS in the state of VA to be recognized as APRN.

As a Nurse Leader in Virginia, I am in support of changes petitioned to the Board of Nursing to recognize CNSs as Advanced Practice Registered Nurses (ARRN) in Virginia and grant licensure rather than registration. Recognition of the CNS as an APRN is consitstent with the American Nurses Credentialing Center's (ANCC) support of the position. CNS practice in Virginia is inconsistent with other states across the nation. The Institute of Medicine (IOM) report: The Future of Nursing: Leading Change, Advancing Health supports APRNs nationwide to practice to the fullest extent of their education, which is not currently happening in Virginia. As health care reform becomes a reality, rapid change will need to take place. With millions of Americans entering the health care system for the first time, we will see a shortage of nurses and providers in the near future. Those willing and able to provide care to will require support from their peers within the healthcare industry as well as from our government officials in order to meet the demands that will be required.

I am in support of the changes requested on this petition.

As a Family Nurse Practitioner, I am in support of the changes petitioned to the Board of Nursing to recognize CNSs as Advanced Practice Registered Nurses (APRN) in Virginia and grant licensure rather than registration. Recognition of the CNS as an APRN is consitstent with the American Nurses Credentialing Center's (ANCC) support of the position. NP and CNS practice in Virginia is inconsistent with other states across the nation. The Institute of Medicine (IOM) report: The Future of Nursing: Leading Change, Advancing Health supports APRNs nationwide to practice to the fullest extent of their education, which is not currently happening in Virginia. As health care reform becomes a reality, rapid change will need to take place. With millions of Americans entering the health care system for the first time, we will see a shortage of nurses and providers in the near future. Those willing and able to provide care will require support from their peers within the healthcare industry as well as from our government officials in order to meet the demands that will be required.

I am in support of the changes requested on this petition

As a Registered Nurses and Nurse Practitioner student, I am in support of the changes petitioned to the Board of Nursing to recognize CNSs as Advanced Practice Registered Nurses (APRN) in Virginia and grant licensure rather than registration. Recognition of the CNS as an APRN is consitstent with the American Nurses Credentialing Center's (ANCC) support of the position. NP and CNS practice in Virginia is inconsistent with other states across the nation. The Institute of Medicine (IOM) report: The Future of Nursing: Leading Change, Advancing Health supports APRNs nationwide to practice to the fullest extent of their education, which is not currently happening in Virginia. As health care reform becomes a reality, rapid change will need to take place. With millions of Americans entering the health care system for the first time, we will see a shortage of nurses and providers in the near future. Those willing and able to provide care will require support from their peers within the healthcare industry as well as from our government officials in order to meet the demands that will be required.

I am in support of the changes requested on this petition

As an Emergency Management Coordinator in a rural part of the state, I am priviledged to serve many disadvanted people in our local area. With a growing population and more needs than available providers, it is crucial to utilize our current resources to their maximum ability. There are many opportunities to serve and Advanced Practice Registered Nurses (APRNs) could work to their full potential with the changes proposed in this petition.

I support this petition to recognize and grant licensure to CNSs in the state of Virginia.

As a Clinical Nurse Specialist (CNS) in Virginia, I am in support of changes petitioned to the Board of Nursing to recognize CNSs as Advanced Practice Registered Nurses (ARRN) in Virginia and grant licensure rather than registration. Recognition of the CNS as an APRN is consitstent with the American Nurses Credentialing Center's (ANCC) support of the position. CNS practice in Virginia is inconsistent with other states across the nation. The Institute of Medicine (IOM) report: The Future of Nursing: Leading Change, Advancing Health supports APRNs nationwide to practice to the fullest extent of their education, which is not currently happening in Virginia. As health care reform becomes a reality, rapid change will need to take place. With millions of Americans entering the health care system for the first time, we will see a shortage of nurses and providers in the near future. Those willing and able to provide care to will require support from their peers within the healthcare industry as well as from our government officials in order to meet the demands that will be required.

I am in support of the changes requested on this petition.

As a Board Certified (by ANCC) CNS in Virginia, I support the Virginia Clinical Nurse Specialist organization (VaCNS)  petition to the Virginia State Board of Health requesting a review of the regulations regarding CNS practice in Virginia. The ever increasing population of older adults and the uninsured demands that all nurses with advance degress be allowed to practice to the full extent of their education. The recent release of the Institutes of Medicine's Future of Nursing addresses these issues. CNS's should be granted Advance Practice Licensure consistent with ANCC recommendations.

The Clinical Nurse Practitioner is an invaluable resource to the healthcare team, and should be allowed to practice to the fullest extent of their skill and educational abilities. I have worked with several highly skilled and knowledgeable practitioners in my 19 years as a registered nurse, and have found their services exceptional to the advancement of patient care. I challenge each of you to make this a reality for clinical nurse specialist as each of you are charged to be the advocates for each of your constituents!

The Clinical Nurse Practitioner is an invaluable resource to the healthcare team, and should be allowed to practice to the fullest extent of their skill and educational abilities. I have worked with several highly skilled and knowledgeable practitioners in my 19 years as a registered nurse, and have found their services exceptional to the advancement of patient care. I challenge each of you to make this a reality for clinical nurse specialist as each of you are charged to be the advocates for each of your constituents!

I am in support of the changes requested on this petition.

The Clinical Nurse Specialist is an invaluable resource to the healthcare team, and should be allowed to practice to the fullest extent of their skill and educational abilities. As a Registered Nurse, I have worked with several highly skilled and knowledgeable CNSs and have found their services exceptional to the advancement of patient care. I challenge each of you to make this a reality for clinical nurse specialist.

I am in support of the changes proposed by this petition.

The Clinical Nurse Specialist is an invaluable resource to the healthcare team, and should be allowed to practice to the fullest extent of their skill and educational abilities. As a Registered Nurse, I have worked with several highly skilled and knowledgeable CNSs and have found their services exceptional to the advancement of patient care. I challenge each of you to make the requests in this petition a reality for our state's CNSs.

I am in support of the changes proposed by this petition.

I longed wished that someone in our government had the tonsillar stones to pass this petition.

The Clinical Nurse Specialist is an invaluable resource to the healthcare team, and should be allowed to practice to the fullest extent of their skill and educational abilities. As a Registered Nurse, I have worked with several highly skilled and knowledgeable CNSs and have found their services exceptional to the advancement of patient care. I challenge each of you to make the requests in this petition a reality for our state's CNSs.

I am in support of the changes proposed by this petition.

The Clinical Nurse Specialist is an invaluable resource to the healthcare team, and should be allowed to practice to the fullest extent of their skill and educational abilities. As a Registered Nurse, I have worked with several highly skilled and knowledgeable CNSs and have found their services exceptional to the advancement of patient care. I challenge each of you to make the requests in this petition a reality for our state's CNSs.

I am in support of the changes proposed by this petition.

This could go a long way for us, especially important when dealing with various issues, like tonsil stones. In this environment would would so hard to get this done.

As an RN who is preparing to sit for the Clinical Nurse Specialist (CNS) board exam in Virginia, I am in support of the changes petitioned to the Board of Nursing to recognize CNSs as Advanced Practice Registered Nurses (APRN) in Virginia and grant licensure rather than registration. This would be consistent with the support  of the recognition of the CNS as an APRN by the American Nurses Credentialing Center (ANCC). CNSs need to be allowed to practice to the fullest extent of their education, especially as more Americans are expected to be entering the healthcare system, often with multiple disease processes and health issues that a CNS could be of invaluable assistance in managing.

I received my Masters in Science degree in the Clinical Nurse Specialist track about 20 years ago and have been practicing in a role that has required this degree for over 15 years.  I am also recognized by the American Nurses Credentialing Center as a board-certified CNS.  As you are aware, in the state of Virginia, one can become registered, but not licensed, as a Clinical Nurse Specialist.  This limitation significantly impacts the CNS's contribution to patient outcomes in all settings.  The recent release of the IOM report raised concerns regarding the current state of Registered Nurses working to their full potential, in an effort to optimize patient outcomes.  I STRONGLY encourage the Commonwealth to take a proactive position in supporting our patient outcomes, and addressing the IOM concerns, by favorably accepting  this petition.

Virginia is one of the few states who does not recognize the full scope of practice of APRNs in general, and CNSs in specific.  In many other states CNSs are licensed to prescribe medications, and this should be in their scope in VA as well.  I fully support recognizing CNSs as APRNs and continuing to make regulations that reflect the full training and scope of practice of all APRNs.

 I am in support of changes petitioned to the Board of Nursing to recognize CNSs as Advanced Practice Registered Nurses (ARRN) in Virginia and grant licensure rather than registration. Recognition of the CNS as an APRN is consitstent with the American Nurses Credentialing Center's (ANCC) support of the position. CNS practice in Virginia is inconsistent with other states across the nation. The Institute of Medicine (IOM) report: The Future of Nursing: Leading Change, Advancing Health supports APRNs nationwide to practice to the fullest extent of their education, which is not currently happening in Virginia. As health care reform becomes a reality, rapid change will need to take place. With millions of Americans entering the health care system for the first time, we will see a shortage of nurses and providers in the near future. Those willing and able to provide care to will require support from their peers within the healthcare industry as well as from our government officials in order to meet the demands that will be required.

I am in support of the changes requested on this petition.

I am in support of the proposal to recognize CNSs as Advanced Practice Registered Nurses (ARRN) in Virginia and grant licensure rather than registration. The current process is inconsistent with similar processes in other states across the nation. We have to remember that there are millions of Americans entering the health care system for the first time, we are already seeing a shortage of nurses and providers. Change is needed now.

I am in support of the changes being petitioned for.

James Hamilton

Positive insites

I urge you to vote for CNS to be recognize our CNS as APN. They are truly an assett at our facility and to myself as well as other nurses that I work with.

I am in support of the petition ro recognize and license the CNS as an APRN in the Commonwealth of Virginia.

 I am in support of changes petitioned to the Board of Nursing to recognize CNSs as Advanced Practice Registered Nurses (ARRN) in Virginia and grant licensure rather than registration. Recognition of the CNS as an APRN is consitstent with the American Nurses Credentialing Center's (ANCC) support of the position. CNS practice in Virginia is inconsistent with other states across the nation. The Institute of Medicine (IOM) report: The Future of Nursing: Leading Change, Advancing Health supports APRNs nationwide to practice to the fullest extent of their education, which is not currently happening in Virginia. As health care reform becomes a reality, rapid change will need to take place.

I strongly support the recently submitted petition to the VA Board of Nursing to recognize and provide licensure to Clinical Nurse Specialists (CNS) as Advanced Practice Registered Nurses. This recommendation has been endorsed by the American Nurses Credentialing Center and the Institute of Medicine and will allow the CNSs in Virginia to practice to the full extent of their advanced education, so necessary in today’s healthcare climate.

The Clinical Nurse Specialist is an invaluable resource to the healthcare team, and should be allowed to practice to the fullest extent of their skill and educational abilities. As a Registered Nurse, I have worked with several highly skilled and knowledgeable CNSs and have found their services exceptional to the advancement of patient care. I challenge each of you to make this a reality for Clinical Nurse Specialists.

I am in support of the changes proposed by this petition.

The Clinical Nurse Specialist is an invaluable resource to the healthcare team, and should be allowed to practice to the fullest extent of their skill and educational abilities. As a Registered Nurse, I have worked with several highly skilled and knowledgeable CNSs and have found their services exceptional to the advancement of patient care. I challenge each of you to make this a reality for clinical nurse specialist.

I am in support of the changes proposed by this petition.

The Clinical Nurse Specialist is an invaluable resource to the healthcare team, and should be allowed to practice to the fullest extent of their skill and educational abilities. As a Registered Nurse, I have worked with several highly skilled and knowledgeable CNSs and have found their services exceptional to the advancement of patient care. I challenge each of you to make this a reality for clinical nurse specialist.

I am in support of the changes proposed by this petition.

The Clinical Nurse Specialist is an invaluable resource to the healthcare team, and should be allowed to practice to the fullest extent of their skill and educational abilities. As a Registered Nurse, I have worked with several highly skilled and knowledgeable CNSs and have found their services exceptional to the advancement of patient care. I challenge each of you to make this a reality for clinical nurse specialist.

I am in support of the changes proposed by this petition.