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.