I support the Virginia Association of Clinical Nurse Specialists’ petition to revise regulations related to registration and practice authority for Clinical Nurse Specialists (CNS) in the state. The proposed revisions will decrease and/or eliminate barriers to scope of practice for CNSs in Virginia. The Consensus Model for Advanced Practice Registered Nurses (APRN) (2008) was published by the National Council of State Boards of Nursing (NCSBN) to provide nationally recognized standards of practice and licensure for APRNs in all states.  Yet, Virginia has not fully adopted the Consensus Model related to the CNS, thereby creating barriers to scope of practice.  These barriers to scope of practice are depriving citizens of the commonwealth with access to comprehensive medical care and services from this APRN. This is particularly true in rural areas of the state that have limited medical resources and healthcare providers.  Additionally, the prevalence of individuals suffering from chronic disease conditions in Virginia makes this petition for CNS full practice authority (i.e., prescriptive authority) a priority to combat the growing epidemic.  Those suffering from chronic diseases currently account for the majority of healthcare associated costs in the country.  The National Association of Clinical Nurse Specialists (2017) and the Institute of Medicine (2010) support full scope of practice for CNSs to address the growing epidemic of chronic diseases.   

CNSs have the education and training, as well as national certification, to practice and be recognized as an APRN.  The CNS role is influential within three spheres of the healthcare system – patient, nurse, and organization.  The uniqueness of the role’s influence and expertise in clinical care make the CNS a valuable asset to healthcare in Virginia.  This petition to revise regulations governing CNS practice will add to the role’s value and have a positive impact on healthcare throughout the state. I urge your strong support of this petition which will provide a win-win situation for everyone - nurses, APRNs, healthcare organizations, and the citizens of Virginia.