As a practicing Clinical Nurse Specialist (CNS) in the Commonwealth of Virginia I am writing to request reconsideration for the CNS role to allow full practice authority. The CNS is uniquely skilled (and trained) to be a practice expert within a particular patient population. Our role is dynamic, allowing us to optimize care and prevent and reduce patient complications in a complex and ever changing care environment. Currently, Virginia is overly restrictive of the CNS practice, recognizing the role as an APRN but denying the privileges afforded to our APRN counterparts. This limits CNS practice and ability to serve patients, healthcare teams, and systems at the highest levels. 36/50 states have granted the CNS role full authority; it’s time for the Commonwealth to follow suit.