I support the Virginia Association of Clinical Nurse Specialists’ petition to revise regulations governing the practice authority for the Clinical Nurse Specialist (CNS) in the Commonwealth of Virginia.  Clinical Nurse Specialists are one of the four categories of advanced practice nurses (APRN) that provide expert advanced care to patients each with different practice characteristics.  However, as an advanced practice nurse the goal of the CNS is to meet the health needs of patients, families, populations, and communities.    The CNS is differentiated from other APRNs by our overarching competencies directed at enhancement of professional nursing practice and improving patient outcomes.  Nevertheless, we are at a standstill due to the current practice limitations. As APRNs, CNSs are an integral member of the healthcare system, which if allowed to practice to the full scope of practice are well suited to meet the ever increasing complex and diverse needs of the patient, family, systems, and communities.  Which would also meet the industry and societal directives to evolve nursing practice and improve patient outcomes across the continuum of care.  Given the current state of health in the United States it is imperative that we (CNSs) are allowed to practice to the full extent of training to help alleviate the burden of the health crisis within the United States.  So, I urge the Virginia Board of Nursing to thoroughly and objectively consider this request which will begin alignment with the tenets of the Consensus Model for APRN Regulation (2008), the National CNS practice standards, and neighboring states but most importantly will prioritize the health outcomes of Virginians.