I am supportive of revising the current clinical nurse specialists regulations based upon the Consensus Model for APRN Regulations. By adopting the language of this model, the VIrginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs) including clinical nurse specialists. Thank you for your consideration.

I am supportive of revising the current Clinical Nurse Specialists regulations based upon the

. By adopting the language of this model, the VIrginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs), including Clinical Nurse Specialists,  to meet the growing health care needs of the Commonwealth. Thank you for your consideration.

I am also in support of revising the regulations for CNS in accordance with the Consensus Model for APRN Regulations below:

By adopting the language of this model, the VIrginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs), including Clinical Nurse Specialists, to meet the growing health care needs of the Commonwealth. Thank you for your consideration.

I agree that it is time that the Virginia Board of Nursing ammend the regulations to grant Clinical Nurse Specialist the recognition of Advanced Practice Nurse status. Many of the CNS's in my home site have attained the DNP status through hard work and dedication to the job. Our desire  is to remain focused on the patient and maintain a strong education component to our practice. As the need for patient understanding of directions (whether medicines, treatments, services, etc.) increases in the current health care focus it is imperative that the CNS be recognized as providing this invaluable service. Nursing has been recognized by the community for the service that individuals provide and as a group the CNS practitioners need to be recognized as a peer with other Advanced Practice Nurses as more of us work collaboratively with medical and health care professionals meeting unique needs for our patient population. Thank you for your consideration.

I support revising the current clinical nurse specialists regulations based upon the Consensus Model for APRN Regulations. By adopting the language of this model, the VIrginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs) including clinical nurse specialists. It is long overdue in Virginia. Thank you for your time on this important matter, Patrick Coyne  MSN, FAAN

I support revising the current clinical nurse specialists regulations based upon the Consensus Model for APRN Regulations. By adopting the language of this model, the VIrginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs) including clinical nurse specialists. It is long overdue in Virginia. Thank you for your consideration.

In Support of Revising the CNS Regulations

I  support revising the regulations for CNS in accordance with the Consensus Model for APRN Regulations below:

By adopting the language of this model, the VIrginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs), including Clinical Nurse Specialists, to meet the growing health care needs of the Commonwealth. Thank you for your consideration.

As healthcare is moving to a new model of delivery with the Accountable Care Organizations (ACOs), Clinical Nurse Specialists will be able to contribute greatly to the transition as well as promote seamless care for the patients within an organization.  As we move closer to the 2015 APN  Regulatory Model, this is a significant step that aids CNSs and all levels of nurses to work to their respective scopes of practice.  Please support these regulation changes as advancing nursing practice.

I am supportive of revising the current Clinical Nurse Specialist regulations based upon the Consensus Model for APRN Regulations. By adopting the language of this model, the VIrginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs), including Clinical Nurse Specialists, to meet the growing health care needs of the Commonwealth. Thank you for your consideration.

I am supportive of revising the current Clinical Nurse Specialist regulations based upon the Consensus Model for APRN Regulations. By adopting the language of this model, the VIrginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs), including Clinical Nurse Specialists, to meet the growing health care needs of the Commonwealth. Thank you for your consideration.

CNSs are advance practice registered nurses, a vital part of the health care team and recognized as APRNs in the new LACE model and in the Model Nurse Practice Act and Regulations of the National Council of Boards of Nursing.  Now is the time to get the states' statutes and administrative rules in order.  2015 is right around the corner.  CNSs MUST be officially recognized as APRNs in each state and allowed, indeed, protected, to practice their profession to the fullest extent as called for in the Institute of Medicine's Report on the Future of Nursing. 

It is time to drop the turf wars and come together as a nation for the benefit of our patients and yes, for ourselves when we are patients.  I'm sure YOU would want the best care possible delivered by these nurses.  Make it happen!  Vote yes on this regulatory action.

Wailua Brandman MSN APRN-Rx PMHCNS/NP-BC FAANP

Clinical Director, Ke`ena Mauliola Nele Paia LLC

Immediate Past President, Hawai`i Association of Professional Nurses

Member, APRN Advisory Committee, Hawai`i Board of Nursing

I fully endorse the effort of the Virginia Board of Nursing to revise the regulatory language regarding Clinical Nurse Specialist practice, recognizing Clinical Nurse Specialists as Advanced Practice Registered Nurses. This move is consistent with current national initiatives, specifically the APRN Consensus Model and the most recent Institute of Medicine Report. Clinical Nurse Specialists are prepared as advanced practitioners as substantiated by the APRN Consenus Model. The Commonwealth will promote competent, quality care (and access to such care) through ensuring consistency in the licensure, accreditation, certification, and education of advanced practice nurses by supporting this regulatory effort.

I support the changes in the Clinical Nurse Specialist regulations. I believe that clilnical nurse specialist should be allowed to practice to the full scope of their nursing practice as outoined in the APRN guidelines.  As the public as gained more access to care given by APRNs including Clinical Specialists, the demand is increasing.  This is reflected in my own multidisciplinary private practice9 Family Therapy Center)  in which the providers most requested are the Psychiatric Nurse Clinicl Specialists. Patients like the fact that their therapist  can treat them in a wholistic way , integrating physical and emotional needs, as well as coordinating care with other providers, in other words, using the Nursing Process, to treat individuals and families throughout the lifespan.

I support the revision of the current Clinical Nurse Specialist regulations based upon the Consensus Model for APRN Regulations.  Why has it taken so long for this state to "come up the plate" in regards to CNS's and their role as APRN's??  This Model will clarify the role and cement the requirements for CNS. 

CNSs are advanced practice registered nurses, a vital part of the health care team and recognized as APRNS in the new LACE model and the Model Nurse Practice Act and Regulations of the National Council of the Boards of Nursing. CNSs must be officially recognized as APRNs in each state, and allowed, indeed, protected, to practice their profession to the fullest extent as called for in the Institute of Medicine's Report on the Future of Nursing. I fully support regulatory action in Virginia and all states to recognize CNSs as APRNs.  

Many states, including Ohio, already recognize CNS as an APRN.  I am a CNS and APRN with prescriptive authority practicing child-adolescent psychiatric mental health in the state of Ohio. In the Ohio Revised Code 4723.01, advanced practice nurses are defined as "certified registered nurse anesthetist, clinical nurse specialist, certified nurse-midwife and certified nurse practitioner".  I feel that it is vital that all states, including Virginia, recognize CNS as an APRN for the access to medicine, safety and welfare of all patients.

Respectfully submitted,

Sally Hough, MS, APRN, PMHCNS-BC

CNSs are advance practice registered nurses, a vital part of the health care team and recognized as APRNs in the new LACE model and in the Model Nurse Practice Act and Regulations of the National Council of Boards of Nursing.  By adopting the language of the LACE model, the VIrginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs), including Clinical Nurse Specialists, to meet the growing health care needs of the Commonwealth.  

CNSs MUST be officially recognized as APRNs in each state and allowed, indeed, protected, to practice their profession to the fullest extent as called for in the Institute of Medicine's Report on the Future of Nursing and meet the mental health needs of the community.

Thank you for your consideration,

Dr. Cynthia Taylor Handrup, DNP, APN

I am supportive of revising the current Clinical Nurse Specialists regulations based upon the

Consensus Model for APRN Regulations

. By adopting the language of this model, the VIrginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs), including Clinical Nurse Specialists,  to meet the growing health care needs of the Commonwealth. Thank you for your consideration.

Please expedite this process; it is important for the health of the state of Virginia.

Providing the title of APRN for all advanced practice nurses including clinical nurse specialists will provide a simple uniform term for the public to understand that they are asking for and utliizing an advanced practice nurse.  This title will also release much energy for actually doing the work rather than talking about who is doing it and explaining to clients seeking our valued services who and what we are.

Maureen H. McCracken, PMHCNS, BC

Integrative Psychotherapist

I am writing to endorse the inclusion of clinical nurses specialists as advanced practice registered nurses in Virginia rules governing nursing practice. This important group of nurse specialists makes a large and very important contribution to the health and well-being of patients and their families throughout our nation. Each state must take action to recognize their status as APRNs to assure their ongoing ability to provide critically important health services. My own state, Iowa, has recognized the CNS as an APRN (called ARNP in our license) for over 10 years and it has proven to be very effective. I urge you to approve this important policy.

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I support revising the regulations for CNS in accordance with the Consensus Model for APRN Regulations below:

By adopting the language of this model, the VIrginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs), including Clinical Nurse Specialists, to meet the growing health care needs of the Commonwealth. Thank you for your consideration.ype over this text and enter your comments here. You are limited to approximately 3000 words.

CNSs are a vital part of the health care team and must be offically recognized as Advanced Practice Registered Nurses in each state. Regulations are imperative to support their ability to practice to the full extent  (reference: IOM Report on the Future of Nursing). Vote "Yes" to support the provision of quality care to the citizens of your state.

Betsy Brach, PhD, MSN, APRN-PMH

Bethesda, MD

In Indiana, CNS title, education and expertise are recognized as Advanced Practice in statute along with NPs, Nurse Anesthetists and Nurse Midwives. 

I  support revising the regulations for CNS in accordance with the Consensus Model for APRN Regulations below:

By adopting the language of this model, the VIrginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs), including Clinical Nurse Specialists, to meet the growing health care needs of the Commonwealth. Thank you for your consideration.

I am a psych. NP in Maryland. I took same classes with my CNS colleages and they should be recognized as NP. I chose NP because I want to prescribe while my colleages chose CNS because they do not want to prescribe. Prescribing was only thing different from NP and CNS. Thanks.

I  support revising the regulations for CNS in accordance with the Consensus Model for APRN Regulations below:

By adopting the language of this model, the VIrginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs), including Clinical Nurse Specialists, to meet the growing health care needs of the Commonwealth. Thank you for your consideration.

Clinical Nurse Specialists (CNS) are Advanced Practice Registered Nurses (APRNs), its role predating the role of the Nurse Practitioner. By adopting the language of this model, the VA Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent APRNs in their delivery of health care to the public. The VA BON can look to the Oregon State Board of Nursing as an example where both NPs and CNSs are recognized and have prescriptive privileges.

I support any changes to State regulations that result in consistency with the Consensus Model. 

I  support revising the regulations for CNS in accordance with the Consensus Model for APRN Regulations below:

By adopting the language of this model, the VIrginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs), including Clinical Nurse Specialists, to meet the growing health care needs of the Commonwealth. Thank you for your consideration.

Patricia Black, RN, PhD(c), CNS

I support revising the APRN designation to include the CNS category of nurses in Virginia.     CNS's have been performing in the APRN role for many years, & it would be confusing to the general public not to have the CNS nurse not be part of this designation.          

II support revising the regulations for CNS in accordance with the Consensus Model for APRN Regulation.s

I support the VA BON in including CNS as APRN's. I support revising the current clinical nurse specialists regulations based upon the Consensus Model for APRN Regulations. By adopting the language of this model, the VIrginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs) including clinical nurse specialists. It is long overdue in Virginia. Thank you for your consideration.

Josette Millman

I support inclusion of certified Clinical Nurse Specialists as providers of Advanced Practice nursing services. CNS's complete rigorous educational and clinical programs at the graduate level and have much to offer the health care system. 

I support the revision of the current Clinical Nurse Specialist regulations based on the Institute of Medicine Report of October 2011 which identifies the four types of APRNs (IOM, Table 1-1, page 26), and challenges states to reduce fragmentation within the Nursing profession and enhance quality and access of care by allowing APRNs to "work to the full extent of their training and education", (IOM, Key message #1, p. 29).  Such prescribed revisions will also reinforce the role of the CNS in accordance with the nationally developed Consensus Model for APRN Regulations. 

Please support the Revision to CNS Regulations for your state which will enable citizens of the Commonwealth of Virginia to benefit from the expertise of Psychiatric-Mental Health Clinical Nurse Specialists, improving access and quality of care.  Thank you for your attention to my comments.

IOM (2011).  The future of nursing, leading change, advancing health. Washington, DC: The National Academies Press.

PMHCNS-BC are advanced practice nurses.  The have advanced degress, and have passed ANCC certification requirements.  They have been in practice for many years and were treating patients before Psych NP's arrive.  They have been licensed as independant practitioners and have been reimbursed by insurance companies for years.  Some states acknowledge their expertise and other states do not.  I support the this regulatory action. 

I support the revision the current Clinical Nurse Specialist regulations based upon the Consensus Model for APRN Regulations.  By adopting the language of this model, the VIrginia Board of Nursing can ensure uniformity in licensure, accreditation, certification and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs), including Clinical Nurse Specialists, to meet the growing health care needs of the Commonwealth.  Thank you for your consideration.

 I support the revision of the current CNS regulations based on the Consensus Model do APRN Regulations. By adopting the language of the model, the VA. Board of Nursing can ensure uniformity in licensure, accreditation, certification and education to facilitate the regulation of safe and competantancy of  advanced practice nurses (APRNs), including CNS to meet the growing needs of the Commonwealth. Thank you for your time.

I support the revision of the CNS reg. This will help the people of the Common Wealth.

Clinical Nurse Specialists (CNS) are Advanced Practice Nurses (APNs), and are recognized as such in many states. I work in Illinois, where CNSs are integral treatment providers in our health care system. As a Psychiatric CNS, I provide both psychotherapy and medication management to the chronic mentally ill.  I strongly urge the VA Board of Nursing to adopt the Consensus Model,  to ensure uniformity in licensure, accreditation, and certification. Such a move will facilitate the regulation of safe and competent APNs in their delivery of health care to the public, and will allow CNSs to fully practice within the scope of their training.

I am writing to support revising the Virginia Clinical Nurse Specialist regulations in accordance with the Consensus Model for APRN Regulations.  This is definitely in line with the scope of practice of the CNS and will enable appropriate scope of practice.

The CNS role as an APRN must be preserved in Virginia. Like me, many advanced practice nurses who provide psychiatric care are CNS. We were certified as CNS before the Psychiatric Nurse Practitioner role came into existence and most of us have many years of experience and often we have prescriptive authority as I do.

I work providing care to inmates in corrections and I am able to perform the same job responsibilities as my psychiatric NP colleagues - providing psychiatric evaluations, medication management, and therapy to patients. Please continue to recognize the CNS as APRN and allow well prepared and experienced advanced practice nurses to provide care for psychiatric patients in Virginia.
 
 
Linda Barloon, RN, MS, PMHCNS (certified child and adolescent psychiatric clinical nurse specialist)
 

Clinical Nurse Specialists (CNS) are Advanced Practice Nurses (APNs), and are recognized as such in many states. I work in Iowa, where CNSs are integral treatment providers in our health care system. As a Family Psychiatric ARNP, I provide both psychotherapy and medication management to the chronic mentally ill. I strongly urge the VA Board of Nursing to adopt the Consensus Model, to ensure uniformity in licensure, accreditation, and certification. Such a move will facilitate the regulation of safe and competent APNs in their delivery of health care to the public, and will allow CNSs to fully practice within the scope of their training.

Clinical Nurse Specialists (CNS) are Advanced Practice Nurses (APNs), and are recognized as such in many states. I work in Pennsylvania, where CNSs are integral treatment providers in our health care system. I am currently employed as an educator, but have worked many years in psychiatric/mental health care and have worked with many psychiatric CNSs who provide a high quality of care to mentally ill individuals. This Advanced Practice role was the first developed by the profession of nursing following WWII.  I strongly urge the VA Board of Nursing to adopt the Consensus Model,  to ensure uniformity in licensure, accreditation, and certification. Such a move will facilitate the regulation of safe and competent APNs in their delivery of health care to the public, and will allow CNSs to fully practice within the scope of their training.Type over this text and enter your comments here.

As a Virginia CNS, I support the proposed revisions of Virginia CNS regulations in accordance with the Consensus Model for APRN regulation. I am a Child and Adolescent Psychiatric-Mental Health CNS, certified in this specialty since 1986. I practiced marital and family therapy for 30 years, in a psychiatric institute and  in private practice in the Commonwealth of Pennsylvania. My focus has always been clinical practice and my scope of training and education as a CNS have allowed me to practice fully as a family therapist, providing counseling , court ordered child custody evaluations,  behavioral health interventions in community-based primary health care settings and consultation and supervision to other health care providers. A Virginia CNS should be able to fully practice within the scope of her or his training.

Clinical Nurse Specialists are recognized in the discipline of nursing as Advanced Practice Registered Nurses.  Virginia needs to align itself with what is already a reality in the field.  I support this revision to the practice act.

By adopting the language of this model, the Board can ensure uniformity in licensure,  accreditation, certification and education to faciliatate the regulation of safe,and competent , advanced practice registered nurses to include Clinical Nurse Specialists, in meeting the growing need for for health care delivery within the state.

I support the revision of the current CNS regulations based upon the Consensus Model for APRN's.This will ensure uniform practice of APRN's to meet the health care needs of those we serve.  Educating patients, families, and staff in disease specific maintenance and prevention is a vital role that the CNS performs. The CNS role is one of leadership and autonomy in that the CNS's use their education in care planning, their critical thinking skills, and their expertise in the area of their certification.  Thank you for your consideration, Sheila B. Delp,RN,MSN,GCNS-BC

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Aligning the regulations for CNSs in accordance with the Consensus Model for APRN Regulations is an important initiative. Data supports that CNSs deliver safe and effective health care services.

I support revising the regulations for CNS in accordance with the Consensus Model for APRN Regulations.

By adopting the language of this model, the Virginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs), including Clinical Nurse Specialists.

Research  supports that CNSs deliver safe and effective health care services.  This is a critical initiative to align  regulations regarding CNSs  practice in accordance with the Consensus Model for APRN Regulations .I  endorse support of  revising the regulations for CNS in accordance with the Consensus Model for APRN Regulations.

The Virginia Board of Nursing can ensure uniformity in licensure, accreditation, certification, and education to facilitate the regulation of safe and competent advanced practice registered nurses (APRNs), including Clinical Nurse Specialists by adopting the language of this model,

I support the designation of the term APRN to include CNS in the Va regulatory documents.  As a mental health therapist in Virginia, it has been difficult to be limited in scope of practice due to the state regulations that are not consistent with most of the other states in the US.  Thank you for working to change this.