Dannie Suber, Clinical Nurse Specialist, Critical Care Unit, William Beaumont Army Medical Center, instructs Intensive Care Unit Nurses on the functions of a portable ultrasound system as part of regular operations at WBAMC’s ICU, Sept. 5. (Photo Credit: Marcy Sanchez)
In the United States there are approximately 72,000 Clinical Nurse Specialists (CNS) and approximately 2.7 million nurses. That’s one CNS to every 37.5 nurses.
What is a CNS you may ask?
Clinical Nurse Specialists are Advanced Practice Registered Nurses (APRNs) who not only provide patient care but specialize in mentoring, educating and progressing clinical practices in specific patient populations. Sept. 1 – 7 marks the annual National CNS Recognition Week.
“They’re not the same as other (APRNs),” said Col. Gayla Wilson, chief nursing officer, William Beaumont Army Medical Center. “They focus on their clinical areas. They’re spectacular in what they do. One of the key roles, as educators, is bringing the latest and greatest evidence-based practices to the fight.”
Clinical Nurse Specialists are one of four APRNs which include nurse anesthetists, nurse midwives and nurse practitioners. While CNSs in a civilian capacity are capable of diagnosing and prescribing medication, Army CNSs focus on progressing Army Medicine as a whole and employing best-practice in their respective specialties.
“I think the biggest difference (for Army CNSs) is shifting focus from single patient care to advancing the care of all patients,” said Lt. Col. Patrick Marlow, CNS, Emergency Department, WBAMC. “While others work full time with patient care, (being a CNS) gives us the education and time to implement programs and efforts (to advance their clinical areas).”
Recently, Marlow, a Milwaukee native, was instrumental in implementing an Emergency Department program which decreased wait times for beneficiaries while increasing primary care engagement with active-duty service members. Although CNSs do take an active role in patient care, their greatest impact is improving overall proficiency and efficiency of their units.
“(CNSs) create strong foundations for the staff,” said Wilson. “I don’t have to depend on the (officer in charge of a unit) to carve time out of their day to make sure all of their staff understand the latest practices.”
“We are considered expert clinicians at the bedside but one of our more significant roles is to help guide and mentor newer nurses,” said Maj. Maria Pescatore, CNS and officer in charge, Medical-Surgical Unit, WBAMC. “CNSs help improve new nurses’ skills and critical thinking while increasing their capabilities and development, breaking them out of a novice role to an advanced one.”
While CNSs continuously research for best practices in their fields, their expertise goes beyond clinical practices as they play a role in improving safety measures in their units as well. Wilson also points out this year’s CNS Week theme “Leading Changes to Healthier Living,” is embodied by WBAMC CNSs in their vigilant staff education including raising awareness of proper patient lifting techniques, increasing communication among staff and building resilience.
“My favorite part (about being a CNS) is being with the new nurses and mentoring and guiding them through their nursing practice,” said Pescatore, a native of Binghamton, New York. “The best part is to watch them grow; it reinvigorates why we do what we do.”
One unique challenge WBAMC CNSs face is preparing to transition to the Fort Bliss Replacement Hospital, which is slated to open in 2019, by providing input regarding development of clinical areas to maximize best practices by healthcare professionals. Additionally, Wilson states CNSs are active in mitigating costs by researching and endorsing more efficient equipment and supplies.
“(CNSs) improve efficiency, competency and throughput capabilities by going with the best product and educating staff on utilization of the best product,” said Wilson. “(CNSs) are definitely moving us in the right direction and moving us as a team.”
There are currently six CNS roles at WBAMC covering the hospital’s Critical Care Unit, Medical and Surgical Units, Perioperative Nursing Services, Maternal Child Health Services and Emergency Services. As WBAMC transitions from Level III Trauma Center designation to Level II, their roles are crucial as subject-matter experts to train and educate nursing staff on efficient practices to prepare for more comprehensive or definitive care.
Because of the continuous advancements CNSs provide to clinical practices, their actions sometimes require an interdisciplinary approach to formulate changes which improves overall patient care at WBAMC.
Over the course of this year’s CNS week WBAMC CNSs educated beneficiaries and fellow staff members as to how the role they have in the hospital impacts patient care and readiness for service members.
Author: Marcy Sanchez – WBAMC