What in the world is a clinical nurse specialist?

By Linda Smithson, RN, Surgical Services CNS
Children’s Hospital

Whenever I tell someone I am a clinical nurse specialist (CNS), I am usually asked what that means. Although Children’s Hospital has had CNS positions for a long time, many people do not really know what we do.

There are five clinical nurse specialist positions at Children’s Hospital: in Pulmonology, Critical Care, Surgical Services, Hematology/Oncology and Endocrinology. Each CNS works with physicians and nurses to monitor patient care and provide support to improve care and “outcomes” (the results of a patient’s care). Clinical nurse specialists have a great deal of hands-on nursing experience (“clinical experience”) as well as a graduate degree in nursing.

Clinical nurse specialists at Children’s Hospital have different responsibilities, depending on which area of specialty they work in. But in general, the clinical nurse specialists’ roles include expert clinician, educator, consultant, researcher and administrator. In addition, the clinical nurse specialists are role models, patient advocates, change agents, leaders and cost-effective practitioners.

So how do we spend our time? When we are not in a nursing area, we act as consultants on nursing committees; write patient education materials; educate new employees; write, review and revise nursing procedures; represent Children’s Hospital at national conferences; provide education for the community; organize special projects; and survey literature for current research findings.

If a nurse needs information about an unusual diagnosis or a new piece of equipment, a clinical nurse specialist will do the research. Many new products are introduced or researched to keep Children’s Hospital up-to-date with the latest in medical technology.

Most importantly, the clinical nurse specialist is able, due to extensive education and experience, to assess the wide variety of needs of patients with complex medical issues. The clinical nurse specialist coordinates the care of such patients with all involved hospital departments as well as outside agencies that may also be involved.

Sometimes the clinical nurse specialists’ role takes them outside the hospital setting. The clinical nurse specialists at Children’s Hospital conducted a conference for school nurses from throughout East Tennessee, offering education in topics such as “Asthma and the School-age Child,” “Diabetes Old and New: What Lies Ahead?” and “Infection Control Issues in the Public Education System.” The conference helped to educate school nurses about some of the growing health problems among children that can have an effect on the educational process.

Clinical nurse specialists also are very involved in the education each summer of “new graduate nurses,” who are nurses who recently graduated from nursing school and then were hired to work at Children’s Hospital.