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APRN LACE dialogue for CNSs
Blog is about the changes and updates related to the implementation of the Advanced Practice Registered Nurse Consensus Model for Regulation and the Licensure, Accreditation, Certification and Education changes that will need to take place over the next few years.
Sunday, April 03, 2011
Practice issues with the Model?
What are the potential practice issues for those of us who are "oldsters" in the CNS world? There can potentially be many...depending on the state of your career and the state in which you live. Let's talk about each of these areas:
 
The state of your career: what on earth does this mean? Where are you in your career? Early? Late? Somewhere in between? If you are planning to keep working for a number of years it would behoove you to keep an eye on what is happening at the state level but we will touch on that in just a minute. In terms of your personal state of affairs do you have the following?
1) The three P's: Pathopysiology, Pharmacology and Physical/Health Assessment as separate courses on your transcript
2) at least 500 clinical hours reflected on your transcript
3) a national certification examination
4) if you want/must have/need prescriptive authority do you have clinical practicum hours reflecting that you completed a supervised rotation in differential diagnosis and medical management of a patient population
 
These will be the elements required in order to meet the new model. Now...I am not stating that you MUST go back and get these if you do not have them. What I am stating is that you need to watch what is happening in your state and how your state board of nursing is going to interpret these elements and for which populations of nursing.
 
If you plan to retire soon...I am jealous! But also would ask you to consider if the changes are worth your time if you will be leaving practice soon.
 
If you are not yet ready for retirement but are in between an active clinical practice and a change in your career to more of an administrative bent then you need to consider if you will move back into clinical practice any time in the near future. If you plan to do so, or simply want to keep your options open for the future you probably should consider moving in the direction of an academic institution that can provide the support you need to complete the requirements.Besides, any education is good education and you may be surprized at what you learn and can then apply to active clinical practice or administrative practice with a 'current affairs' update.
 
If you plan to work a long time and do not have these elements, and your state is not planning on providing a grandfather clause or alternatively you plan on moving to another state sometime in the future, it would be best to consider how you can get these elements reflected on a transcript for future protection of your practice.
 
All of these options are up to you and your anticipated needs as you consider how the state of your state will impact your practice. How your state chooses to interpret the APRN Consensus Model will impact what you ultimately choose to do in preparation for the 2015 implementation date. Remember that you can have a tremendous impact on how they define and interpret the model for your state...
 
State of your state: How will the elements above be interpreted by your state? As an example, you may not have to do any of the above if your state is going to create a grandfathering clause and you do not plan to move to another state any time in the duration of time remaining in your career.
 
Your state may already have most of the elements in place for our Nurse Practioner partners and may interpret that CNSs would/could/should just 'tow the line' like the NPs. That could do tremendous harm to some CNSs and could create a restraint of trade situation...do you know what your state is planning?
 
Are CNSs already a strong and recognized voice in your state? Most are not...where is your state in the mix?
 
All of these elements can and may very well have an impact on your ability to practice now, or in the near future. Are you prepared?
 
 
9/9/2011
Terri L. Ares said:
One of the practice issues that has arisen involves where perinatal nurses will fit in the population foci of the model. There are some perinatal and parent-child (maternal-child) CNS programs that Labor & Delivery, Mother-Baby, High Risk Antepartum, and Obstetric nurses have been able to attend (though no certification exam exists for them). Has there been any discussion regarding where these specialty nurses will fit into the new population foci? Adult/Gero? Family? Women's/Gender Health?
About the Author

Kelly A Goudreau DSN, RN, ACNS-BC
Kelly A Goudreau DSN, RN, ACNS-BC is an Associate Editor for the Clinical Nurse Specialist Journal and has been a participant on behalf of NACNS in the development of the APRN Consensus Model and subsequent discussions about implementation of the LACE entity.

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