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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, March 18, 2012
Post-Conference Euphoria and work to be done....
The conference was a huge success with 560 CNSs in attendance and a host of extraordinary poster and podium presenations. WE are an amazing group of clinicians and it thrills, energizes and encourages me every time I attend an NACNS conference. It is easy to get lost in the shuffle and feel like you are not making a difference when you slog day to day in the trenches in a place that has one, two or few CNSs and that does not seem to understand or appreciate your role. The conference is a place to connect with others who are in similiar situations, to see their good work and become re-energized with the passion that lead you to become a CNS in the first place.
 
Thank you to all of you who came to me during the conference and indicated that you are both reading and sending others to read the content of the blog. As I stated to a few of you I am more than willing to indicate that a question came forward without you having to post to the blog...just send me an e-mail and I will do my best to respond to you in the blog so all can see the question but you do not have to become public with your question. I will hold you anonymous if you choose to be anonymous...just ask the questions. If you have them then so do others...my e-mail is kagoudreau@hotmail.com
 
The Legislative/Regulatory Pre-Conference started the week off with a good discussion about what tools are available for those of you who are looking to make changes in your state rules or regulations regarding recognition of CNSs. I mentioned the tool kit in my last blog and encourage you to take a look at the resources that are available to you free of charge on the NACNS website. There are tips and suggestions on how to proceed and a list of talking points for you to use with your state legislators as you move to educate them about your role. The tools and support are there..just seek them out and you will be pleasantly surprised with the support you get!
 
The NACNS statement on the APRN Consensus Model was also released immediately following the conference. It is unfortunate that it could not be released prior to the conference or during the conference so that you who attended could read it and provide your feedback but at least it is out now. There are some key issues that have been identified in the document that I will highlight over the next couple of weeks in the blog. The first one is the overarching concern that there is great variability in the manner in which the states are implementing the Consensus Model.
 
There will be a LACE call tomorrow and one of the topics is that NACNS released this document. It will be interesting to hear what other organizations are experiencing now that NACNS has released its concerns in a public forum. I will keep you posted...
 
Grandfathering is another key issue that is of concern...the implications are far reaching and varied by state and I know I have mentioned a few times in the blog that there are issues around how to grandfather CNSs in a state where there has never been recognition of CNSs and no clearly understood number of CNSs practicing in the state. Mississippi is one example of this. It is not easy to identify what needs to be done when you have no idea how many people changes will impact and whether or not it will impact them a small amount (needing to return to school for a course) or a very large amount (no longer able to provide services as a CNS due to massive changes in legislation). Also, what about a CNS who wants to move from one state to another due to family changes? If they move from Oregon which has a very progressive state board and has essentially already implemented the vast majority of the elements in the model, to a state that does not even recognize a CNS at this time? Chaos...
 
Certification...another hot topic...either because a certification did/does not exist or because the CNS chose not to become certified due to it not being necessary there are CNSs who are losing their jobs now. Employers are looking at the CNS and seeing whether or not they have certification as a CNS...if they are not certified they are letting them go. This has HUGE economic impact on the individual CNS, their patient population, and the nurses they serve. Let's be reasonable...if the reason that a CNS is being let go is that they are not performing well we need to have that information rather than blaming it on a lack of certification. If the reason is economic then I challenge that as well...CNSs are worth their weight in gold and in today's economy that is a lot!! CNSs you need to be able to speak economics and tell your CNOs what money you are saving the organization through your actions. I am also challenging my fellow nurse executives to be honest and forthright and not hide behind a convenient excuse in the form of the APRN Consensus Model. It is time to be real and honest with each other and our employees.
 
There is much more to talk about but I will leave it at that for now. Watch for my blog next week where I will discuss some of the other topics in the paper released by NACNS and perhaps some of the key concerns raised in the LACE discussion. Stay tuned!
 
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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