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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 15, 2012
After a week in the Bahamas...back to reality!
I took a week off to celebrate a birthday and take a cruise. It was lovely but now it is time to get back to the reality of life in the world of the APRN. Let's discuss the remaining issues identified in the NACNS Statement on the APRN Consensus Model Implementation. There are three more points that were raised in the document in addition to the ones I already mentioned a couple of blogs ago (the grandfathering clause, and certification examinations in every area needed for CNS practice according to the model). The additional three areas for consideration are: 1) CNSs losing their jobs due to misinterpretations of the model; 2) accreditors of schools of nursing not allowing sufficient time for schools to respond; and 3) challenges in curriculum revision. Let's look at each individually.
 
First, let's examine the issue of CNSs losing their jobs as a result of misinterpretations of the model. It is being reported to NACNS that CNSs are being let go from their jobs as a result of not having current certification examination status in place. The misinterpretation is that they cannot be CNSs if they do not already have a certification in place. This is in spite of the fact that there may not BE a certification examination in place for that particular CNS.
 
There could be many reasons for this to be taking place....not the least of which may be a ready excuse to "get rid of" an employee who is perceived to be troublesome...we CNSs can be that way because we will not stand for inappropriate care. Other reasons could be budgetary in an era of tight finacial situations, or simply a lack of perceived need for the role due to a lack of effective communication on the part of the CNS or the management structure. Whatever the reasons for dismissal, they need to be clearly articulated and not blamed on a certification examination. The grandfathering clause, if implemented fully and properly, would address the needs of existing CNSs who do not currently hold national certification. To remove them for a requirement that was not in place at the time they were hired and is beyond their ability to address when they are fully functional and have no undue patient outcomes is unconscienable. We can, and should, be doing better than that. 
 
Have YOU lost your job as a CNS due to some of these misperceptions? Talk to us about your situation...let's look at the issue and learn from it so that we can help others not fall into the same pit...and perhaps also help you.
 
The next issue is related to schools of nursing and the changes that must take place in the curriculum in order for the APRN model to be fully implemented. Let's leave that until next week though....the discussion so far in this column is very important and I want to give folks an opportunity to discuss. Chime in with your feedback...let's support those who may be in this situation and make some suggestions for how to cope...let's dialogue.
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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