Clinical Practice: PDF OnlyLamm Barbara M.S.N. R.N.; Dungan, Joyce M. M.S.N., R.N.C., Ed.D.; Hiromoto, Brenda C.E.T.N., M.S.N., R.N.Clinical Nurse Specialist: Winter 1991 - p 182-188 Buy Abstract THE CLINICAL NURSE SPECIALIST impacts the client with chronicity by strategic management of cost and quality outcomes. Three enabling strategies: counseling, social support, and teaching-learning are the tools the nurse and client use to implement long-term lifestyle adjustment to chronicity. Reduced health care system utilization and increased self-esteem and self-care abilities are the result of the strategies. Lifestyle management warrants further nursing research © Williams & Wilkins 1991. All Rights Reserved.