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, January 15, 2012

What about Specialty?
Well...the holiday season is well and gone and a new year has begun. We are one year closer to the intended implementation of the APRN Consensus Model with the anticipated date of full roll out being 2015.
The changes that are coming are moving along...slowly but they are moving along. So as the implementation occurs there is a question about specialty...where is it, how does it fit within the context of the model and what will happen to the CNS as a result of a "lack of specialty." I know that some are very confused by the model and the fact that specialty is not identified other than to state that it is not in the model and is in fact a part of the professional organization responsibility.
One of the most difficult things to wrap your mind around is the fact that there is, and should be, a clear separation between the professional role and how it is regulated. The issue that many get confused is the perception that how you are regulated is how you should function. That is true to a certain extent but not fully...let me explain.
The focus of regulation is protection of the public. Plain and simple. It is not to determine the fate of various disciplines within the profession. The focus of the professional groups are to clarify the competencies required and to promote the disciplines within the profession.
Regulation looks for minimal competencies for practice...think about the NCLEX-RN examination. It is intended only to determine whether or not the nurse is competent for entry to practice. It does not determine whether the nurse is able to function well, whether they are able to manage their time effectively, whether they have specialty expertise in a particular area of nursing. It is simply to determine minimal competency. Think of the APRN Consensus Model in the same way. It is an agreement between a large number of nursing organizations on the minimal competencies required of a nurse as they enter the world of advanced practice. It does not determine or require that they are specialists in any area. It identifies the minimal expectations for education, accreditation of the educational program, and certification as an entry to practice and determination for initial licensure as an APRN.
Specialty is an essential element of the minimal competencies for a Clinical Nurse Specialist. But it is not an element required for licensure. There are core competencies that all CNSs must demonstrate, there are core educational requirements and there are certification requirements that will be more important as the model is implemented but specialty is not within the purview of regulation any more....and that is a good thing.
We now are free to explore competencies for specific specialties without having to address the issue within a regulatory model. What do you think?