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Clinical Nurse Leader

JONA Volume 37, Number 10, pp 429-431 Copyright B 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins


Clinical Nurse Leader and Clinical

Nurse Specialist Role Delineation in the Acute Care Setting

Patricia Thompson, MN, RN, APN, FNP-C, PCCN Kevin Lulham, MSN, RN, CCRN

More than 90 members of the American Association of Colleges of Nursing and 190 practice sites have partnered to develop the clinical nurse leader (CNL) role. The partnership has created syn- ergy between education and prac- tice and nurtured innovation and diffusion of learning on a national basis. In this ongoing department, the edito , Jolene Tornabeni, MA, RN, FAAN, FACHE, showcases a variety of nurse leaders who dis- cuss their new patient care deliv- ery models in preparation for the CNL role and CNLs who high- light partnerships with their clini- cal colleagues to improve patient care. In this article, the authors explore differences and similarities between the CNL and the clinical nurse specialist roles, describing the working strategies between a CNL and clinical nurse specialist,

Authors’ Affiliations: Care Coordina- tor (Clinical Nurse Leader), 5NS Tele- metry, Nurse Practitioner, Emergency Services (Mrs Thompson); Clinical Nurse Specialist, Cardiac Services (Mr Lulham), University Health Care System, Univer- sity Hospital, Augusta, Georgia.

Corresponding author: Mrs Thompson, University Health Care System, University Hospital, 1350 Walton Way, Augusta, GA 30910 (patthompson@uh.org).

and role delineations that have re- sulted from their cooperation, col- laboration, and planning.

The role of the clinical nurse leader (CNL) has challenged the nursing profession with clarifying potential duplication of nursing roles, role overlap, and the specific benefits this new emerging role has created. The American Association of Col- leges of Nursing has defined the CNL as ‘‘a leader in the health- care delivery system across all settings in which healthcare is deliveredIfunctions within a mi- crosystem and assumes account- ability for healthcare outcomes for a specific group of clients within a unit or setting through the assimilation and application of research-based information to design, implement, and evaluate client plans of care.^1 The role is further described as designing, implementing, and evaluating cli- ent care by coordination, delega- tion, and supervision of the care provided by the healthcare team, including licensed nursing, techni- cians, and other health profes- sionals. It also states that the CNL is educated as a ‘‘generalist^ master’s degreeYprepared registered nurse. 1

According to the American Nurses Association, clinical nurse specialists (CNSs) are ‘‘clinical experts in evidenced-based nurs- ing practice within a specialty area, treating and managing the health concerns of patients and populationsImay be focused on individuals, populations, setting type of care, type of problem, or diagnostic systems subspecialty. CNSs practice autonomously and integrate knowledge of disease and medical treatments into as- sessment, diagnosis, and treat- ment of patient’s illness. CNSs provide leadership in advancing the practice of nursing to achieve quality and cost-effective patient outcomes as well as provide lead- ership of multidisciplinary groups in designing and implementing innovative alternative solutions that address system problems and/or patient care issue. CNSs serve as patient advocate, consul- tant, and researcher in various settings.^2 The CNS is educated as an advanced practice master’s degreeYprepared registered nurse.

Role similarities and differ- ences between CNLs and CNSs according to the American Asso- ciation of Colleges of Nursing in- clude ‘‘the CNLs are educated as


  • Vol. 37, No. 10

October 2007


Copyright @ Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

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