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Nursing Practice Problems


Clinical Nurse Specialist (CNS) is a nursing profession that lists only qualified, educated, and highly trained personnel. Yet, they also can face certain barriers to the implementation of the full arsenal of their knowledge and abilities. For instance, CNSs experience difficulties with understanding their role in all clarity. The significance of the issue is supported by the fact that such an unstable position in the hierarchy of nursing professions sometimes imposes limitations in regard to job responsibilities (Foster & Flanders, 2014). The present paper aims to describe the problem in detail and provide a rationale for it.

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Problem Description

As a nurse progresses from college level of study to the master’s degree, they acquire a variety of skills and knowledge that they hone in hospitals or homes of the patients. Such a long professional path builds a versatile specialist such as CNS. However, there is a major side effect of such a multifaceted nature of this nursing profession. Having a plethora of competencies and skills, such a nurse can serve a clinic in almost any quality. CNSs can either directly provide care to patients, educate them, manage nurse or interprofessional teams, conduct research, develop and implement new clinical policies, etc. The problem lies in the affinity to a certain activity that can occasionally blur the definition of a CNS’s role in the eyes of the colleagues, and, consequently, nurses themselves. For instance, a CNS predominantly occupied by care provision is often incorrectly referred to as physician (Foster & Flanders, 2014). Begley et al. (2013) also recognize that among clinical personnel there is a certain confusion between professional roles and definitions. Therefore, the issue appears to be rather established in practice and recognized by theory.

The rationale for the Problem

The problem or role vagueness is rather significant due to a variety of reasons. Firstly, it impedes the practical use of the CNS’s skills and competencies. Foster and Flanders (2014) argue that after certain years of practice in one of the spheres, CNS may lose an edge in another. The versatile nature of the knowledge background and skillset presupposes such a specialist to provide help where it is needed the most at the time. Yet, not always, CNS’s competencies are utilized in such a manner. The lack of respect is also associated with external role confusion fosters poor job satisfaction and frustration (Foster & Flanders, 2014). McClelland, McCoy, and Burson (2013) note that the limitations are reinforced not only by colleagues but also by the clinic’s management, family, friends, etc. In addition to that, salary levels do not always correspond to the level of theoretical and practical expertise of CNS, which also contributes to poor role recognition (Foster & Flanders, 2014).


All things considered, clinical nurse specialist is a status that is difficult to achieve, yet even more difficult to fully comprehend. Many healthcare workers, patients, and other people do not recognize or understand the role of CNSs. It often leads to having untapped potential within the clinic workforce and poor self-respect among such CNSs themselves.


Begley, C., Elliott, N., Lalor, J., Coyne, I., Higgins, A., & Comiskey, C. M. (2013). Differences between clinical specialist and advanced practitioner clinical practice, leadership, and research roles, responsibilities, and perceived outcomes (the SCAPE study). Journal of Advanced Nursing, 69(6), 1323-1337.

Foster, J., & Flanders, S. (2014). Challenges in CNS practice and education. OJIN: The Online Journal of Issues in Nursing, 19(2). Web.

McClelland, M., McCoy, M. A., & Burson, R. (2013). Clinical nurse specialists: Then, now, and the future of the profession. Clinical Nurse Specialist, 27(2), 96-102.

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