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Nursing

What is a Clinical Nurse Specialist?

What is a Clinical Nurse Specialist?

A Clinical Nurse Specialist is an Advanced Practice Registered Nurse who, through study and supervised practice at the graduate level (master's or doctorate) has become an expert in a defined area of knowledge and practice in a selected clinical area of nursing (ANA 1980).

Specialty practice is a part of the discipline of nursing that is more focused than generalist practice; it is the diagnosis and treatment of human responses to actual or potential health problems within a specialized area of nursing (ANA 1986, p 1).

The Clinical Nurse Specialist functions in the role of expert clinician, educator, consultant, researcher, and leader. In collaboration with the medical staff and nursing staff, the Clinical Nurse Specialist monitors the clinical care of patients and provides clinical support to improve patient care and patient outcomes. Incorporated within each of these role functions, the Clinical Nurse Specialist is a role model, patient advocate, change agent, leader, and cost-effective practitioner.

The clinical nurse specialist's expertise is derived from combining graduate study with clinical experience. The clinical nurse specialist must have an earned graduate degree that represents study and advanced clinical practice related to the specialty. This educational program features an extensive study of nursing theories and information from other fields. Advanced scientific concepts, research methodologies, supervised clinical practice, and other information relevant to the particular area of clinical specialization are included in the curriculum. Some clinical nurse specialist seek doctoral education to refine their research skills and expand their knowledge. (ANA 1986, p1)

The mission of the Clinical Nurse Specialist (CNS) team is to enhance best nursing practices and improve patient outcomes.

Although United Medical Center has had CNS positions for over a year, many people do not really know what we do. There are 9 clinical nurse specialist positions at CRMC:
  • Critical Care
  • Surgical/Ortho Services
  • Oncology
  • Medical
  • Women’s and Children’s Services
  • Behavioral Health
  • Emergency Department
Each CNS works with physicians and nurses to monitor patient care and provide support to improve care and “outcomes” (the results of a patient’s care). Clinical nurse specialists have a great deal of hands-on nursing experience (“clinical experience”) as well as a graduate degree in nursing.

Clinical nurse specialists at CRMC have different responsibilities, depending on which area of specialty they work in. But in general, the clinical nurse specialists’ roles include expert clinician, educator, researcher and leader. In addition, the clinical nurse specialists are role models, patient advocates, change agents, leaders and cost-effective practitioners.

So how do we spend our time? When we are not in a nursing area, we act as consultants on nursing councils and committees; educate new and experienced employees; write, review and revise nursing procedures; represent CRMC at national conferences; provide education for the community; organize special projects; and survey literature for current research findings. If a nurse needs information about an unusual diagnosis or a new piece of equipment, a clinical nurse specialist will do the research.

Most importantly, the clinical nurse specialist is able, due to extensive education and experience, to assess the wide variety of needs of patients with complex medical issues. The clinical nurse specialist communicates daily with physicians, social workers, physical therapists, dieticians, discharge planners, home care and registered nurses. The CNS is the key link in collaborating the health care team members to facilitate a smooth hospital stay.

Sometimes the clinical nurse specialists’ role takes them outside the hospital setting, teaching resident physicians, nurse practitioner and undergraduate students and other professionals in the community. Clinical nurse specialists also are very involved in the education each summer of “new graduate nurses,” who are nurses who recently graduated from nursing school and then were hired to work at CRMC.

References:

American Nurses Association. The Role of the Clinical Nurse Specialist. Kansas City, Mo.; the Association, 1986.

American Nurses Association. Nursing: A Social Policy Statement. Kansas City, Mo.; the Association, 1980.

Who Are Clinical Nurse Specialists at United Medical Center?

Our Clinical Nurse Specialists are:

Todd Berger, MSN, APRN-BC
Clinical Nurse Specialist for ICU and Telemetry
Phone: 633-7120 (office) 287-0929 (cell)
Email: tberger@crmcwy.org

Place of Birth: Lincoln, Nebraska

Graduate School: University of Nebraska Medical Center
Nursing School: Creighton University


National Certification: Advanced Practice Registered Nurse – Acute Care

Professional Positions:
Clinical Nurse Specialist,CCU, Cheyenne Regional Medical Center, Cheyenne, Wyoming.
Clinical Nurse Specialist, LTACH, Madonna Rehabilitation Hospital, Lincoln, Nebraska.
Staff Nurse, Per Diem Float Pool, St. Elizabeth Regional Medical Center, Lincoln, Nebraska.
Staff Nurse, ICU, TCU, Bryan/LGH Medical Center, Lincoln, Nebraska
Staff Nurse, Telemetry, Creighton Hospital, Omaha, Nebraska
Staff Nurse, Med-Surg, University of Nebraska Medical Center, Omaha, Nebraska

Professional Organizations:
National Association of Clinical Nurse Specialists
American Academy of Nurse Practitioners
Sigma Theta Tau

Patti Gardner, MSN, CNM, IBCLC
Clinical Nurse Specialist for Women's Health and Lactation
Phone: 307-432-6628
Email: pgardner@CRMCwy.org

Place of Birth: Perryton, Texas

Graduate School:
MSN, University of Wyoming, Laramie, Wyoming
Post-Masters in Midwifery, University of Colorado Health Sciences Center, Denver, Colorado

National Certifications:
Sexual Assault Nurse Examiner (SANE), 2004.
International Board Certified Lactation Consultant, 2002.
Board Certified Nurse Midwife, 2001.
Certified Neonatal Resuscitation Program Instructor, 1999.
Certified Lactation Educator, UCLA, 1995.

Professional Positions: Clinical Nurse Specialist: Women’s Health and Lactation, Department of Women and Children’s Services, United Medical Center, Cheyenne, WY.
Lactation Consultant and Program Developer, Department of Women and Children’s Services, United Medical Center, Cheyenne, WY
Maternal-Child Nursing Faculty, Laramie County Community College, Cheyenne, WY.

Professional Organizations:
Wyoming Chapter of Healthy Mothers Healthy Babies
American College of Nurse Midwives.
Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN).
International Lactation Consultant Association (ILCA).
Phi Kappa Phi, Interdisciplinary Honor Society.
Sigma Theta Tau, Nursing Honor Society
American Nurses Association

Professional Publications and Presentations: Gardner, P (2006). Outcomes of Implementing a Lactation Program at a Rural Community Hospital. Poster presentation at the Western Institute of Nursing 39th Annual Communicating Nursing Research Conference, Albuquerque, New Mexico.

Wilhelm, S., Stepans, M.B., Hertzog, M., Rodehorst, T.K., & Gardner, P.(in press). Motivational interviewing to promote sustained breastfeeding. Journal of Obstetric, Gynecology, & Neonatal Nursing.

Spiegelberg Gardner, P. Previous Traumatic Birth: An Impetus for Elected Cesarean Birth (2003). The Journal of Perinatal Education, 12(1), pp. 1-5.

Humenick, S.S., Hill, P. & Spiegelberg, P. (1998). Breastfeeding and Health Professional Encouragement. Journal of Human Lactation, 14(4), pp. 305 310.

Spiegelberg, P.L. (1994). The relationship among type of health professional, type of advice given to Breast-feeding women and subsequent patterns of Breast-feeding. Master's thesis. University of Wyoming, Laramie, WY.

Spiegelberg, P.L. (1994). The relationship among type of health professional, type of advice given to Breast-feeding women and subsequent patterns of Breast-feeding. Poster Session, presented at 2nd Annual Baby-Friendly Conference, Chicago, Ill., 1996.

Spiegelberg, P.L. (1994). The relationship among type of health professional, type of advice given to Breast-feeding women and subsequent patterns of Breast-feeding. Poster Session, presented at 1st Annual Baby-Friendly Conference, Minneapolis, MN., 1995.

Spiegelberg, P.L. (1994). Early detection of pregnancy induced hypertension. In S. S. Humenick (Ed.) Analysis of current assessment strategies in the health care of young children and childbearing families. (pp. 50 a c). East Norwalk, Ct.: Appleton Century Crofts.

Spiegelberg, P.L. (1994). The APGAR scoring system. In S. S. Humenick (Ed.) Analysis of current assessment strategies in the health care of young children and childbearing families. (pp. 109 a b). East Norwalk, Ct.: Appleton Century Crofts.

Burman, M., Spiegelberg, P.L., Harrison, V. & Cordona, M. (1993). Toward a healthy Wyoming: Incidence and duration of Breast-feeding (Technical report). Laramie: University of Wyoming, School of Nursing.

Spiegelberg, P.L. (1992). Gestational age assessment. In S. S. Humenick (Ed.) Analysis of current assessment strategies in the health care of young children and childbearing families. (pp. 145 a c). East Norwalk, Ct.: Appleton Century Crofts.

Breastfeeding Promotion for Hospitals, Mountain Plains Health Consortium. Fort Meade, South Dakota, May, 2002.

Bonnie Bath, RN, MSN(c), CDE
Clinical Nurse Specialist for Medical Nursing
Phone: 307-633-7984
Email: bbath@CRMCwy.org

Place of Birth: Laramie, Wyoming

Graduate School:
University of Phoenix

National Certifications:
Certified Diabetic Educator

Professional Positions:
Certified Diabetic Educator, United Medical Center
Unit Based Educator-Medical/Oncology, United Medical Center

Professional Organizations:
American Association of Diabetic Educators
Oncology Nursing Society
High Plains Oncology Professionals

Research Interests:
Improving outcomes for Newly Diagnosed Diabetics

Professional Activities:
Data collector for various Diabetic products

Mary Kay Goetter, MSN, RNC
Director of Nursing Practice
Phone: 307-633-7380
Email: mgoetter@CRMCwy.org

Place of Birth: Milwaukee, Wisconsin

Graduate School: University of Wyoming, MSN
University of Northern Colorado, Doctoral student

National Certifications:
National Certification Corporation (NCC) for the Obstetric, Gynecologic and Neonatal Nursing Specialties, Maternal Newborn Nursing, Certificate of Added Qualification, Electronic Fetal Monitoring

Professional Positions:
Director Nursing Practice, United Medical Center
Magnet Project Director, United Medical Center
Chief Nurse, Wyoming Air National Guard

Professional Organizations:
AWOHNN
Council for the Advancement of Nursing Science
American Nurses' Association
Sigma Theta Tau International Honor Society in Nursing
Phi Kappa Phi Honor Society
Association of Air National Guard Nurses
Veterans of Foreign Wars
Men in Nursing

Research Publications and Presentations:
Goetter, M. C., & Stepans, M. B. (2005). First-time mothers' selection of infant supine sleep positioning. Journal of Perinatal Education, 14(4), 16-23.




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