临床护理专家的角色功能及发展趋势

临床护理专家是指在某专科或专病具有较高水平的护理人才,其主要角色功能包括临床实践、护理研究、护理教学、护理会诊以及护理管理五大基本职能和社会心理治疗以及高级医疗、护理技能等方面的特殊职能。为了适应患、患家属、医疗机构及社区需求的复杂化和变化性, 临床护理专家与护理开业的角色进行合并进未来发展的必然趋势。     

Rethinking the Merger of the Clinical Nurse Specialist and the Nurse Practitioner Roles

The clinical nurse specialist (CNS) and nurse practitioner (NP) have been distinct and separate advanced nursing practice roles since the 1960s. The forces of economics and health care reform have fostered an interest in merging these two advanced practice roles. Economic and regulatory advantages have been noted in the literature for both roles. What is not so evident are the possible disadvantages. Several aspects of the merger issue are explored as is the recent background of the creation of the CNS and NP roles. Problems and questions are asked to stimulate future discussions in nursing's professional associations and in education and service settings.     

Joining of 2 Powerful Nursing Forces,the Clinical Nurse Specialist and Clinical Nurse Leader

Nurse executives in 2 adult, acute care hospitals support utilization of the clinical nurse specialist (CNS) and clinical nurse leader (CNL), as master’s prepared roles with specialized education, training, and content expertise in clinical care. Utilizing both roles created a dynamic structure to facilitate high quality patient care that is efficient, safe, and cost effective. As the nursing shortage continues to grow and demands of health care continue to expand, the CNS and CNL will ensure high quality care through implementation of evidence-based practice, ongoing quality improvement initiatives, and providing an added layer of clinical care and decision-making support for bedside nurses.     

The Imposter Phenomenon in the Clinical Nurse Specialist Role

The imposter phenomenon describes individuals who at times feel as if they are imposters in their chosen profession. Individuals experiencing the phenomenon have a deep feeling that they are fooling everyone. The title of clinical nurse specialist (CNS) in itself may foster misinterpretations and false beliefs in oneself or others. The term "specialist" implies expertise in the five subroles of the CNS (educator, consultant, research, clinician and manager). Feelings of imposture within the CNS role can precipitate or exacerbate low self-esteem and lead to ineffective role implementation. The phenomenon must be recognized in the CNS and management strategies instituted. Management strategies include peer support, CNS mentoring and self-provided positive reinforcement. Further research is essential to document the existence of the phenomenon within the CNS role and the creation of effective management strategies to prevent or alleviate it.     

培育专科护士队伍 加速护理学科发展

本文以专科护士队伍培育为主线,从实践层面,介绍了专科护士培养对象的选拔、培养模式的选择、专科护士的使用以及其在提高临床护理质量、促进护理学科发展中发挥的积极作用。并阐述了北京协和医院在专科护士队伍培育过程中的一些体会和思考。     

National Validation of the NACNS Clinical Nurse Specialist Core Competencies

Purpose: To validate the 75 core National Association of Clinical Nurse Specialists' (NACNS) clinical nurse specialist (CNS) competencies among practicing CNSs. Specific aims were to (a) determine the extent to which 75 core CNS competencies were used in current CNS practice, (b) determine the importance of those competencies to practicing CNSs, and (c) identify gaps between CNS core competencies and role expectations in current practice.
Design: A survey design was used with both paper-and-pencil and online instruments. The survey included 150 items and three open-ended questions.
Methods: A convenience sampling method was used, which targeted practicing CNSs.
Findings: Respondents ( N =505) were practicing CNSs who entered the field as RNs between 1956 and 2006. The survey had a high degree of internal consistency reliability (0.967%) between the subscales. The 75 NACNS core competencies were found to be useful and important for CNSs. A few gaps were identified between CNS core competencies and CNS role expectations in current practice.
Conclusions: No one method for validating competencies will be satisfactory for all situations; however, the processes and methods used in this study were well suited to accomplish the goal of validating CNS core competencies. The process described here may be instructive to leaders of other national and international professional organizations interested in developing and evaluating competencies. Core competencies are useful and important to currently practicing CNSs.
Clinical Relevance: The CNS role is growing internationally. Core CNS competencies can be a framework for CNS role development, education, and practice. As described here, a competency validation survey is one way to assure that CNSs are meeting healthcare needs.     

三级综合医院临床护理专家岗位设置及实践探索

文章总结了上海交通大学医学院附属仁济医院近10年来临床护理专家岗位设置及临床实践探索的相关经验.在设定入选标准、明确申报方案、制订管理及考核办法的基础上,医院护理部对临床护理专家进行统一选拔聘任,并以2年为1个考核周期,通过明确聘任等级、设立专项基金、明确岗位职责等一系列举措,各临床护理专家在临床实践、专科队伍建设、护...