You may be very familiar with the Nurse Practitioner (NP) role, but if you are like many nurses in Calgary, you do not know the definition of a Clinical Nurse Specialist (CNS).
Both of these roles are the only recognized Advanced Nursing Practice (ANP) roles in Canada according to the Canadian Nurses Association (CNA). Graduate prepared Advanced Practice Nurses (APNs) use their expertise to help develop and advance professional nursing knowledge and meeting health needs of patients. While NPs are defined more by direct care and expanded scope of practice, CNSs are considered to be experts in nursing care that help facilitate system changes through evidenced based practice.
Recently, the College and Association of Registered Nurses of Alberta (CARNA) published a short article on the history of ANP in Alberta where the author, Jananee Rasiah, suggested CNS roles originated out of need for expert care post World War 2. Among challenges that APNs face in Alberta, Rasiah identified that there is a lack of role and scope awareness and role overlap. The CNS title that emerged in the 1960’s is not a protected one in Canada. In Alberta, however, the title “specialist” is protected under the Health Professions Act . The official CNA position statement for CNSs defines them as Registered Nurses with a graduate degree in nursing with expertise in a specialty area. Their roles are defined by four competencies: clinical care, systems leadership, advancement of nursing practice, and evaluation and research.
A recent survey by CNA identified 804 CNSs practicing in Canada. According to CARNA, there are currently 494 NPs, 226 CNSs, and 826 graduate level educated nurses in Alberta (the 2 latter statistics are self reported). Clinical Nurse Specialists working for Alberta Health Services are members of United Nurses of Alberta. They play key roles in direct patient care as well as systems changes such as policy and education development. For more information on CNSs, please see this article in the Canadian Nurse.