A Clinical Nurse Specialist (CNS) is an advanced practice registered nurse (APRN).

CNS who have completed masters or doctoral education in nursing and offers advanced
assessment skills, clinical knowledge, and education to patients and other clinicians in a
variety of fields.

-The three main domains of CNS practice or spheres of influence:

Patient
Nursing personnel
System (healthcare system)

-Seven Core Competencies:

*Direct clinical practice includes expertise in advanced assessment, implementing nursing

care, and evaluating outcomes.
*Expert coaching and guidance encompasses modeling clinical expertise while helping
nurses integrate new evidence into practice. It also means providing education or teaching
skills to patients and family.
*Collaboration focuses on multidisciplinary team building.
*Consultation involves reviewing alternative approaches and implementing planned
change.
*Research involves interpreting and using research, evaluating practice, and collaborating
in research.
*Clinical and professional leadership involves responsibility for innovation and change in the
patient care system.
*Ethical decision-making involves influence in negotiating moral dilemmas, allocating
resources, directing patient care and access to care.

Job Description
CNS work in hospitals, clinics, medical offices and other health care facilities. They are
usually experts in a specific area, one example is gerontology (study of old age, age
processing & problems of old people), cardiovascular health or public policy, and also
provides direct patient care and consultation, which is involved in education, research and
facility administration.

CNS specialties are the following categories;

*Disease or Medical Subspecialty which is treating a variety of patients.
*And this involves also in Type of Care which is the rehabilitation, therapy or psychiatric.
*But Type of Problem is based at from example, at a result of mental health exams or other
medical diagnosis or exams the patient undergoes.
*Population which is performing basic wellness assessments like pediatrics (medical care of
infants, children and adolescence), to gynecological (medical practice on female
reproductive system & breast).
*Setting is providing consultations for patients and their families to make sure they
understand a medical condition and options for treatment as well as supervising and working
with other nurses and involves in the management or administration of a clinic or facility.
Examples of these are emergency department and the critical or long-term care of a patient.

Qualifications

*Earning a Bachelor's Degree in Nursing

*Obtaining State License as Registered Nurse
* Experience in specialties chosen
*Earning a Clinical Nurse Specialist Master's Degree from an Accredited Program
*Applying for Certification for advance practice
*Obtaining Advanced Practice Nursing License from State Nursing Board

A Pediatric Nurse Practitioner (PNP) specializes in their care of infants, children and
adolescence.

PNP documents patient progress through careful record keeping, notifies the doctor in the
event of any changes in a patient's situation and often assist doctors by checking vital signs,
drawing blood, giving vaccinations, and taking patient histories during their visits.
PNP candidates are trained on disease management, prevention, and assessment. They
often provide primary healthcare for children at clinics, hospitals and pediatric medical
offices, even in surgical centers or intensive care units, and specialize in specific illnesses or
pediatric areas, such as acute care (active but short-term treatment) or neonatal care
(intensive care unit designed for premature and ill newborn babies).

Job Description

Pediatric nurse practitioners can also choose to work in a pediatric subspecialty, such as
cardiology, neurology, dermatology, gastroenterology, orthopedics, or infectious disease.
They provide services like;
*Health maintenance care, including well-child exams and childhood immunizations
*Routine developmental screenings
*Diagnosis and treatment of common childhood illnesses
*Teaching and counseling of children and their families on issues related to health
Meanwhile acute care and specialty PNP perform services such as:
*Caring for children who have acute, chronic, and critical illnesses
*Conducting advanced physical assessments
*Interpreting lab and diagnostic test results

Qualifications

*Earning a Bachelor's Degree in Nursing

*Obtaining State License as Registered Nurse
* Experience in specialties chosen
*Masters degree in Nursing with a major in pediatric nurse practitioner
*Pediatric Nurse Practitioner Post-Masters Certificate or specialization of PNP
*Obtaining Advanced Practice Nursing License from State Nursing Board
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A Geriatric Nurse Practitioner (GNP) is the specialty of nursing pertaining to older adults.

GNP provides information on treatment and medications to patients and their families,
monitors treatments and keeping detailed records of patient care, and is responsible for
supervision of other nurses and hospital staff, as well as for standards of safety, care quality
and patients' rights.
GNP works in collaboration with older adults, their families, and communities to support
healthy aging, maximum functioning, and quality of life.

Job Description

GNP position may also require an understanding of adult development and sympathy for the
aging process. Part of GNP duties are implementing the plan of care and consulting
physicians, coordinating patient care with other healthcare practitioners, and teaching
patients and their caregivers how to manage an illness.

GNP services are;

*Diagnosing illnesses and diseases
*Prescribing medication and therapy
*Conducting routine check-ups and screenings
*Ordering patient lab tests
*Pain management (employing of easing the patients suffering)
*Focusing on preventative care

Qualification

*Earning a Bachelor's Degree in Nursing

*Obtaining State License as Registered Nurse
* Experience in specialties chosen
*Masters degree in Nursing with a major in geriatric nurse practitioner
*Geriatric Nurse Practitioner Post-Masters Certificate or specialization of PNP
*Obtaining Advanced Practice Nursing License from State Nursing Board

A Certified Nurse Midwife (CNM) is an advanced practice registered nurse who has
specialized in midwifery.

CNM provides primary healthcare for women and most often provide medical care for
relatively healthy women, whose health and births. Usually, CNM collaborates with
obstetrician (deals with pregnancy & childbirth) and gynecologist (deals with female
reproductive organs), especially if the patient is in weak or in risk in birthing.

Job Description

A CNMs duty is to ensure safety delivery and as much as reduce complication in the birth to
both mother and the child.
Services are;
*Prenatal care
*Labor support and management
*Assistance during the birth delivery

*Care after your baby's birth

*Pregnancy education on topics such as nutrition, exercise, planning for labor or birth and
parenting
*Education on breastfeeding and baby care
*Preconception counseling
*Care during perimenopause, including counseling

Qualification

*Earning a Bachelor's Degree in Nursing

*Obtaining State License as Registered Nurse
* Experience in specialties chosen
*Masters degree in Nursing with a major in nurse midwifery
* Nurse Midwifery Post-Masters Certificate or specialization of CNM
*Obtaining Advanced Practice Nursing License.
A Certified Registered Nurse Anesthetist (CRNA) is an advanced practice registered nurse
who has specialized in anesthesia.

CRNA cares for a patient before, during and after a medical procedure or surgery by
performing a patient assessment, preparing the patient for anesthesia, administering and
maintaining the anesthesia to ensure proper sedation and pain management, overseeing
patient recovery from anesthesia and caring for the patient's immediate aftermath needs.

Job Description

A CRNAs both duty and responsibility is to ensure safety and painless medical procedure of
the patient.
Services are;
*Administering first-class patient care
*Pain Management (easing the patients suffering)

Qualification

*Earning a Bachelor's Degree in Nursing

*Obtaining State License as Registered Nurse

* Experience in specialties chosen
*Masters degree in Nursing with a major in nurse anesthetist
* Nurse Anesthetist Post-Masters Certificate or specialization of CRNA
*Obtaining Advanced Practice Nursing License.

Roles & Responses of

a Nurse

Princess Ivonne Atillo

BSN-IA