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  1. Fulton, Janet S. PhD, RN, ACNS-BC, FAAN

Article Content

This is the last issue of the year, the 25th year of the journal. The founding editor, Dr Pauline Beecroft, started the journal in 1986 with publisher Williams & Wilkins. Shortly after the National Association of Clinical Nurse Specialists was formed in 1995, the journal became the organization's official publication. It was the first and remains the only peer-reviewed journal dedicated to role and practice of the clinical nurse specialist (CNS). Dr Beecroft retired in 2002, and I was appointed editor by the National Association of Clinical Nurse Specialists Board of Directors. It has been my pleasure to serve the CNS community through this editorship. The journal is the embodiment of our collective CNS talent. We owe a debt of gratitude to the journal's associate editors, feature column editors, authors, reviewers, and commentators. Thank you, one and all, for your generosity.


The journal serves as a communication forum for discussing practice innovation, care models, regulatory issues, educational concerns, and a host of other topics relevant to the CNS. It also provides a window into emerging trends, and I have observed a few since becoming your editor. One trend has been the shift to the Spheres of Influence model1 to describe CNS practice across 3 domains-patients/clients, nurses/nursing practice, and organization/systems. Before this model was introduced, the term CNS practice was rarely used to describe the totality of CNS activities. CNS role was the term most often used when describing the CNS, and it was considered to be composed of several subroles, most often clinician, educator, researcher, and consultant. Now, role has been clarified to mean a unique set of functions defined by core practice competencies, not subroles. Core practice competencies are learned through a formal program of study. When competencies are enacted, the result is CNS practice. Clinical nurse specialist practice competencies can be linked to outcomes at the patient/client, nurses/nursing practice, and organization/system levels. This language shift is bringing much needed clarity to our communications.


The scope of CNS practice is evident in the journal's content. The journal's decision to publish the abstracts began in 2003, and over the years, the abstracts have contributed much evidence for tracking and trending CNS practice. The number of abstracts submitted and accepted continues to increase, along with greater variety in the topics. Leadership for evidence-based practice, quality, safety, and innovation are dominant themes in the abstracts. Publishing the conference abstracts makes our CNS work more visible and accessible. In addition, including author affiliation with the abstract promotes networking and collaboration. The journal would enjoy receiving letters to the editor sharing a few words about networking experiences.


Increasing collaboration between CNSs in clinical settings and school of nursing faculty is an emerging trend. The journal has been receiving more manuscripts describing models and methods for linking practice settings and schools of nursing. As faculty members are becoming more engaged in practice settings, they are providing important support for research and innovation. Nursing may just be achieving that long-desired goal of collaboration as evidenced by the increase in manuscripts about clinical research and program evaluation coauthored by practicing CNSs and nursing faculty. There is also an increase in manuscripts coauthored by CNSs and nurse practitioners, suggesting increased collaboration across advanced practice nurses in clinical settings. The journal is very interested in manuscripts describing collaborative practices between and among faculty and advanced practice nurses. Start writing! Keep writing!


The number of doctor of philosophy (PhD)-prepared nurses in clinical settings is increasing. These PhD-prepared nurses hold administrative titles such as director of nursing research; professional practice; or quality, safety, and clinical innovation. These positions are concentrated in large, multihospital systems where they provide leadership for bringing together nursing faculty and advanced practice nurses around research and evidence-based practice as well as multidisciplinary research agenda. This trend toward adding PhD-prepared nurses to clinical settings may be a driving force behind the increase in faculty involvement in practice settings. Keep those manuscripts coming!


As we move forward into the next 25 years, let us continue the good work. If you have submitted a manuscript to the journal, many thanks! You are welcome to send another and another. If you have still not quite gotten to it, start now. Dissemination is a CNS practice expectation. Through publication, you are not only sharing practice innovations and outcomes but also contributing to the history of the CNS role and practice so wonderfully preserved in the last 25 years of the journal.




1. National Association of Clinical Nurse Specialists (1995/2004). Statement on Clinical Nurse Specialist Education and Practice. Philadelphia, PA: NACNS. [Context Link]