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A journal dedicated to clinical nurse specialists (CNSs) was the vision Pauline Beecroft. In her Passing the Torch editorial (2002;16[2]:55-56), Dr Beecroft described how her vision for a journal-one that would publicize what CNSs did and how they affected patients' health, as well as nursing practice-took hold during a 1985 CNS conference. Owing largely to the support of CNSs at the conference, the membership of the American Nurses Association (ANA) Council of Clinical Nurse Specialists, and the publishers at Williams & Wilkins, the debut issue of Clinical Nurse Specialist appeared in spring 1987. ANA eventually restructured and eliminated the CNS Council; however, the journal continued to publish articles about the CNS role, becoming a national forum for CNSs. Then, in 1995, a group of CNSs, including Dr Beecroft, envisioned a CNS organization to represent the practice and role of the CNS, and the National Association of Clinical Nurse Specialists (NACNS) was formed. The colliding visions resulted in this journal becoming the official journal of NACNS.


It's been a long time coming. Almost 25 years after the CNS role was first described, CNSs have a professional organization with the communication power of a journal. With great pride and pleasure, I introduce to you several editorial and publishing changes. As regular readers will see, the journal has a new look-new color, new graphics, new format! And there are editorial changes, too. Change in the membership of the editorial board creates balance among specialty practice, new ideas, and editorial experience. New and continuing feature columns, presented by experts in the content areas, appear in a new format. Most important, but not so visually noticeable, is a renewed vision of the journal.


The purpose of the journal, approved by the NACNS Board of Directors, is to publish scholarly works by CNS and other advanced practice nurses (APNs) whose manuscripts advance the practice of nursing. The objectives are: (1) to disseminate knowledge about CNS practice; (2) to communicate the outcomes of CNS practice on patients, families, groups, and communities, the nursing profession, and healthcare systems, organizations, and networks; (3) to foster discussion of issues and trends that affect CNS practice; and (4) to promote dialogue between CNS and other advanced practice nurses. In this, your association's journal, you should find information that stimulates new interventions, expands practice outcomes, and changes practice standards and delivery systems.


The journal is guided by the notion of advanced practice as explicated in the NACNS Statement on Clinical Nurse Specialist Practice and Education and is therefore anchored in nursing's autonomous scope of practice-practice that is uniquely nursing and independent in the promotion and maintenance of wellness and the prevention or resolution of illness. The journal is committed to advancing nursing practice by publishing manuscripts that translate new knowledge into innovative nursing care and dialogue about the issues, challenges, and obstacles associated with advancing nursing practice. We, the editorial board, intend for the journal to be more about advanced practice nursing and less about advanced practice nurses.


As the journal's revisioning was taking shape, I happened upon an old dog-eared copy of an article about clinical specialists, written in 1965 by Dr Hildegarde Peplau. I glanced at the words, then found myself reading with greater intensity. Dr Peplau envisioned clinical specialists as expert nurses-nurses with expert theoretical and practice knowledge about nursing, experts whose innovative work would advanced nursing practice. She pointed out that the substantive content of nursing has to do with nursing practice problems-and the theories that explain and help resolve these problems. She noted that much of the responsibility for the development of nursing's substantive content belongs to the clinical specialist. Today we call upon CNSs to work in partnerships with researchers to develop substantive content, the knowledge, of nursing; however, it remains today as Dr Peplau noted all those years ago-the CNS is the link between new knowledge and nursing practice.


It is just as important today as it was in 1965 that innovative practice doesn't end with an individual patient outcome. Dr Peplau's notion of a clinical specialists included responsibility for changing nursing practice-that the standard of care improves because of the innovative actions of CNSs. Dr Peplau's mandate for CNSs to communicate, educate, and lead the profession is clear in her call for CNSs to publish. CNSs work with the most complex clinical problems in nursing, but it is not enough-this work must generate a literature that helps to constantly advance the practice of nursing.


Clinical practice is the center of nursing. The primary commitment to society of the profession of nursing is the practice of nursing; all other functions are secondary. The profession evolved to serve patients-which means to deal effectively with the clinical nursing problems that these patients present. The clinical specialist serves as a model of expertness representing advanced or newly developing practices to the general staff nurse. Theoretically, the clinical specialist not only works with the most complex problems in nursing but through such work provides a literature which helps constantly to revise the general practice of nursing (emphasis added). The clinical specialist is a model to "beat tradition." The substantive content of nursing has to do with nursing practice problems and theories that explain and help nurses to resolve these problems. It is precisely because we are short on clinical specialists that we are also short on substantive content. 1


I was impressed by the thought-provoking nature of Dr Peplau's words in the context of contemporary CNS practice and decided to share my dog-eared treasure with you. In this issue, with its spiced-up new look, I find it appropriate to include Dr Peplau's 1965 article "Specialization in Professional Nursing," reprinted in its entirety and unedited. It is the mission of the editorial board to renew the journal in a vision that began long ago with Dr Peplau's call for a literature that helps constantly to revise the practice of nursing. We are proud and pleased to bring to you Clinical Nurse Specialist: The Journal for Advanced Nursing Practice.




1. Peplau H. Specialization in professional nursing. Nurs Sci. 1965:276-277. [Context Link]