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With Nurses Week behind us and Clinical Nurse Specialist Week coming up in September, it is a perfect time to discuss clinical nurse specialist (CNS) attributes that ought to be honed, refined, and exhibited locally, nationally, and internationally, to aid in viewing CNSs as strategic visionary leaders. So, are you in? Are you ready to assess your current level of influence[horizontal ellipsis]and push it forward? Have you taken steps to expand your advocacy skills by addressing critical issues and advances that can make a difference? Do you challenge the status quo? Have you developed and tested novel interventions that might enhance clinical, administrative, or leadership processes and practices? Do you influence and support nursing research and evidence-based practice projects that test the effectiveness of strategies? And, are you taking steps to improve the health of our nation?


First, advance your skills in strategic visioning and leadership. Consider healthcare system design needs related to your area of expertise. How can we create new attention toward health promotion via population health, home care, and telehealth communication? What social determinants of health are important considerations in reaching goals? Because CNSs work in multiple spheres of influence and have leadership, collaboration, and consultation skills, they are critical to achieving system goals, but only when they use their expertise and professional attributes in strategic visioning and leadership to coordinate care across the continuum of healthcare.


Second, challenge the current model of care delivery and disrupt the status quo. It is important for healthcare systems to disrupt themselves and make repairs. Refashioning to higher levels of complexity and integration will enhance the system's ability to adapt to national trends and recover when stressors emerge. When CNSs use their strategic leadership skills to innovate, especially when there is a shared vision for change, their value will be realized in new ways. Clinical nurse specialists should identify where improvements are needed, review the literature for evidence of disruptive changes, contact internal and external stakeholders, and use human resources and administrative data to set the stage for changes in the care delivery model.


Third, CNSs need to master the art of using innovation principles, because innovation is important in promoting true impact. Creativity includes taking the time to understand the current issues and habits-where the bottlenecks and throughput issues are-and successes and being open to novel ideas that have a purpose. Ideas should be plentiful, and interdisciplinary collaborators should assist with enhancement. It is important to know when ideas should be abandoned, so that time is not wasted on moving a nonfunctional or inappropriate concept forward. Furthermore, failures may lead to success, so CNSs should consider failure an important learning experience.


Fourth, CNSs should apply critical strategic thinking skills and mitigate knowledge loss to enhance action-based and educational outcomes. For example, CNSs should consider the multiple actions needed to enhance outcomes and choose those that require urgency first. If there are multiple simultaneous actions that are important, CNSs should predict the ordering that will promote success. Furthermore, CNSs should think ahead when executing an action or educating others on proposed actions, so that critical situations can be avoided. To mitigate knowledge loss, CNSs must disseminate organizational performance and patient-related clinical outcomes that are achieved through evidence-based practice change, quality improvement, and clinical research. Dissemination may include publication and working with internal and local, regional, or national external groups to create and change policies, procedures, and performance measures.


Strategic visionary leadership by CNSs creates visibility for the CNS role and promotes CNS vitality when graduate students select the CNS role as a profession. More importantly, visionary leadership will accelerate best practices and optimum clinical outcomes that promote the mission of healthcare. Finally, strategic visionary leadership by CNSs will create change, promote innovative practices, and facilitate rigorous clinical research that can advance nursing practice.