Creating our future: challenges and opportunities for the clinical nurse specialist

Rapid change, increasing technology, and cost-containment pressures present both challenges and opportunities for clinical nurse specialists (CNSs). Challenges stem from outside forces as well as from within the nursing profession, threatening the CNS role. At the same time, opportunities exist to expand advanced practice roles. To maximize these opportunities, consensus on the standards and qualifications for advanced practice is necessary. Certification and reimbursement for CNSs, clarification of advanced practice roles in new practice models, and strengthening of collaborative practice are some strategies to respond to these challenges and opportunities. Increased CNS accountability for defined institutional priorities also is crucial to the future of the CNS.