Practical strategies for CNS role implementation

Methods of implementing the clinical nurse specialist (CNS) role can be approached in many ways. Providing the clinical specialist with concrete strategies to use during role implementation or expansion can aid in expediting the acceptance process for the CNS. Some authors have discussed phases the CNS encounters during role development. Time span of these phases vary greatly, dependent not only on the individual specialist, but also on the system for which they are employed. Kramer's four phases detailing the adjustment period of the newly practicing nurse may be used when discussing CNS role implementation. These four phases are: honeymoon, shock/rejection, recovery, and resolution. Practical suggestions to expedite role implementation can make progression through these phases easier and less overwhelming. Although obstacles will often be present, the CNS must then become a catalyst by using creative ideas and effective coping mechanisms to effect change and advance the role.