Utilization pattern of clinical nurse specialists in the Baltimore-Washington area

In the present cost containment environment, hospitals often change their employment patterns. Nurses in advanced practice roles are particularly vulnerable to reassignment. In order to determine if the employment of Clinical Nurse Specialists (CNSs) in the Baltimore-Washington area had decreased and to determine what specialty areas employed the most CNSs, a survey of all area hospitals was conducted. The nursing departments of all 88 hospitals were contacted by phone with 40 of them (45%) agreeing to provide data. Seventeen institutions reported employing a total of 119 CNSs. Of these, only 12 required a Master's degree for nurses to hold that position. As expected, larger institutions employed more CNSs. This role appears to be stable, with only two institutions having eliminated CNS positions recently and five reporting plans to add such positions in the near future. Most CNSs reported either directly or indirectly to the Director of Nursing. Those in positions funded by another source reported to personnel in the funding department or agency. Almost all CNSs had clinical titles, and Psychiatric, Oncology, Medical and/or Surgical, Pediatrics or Critical Care were the most prevalent specialties mentioned. The CNS role is a viable role in the Baltimore-Washington area even in this time of cost containment. Most CNSs are identified with their area of clinical specialization.