CNS Leadership During a Public Health Crisis: Implications for Curriculum and Competency Development

Nurses play a key role in disaster management. Established disaster nursing competencies are available but lack consistent integration into curricula. As advanced practice registered nurses (APRNs), clinical nurse specialists (CNSs) have demonstrated evidence of leadership through crisis. Additional evidence is needed regarding CNS experiences during the pandemic to validate evidence of disaster competencies and clarify gaps. The study aims were to describe (1) how CNSs modified practice to respond to pandemic demands and (2) outcomes associated with CNS practice. This was a qualitative descriptive study involving 17 CNSs across the US Focus groups were conducted using a semi-structured interview guide. Data were analyzed using content analysis. The overarching category associated with CNS practice was "navigating the unknown." Six subcategories emerged, including creating best practices, being a communication conduit, adapting work routines, providing psychological support, filling education gaps, and coordinating care. CNSs are the practice leaders from the front line to the boardroom, ready to inform strategic planning, and systems to prepare and respond to emergencies. Advanced level disaster management preparation is essential for APRNs to actualize strategic capabilities within health care systems. Disaster management education recommendations based on study results should be used to inform CNS practice competencies and academic curriculum.