[Clinical nurse specialist]

Advanced nursing practice depends upon proper preparation through education and skill development. Skills should constantly be redefined and improved through out professional life. Therefore nurses need a safe professional framework in which to practice--called "protected autonomy". Critical debate between the CNS and nurse practitioner, about practice activity are a means to professional development. Support from a CNS could be an unshackling process--an opening of previously locked doors. Far from being a corrective experience, it should be seen as an exploratory relationship in an environment which aids development and promotes change. The CNS brings expertise to the day-to-day practice world of nurses. She has the ability to demonstrate excellence in practice, and the opportunity to bring to the clinical setting the expertise that can only be acquired over many years of learning. The CNS has a very clear "image" in her head of what nursing is. She promotes care which is personalized and patient-centered, not ritualized or institutionalized.