Can we afford not to have clinical nurse specialists?

The clinical nurse specialist (CNS) is in an excellent position to lead and design the necessary changes required in acute, chronic, and home care settings to meet the economic and legislative agendas to reshape health-care delivery. In this article, the authors, through the use of examples, outline key quality characteristics of a successful unit-based, system-focused model of CNS practice. Clearly, the benefits obtained from the outcomes of a traditional CNS role make a significant contribution to the profession of nursing and to the public. Without the CNS role, the opportunity for system change and the development and nurturing of the front-line health-care worker may be lost.