At the National Association of Clinical Nurse Specialists (NACNS) conference, we spoke with Melanie Duffy, MSN, RN, CCRN, CCNS, co-editor of Clinical Nurse Specialist Toolkit: A Guide for the New Clinical Nurse Specialist.  Read our interview below:


Springer Publishing Company: To start off, could you talk a little about the impetus behind you co-editing Clinical Nurse Specialist Toolkit, and if there were any similar books available when you all decided to write it?

Melanie Duffy: There wasn’t anything available in the field at that particular time. I was at a board meeting one year and we were talking about how we needed information for the novice clinical nurse specialist.  How do you get started in your practice? Also, information was needed for clinical nurse specialists who had been practicing for a while. There were a lot of books out there that talked about the role, but not how you get started or, once you’ve been in the role, are there new and different things that you could look at, that you could apply to do, or things that you could think about—how to get started on different projects.  So we thought, well why don’t we come up with some kind of resource for the novice clinical nurse specialist that would also be good for the experienced clinical nurse specialist, and I said that that’s something I would like to work on and I sort of got volunteered to head up the project, which was fine. I really wanted to do that, and that’s how I became primary editor of the book. So I included two other people on the board to help me with the editing. We asked people to help us write the book, write different chapters, and the result was the toolkit which is still being used today in a lot of graduate programs, and I’m really pleased with that.


SPC: Since the book came out in 2009 how has the response been? Have you heard from new clinical nurse specialists about how they use the book?

MD: Yes, I am still hearing from clinical nurse specialists that they really like the book. In fact, I just heard from one today that she uses it in her graduate program. She used it as a student, and her colleagues use it as well. And she said that when she is working with novice clinical nurse specialists, or even people who are still students, that she orders the book for them and gives it to them—so that she has to keep replenishing her stock because she keeps giving her book away, which makes me feel good!


SPC: Since the book came out we’ve obviously had a lot of changes in health care.  How has that affected being a clinical nurse specialist in America today?

MD: I think the role is still the same: the clinical nurse specialist still is the expert in numerous areas in health care, not just nursing but health care in general. With things changing and moving forward with the Affordable Care Act, we have to start thinking about how we can be effective outside a hospital system because most clinical nurse specialists work inside a hospital system. We have to look at what opportunities are available out in the public, out in the community, in our churches, in the YMCA’s…where can we be beneficial, but not necessarily be in a hospital setting inside four walls. How can we help people and still practice in our role and still be health care providers.


SPC: And given all that’s changing, are you working on anything right now for the field? Any books or articles?

MD: I’m not currently working on a book or article. I am working on some legislative initiatives in my home state of Pennsylvania. We need to move the clinical nurse specialist forward in that state and I’m a big part of that, so I’m not working on a specific book or article, that may come out of the work, but right now I’m just legislatively active.


SPC: So it’s been about five years since the book came out. Where do you think the field will be in five years from now?

MD: I think currently the clinical nurse specialist is going to be outside the hospital, as I mentioned.  I think the clinical nurse specialist is the one who is going to be practicing in the homeless shelters, or in the really rural areas where we have the underserved and uninsured, and underinsured, populations. We still have those populations and unfortunately they’re not getting the care they need or the care that they deserve. I think the clinical nurse specialist really is well positioned to be the one that can grant that…that can improve the care of those populations in those kinds of settings.


SPC: What are some of the hot topics or trends being discussed in this NACNS meeting?

MD: I think two of the hot topics are the implementation of the APRN Consensus Model which is supposed to go into effect in 2015. That was a recommended start date. Different states are in different places in that process, so that’s a hot topic that’s being discussed. And the second hot topic is the accountable care organizations, and just exactly what that is going to look like in the next two or three years, or even sooner. How are organizations going to adapt to that model, and how are we going to adapt to working within that model.


SPC: Well Melanie Duffy, thank you for your time.

MD: Thank you. And one final thing that I would like to say is that the clinical nurse specialist probably has more opportunities than ever before to really be an effective partner in the health care system and I think we have a lot to offer. Clinical nurse specialists are not going away—we’re here for the long haul.