At the Crossroads: We must Blend the CNS + NP Roles

On June 11, 1996, Governor George V. Voinovich signed Sub SB 154, The Advanced Practice Nursing Bill, into law. This event followed six legislative attempts in the past decade to grant legal authority for Advanced Practice Nurses (APNs) in Ohio (Pearson, 1996). Title protection, scope of practice, collaboration/supervision arrangements with physicians, Board of Nursing regulation and education/certification requirements for nurse practitioners (NPs), nurse midwives (NMs), nurse anesthetists (NAs), and clinical nurse specialists (CNSs) have been tenaciously negotiated by nurses, physicians, hospitals, pharmacists, insurers and legislators. (Stir & Savino, 1996). However, the celebration of this monumental achievement may be overshadowed by an even greater controversy within the nursing profession -- to merge or not to merge the roles of the NP and the CNS. That is the question! The position taken in this paper is that we must merge the roles to create an Advanced Practice Nurse (APN) role.