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A Clinical Nurse Specialists (CNS) is an advanced practice registered nurse with expertise in nursing management of a defined specialty population. CNS practice is characterized by the translation of knowledge and evidence-based standards into high quality patient care delivery and patient outcomes, either by providing direct care or by influencing the practice of others. Special knowledge and skills are required for the role, including clinical expertise, advanced understanding of evidence-based practice, and proficiency in communication, collaboration, consultation, evaluation, education, mentorship, and change management strategies. The CNS creates an environment that supports clinical inquiry to improve clinical and service outcomes across three spheres of influence: the patient/family, nurses and nursing practice, and the organization/system (NACNS, 2010). 

• Master's degree (MSN or MS in Nursing)

• Certification as a Clinical Nurse Specialist

• Minimum of two years of recent clinical obstetrical nursing experience
• Minimum requirement of two years of labor and delivery experience
• Previous teaching experience preferred
• Licensed Registered Nurse in good standing with the State of Michigan
• Basic Life Support within orientation period
• Advanced Cardiac Life Support within orientation period if providing coverage for critically ill patient populations.

Exhibits strong analytical, organization and prioritization skills Displays sound computer skills in multiple software applications

Possesses a high degree of flexibility .

Manages and appropriately prioritizes multiple, concurrent projects

Assists with issue identification and problem resolution

Demonstrates strong communication and negotiation skills

Able to work in inter-professional teams Work which produces very high levels of mental/visual fatigue, e.g. CRT work between 70 and 90 percent of the time, and work involving extremely close tolerances and considerable hand/eye coordination for sustained periods of time. Involves regularly lifting of bulky or moderately heavy weights (i.e., up to 50 pounds), and occasionally assisting with heavier tasks or expending the equivalent effort in pushing, pulling, or otherwise handling material, equipment, and other objects. CNS outcomes are achieved through a set of core competencies (NACNS, 2010), employed across three spheres of influence (patient/family, nurses/nursing practice, and systems/organizations), including:

Direct Care: Direct interaction with patients, families, and groups of patients to promote health or well-being and improve quality of life. Characterized by a holistic perspective in the advanced nursing management of health, illness, and disease states. Works with the interdisciplinary team to develop plans of care to achieve high quality outcomes.

Consultation: Patient, staff, or system-focused interaction between professionals, where the CNS is recognized as having specialized expertise in achieving identified outcomes and implementing practice improvements.

System Leadership: Manages change and empowers others to improve nursing practice both within and across systems. Uses systematic processes, practice standards, and innovations to influence nursing practice and outcomes for a specialty population. Leads system change to improve health/nurse sensitive outcomes.

Collaboration: Works jointly with others to optimize clinical outcomes. Collaborates at an advanced level by establishing effective communication and relationships that advance problem-solving and promote clinical excellence.

Coaching: Provides skillful guidance and teaching to advance care of patients, families, groups of patients, and the profession of nursing. Mentors nurses in the acquisition of new knowledge, translation of research into practice, implementation of evidence-based nursing care, and participation in effective clinical teams.

Research: Generates new knowledge and contributes to nursing science by participating in the conduct of nursing research. Interprets, translates, evaluates, and integrates evidence into clinical practice and quality improvement initiatives. Engages in systematic inquiry to evaluate patient care delivery and patient outcomes.

Ethical Decision-Making, Moral Agency, and Advocacy: Identifies, articulates, and takes action on ethical concerns at the patient, family, provider, and system levels. Engages in formal self-evaluation, seeks feedback on performance, and fosters team accountability. Participates in organizational, local, state, national, and international level policy making and other activities related to professional nursing practice.

The following are the primary performance categories and competencies, which are used to evaluate each employee in this job. The specific measurements and records of performance are kept within each department/unit.

I. DOCUMENTATION: Demonstrates the competencies associated with the paperwork or charting aspect of the job. For some jobs, e.g., clerical, this is a major function of the job. For others, e.g., direct patient care jobs, it demonstrates that the employee documents their work appropriately and not how well the work is performed. Data is gathered from charts, notes, paperwork, completed documents, etc.

II. JUDGMENT/DECISION MAKING: Demonstrates the ability to evaluate the factors relevant to a situation and make timely decisions that add value to the services provided. Data is gathered from peer review, observation, customer comments/suggestions, etc.

III. TECHNICAL SKILLS: Demonstrates competency in the skills or tasks required for the employee's job. Data is gathered via peer review, observation, etc.

IV. TEAMWORK: Demonstrates the competencies necessary for developing and maintaining cooperative relationships with other at all levels of the organization by sharing information, workload responsibilities, decision-making and recognition of others in pursuit of a common purpose. Evidence is gathered via peer review, observation, etc.

V. PRODUCTIVITY: Demonstrates the ability to achieve the desired work result effectively and efficiently with the minimum of time and resources. Evaluated through peer review, observation, etc.

VI. QUALITY IMPROVEMENT: Demonstrates competencies necessary for the integration of quality control into the job, department and/or organization-wide improvements. Data is gathered through documented improvement processes.

VII. COMMUNICATION SKILLS: Demonstrates appropriate communication skills with patients, visitors, coworkers, supervision, physicians and others. Includes verbal and telephone skills. Data gathered via observation, workshop/presentation evaluation form, written or verbal feedback from customers.

VIII. PROFESSIONAL GROWTH: Participates in a program of self-development and continuous education. This is for all employee mandatory inservices, other inservices, educational activity, and community service as required by the job. Data gathered from sign in sheets and department records.

IX. EXTENDED ROLES: This itemizes extended roles (if any) the employee performs, i.e., charge, preceptor, etc. For each advanced role, a separate competency list is required.

X. CUSTOMER SERVICE: Demonstrates adherence to the standards as provided in the Bronson "Commitment to Customer Service", i.e., Commitment Statements, Quality Service Standards and the Interaction Process which includes the Service Recovery "AAA Action Plan". Data gathered via observations, customer surveys, and other written and verbal feedback from customers.

XI. AGE SPECIFIC (Direct patient care jobs only.): The employee must be able to demonstrate the competencies necessary to provide services appropriate to the age of the population served. Data gathered from observation and department records.

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