21 NCAC 36 .0228. CLINICAL NURSE SPECIALIST PRACTICE

(a)  A registered nurse who meets the qualifications as outlined in Paragraph (b) of this Rule may be recognized by the Board as a clinical nurse specialist, and perform nursing activities at an advanced skill level as outlined in Paragraph (c) of this Rule.

(b)  In order to be recognized as a Clinical Nurse Specialist, the Board of Nursing shall require an applicant to meet the following qualifications:

(1)           has an unrestricted license to practice as a registered nurse in North Carolina or a party state;

(2)           has completed a master's or higher degree program consisting of a minimum of 500 hours of clinical experience in the clinical nursing specialty as defined in 21 NCAC 36 .0120(41) and consistent with G.S. 90-171.21(d)(4).  For a dual track graduate program, if less than 500 hours per track, a requirement that there must be documentation of any crossover which would justify less than an additional 500 hours for the second track; and

(3)           has current certification in the clinical nursing specialty from a national credentialing body approved by the Board of Nursing, as defined in Paragraph (e) of this Rule and 21 NCAC 36 .0120(26).

(c)  Clinical nurse specialist scope of practice incorporates the basic components of nursing practice as defined in Rule .0224 of this Section as well as the understanding and application of nursing principles at an advanced level in his/her area of clinical nursing specialization which includes:

(1)           assessing clients' health status, synthesizing and analyzing multiple sources of data, and identifying alternative possibilities as to the nature of a healthcare problem;

(2)           diagnosing and managing clients' acute and chronic health problems within a nursing framework;

(3)           formulating strategies to promote wellness and prevent illness;

(4)           prescribing and implementing therapeutic and corrective nursing measures;

(5)           planning for situations beyond the clinical nurse specialist's expertise, and consulting with or referring clients to other health care providers as appropriate;

(6)           promoting and practicing in collegial and collaborative relationships with clients, families, other health care professionals and individuals whose decisions influence the health of individual clients, families and communities;

(7)           initiating, establishing and utilizing measures to evaluate health care outcomes and modify nursing practice decisions;

(8)           assuming leadership for the application of research findings for the improvement of health care outcomes; and

(9)           integrating education, consultation, management, leadership and research into the advanced clinical nursing specialist role.

(d)  The registered nurse who seeks recognition by the Board as a clinical nurse specialist shall:

(1)           complete the appropriate application, which shall include:

(A)          evidence of the appropriate masters, post-master's certificate or doctoral degree as set out in Subparagraph (b)(2) of this Rule; and

(B)          evidence of current certification in a clinical nursing specialty from a national credentialing body as set out in Subparagraph (b)(3) of this Rule;

(2)           submit a processing fee of twenty-five dollars ($25.00) to cover the costs of duplicating and distributing the application materials; and

(3)           submit evidence of initial certification and re-certification at the time such occurs in order to maintain Board of Nursing recognition consistent with Paragraphs (b) and (e) of this Rule.

(e)  The Board of Nursing may approve those national credentialing bodies offering certification and recertification in a clinical nursing specialty which have established the following minimum requirements:

(1)           an unencumbered registered nurse license; and

(2)           certification as a clinical nurse specialist is limited to masters, post-master's certificate or doctoral prepared applicant effective January 1, 2010.

 

History Note:        Authority G.S. 90-171.20(4); 90-171.20(7); 90-171.21(d)(4); 90-171.23(b); 90-171.27(b); 90-171.42(b);

Eff. April 1, 1996;

Amended Eff. April 1, 2008; January 1, 2007; November 1, 2005; August 1, 2005; April 1, 2003.