True Believers at the 2011 Clinical Nurse Leader Summit

By Maureen ‘Shawn’ Kennedy, AJN’s editor-in-chief, who is in Florida this week attending meetings and visiting local schools

It’s January and I’m in Miami (I know, I know). I just finished attending the CNL 2011 Summit (CNL = clinical nurse leader). It was a relatively small meeting, as nursing meetings go, with about 350 attendees who were CNLs, faculty or students in CNL programs, or chief nursing officers from clinical facilities employing CNLs. They were all believers in the value the role brings to clinical practice. There was an energy, an atmosphere of being in on a new and growing phenomenon.

Some background: the CNL is a relatively new role in nursing, first formally proposed by the American Association of Colleges of Nursing in 2003 after several meetings with other nursing groups concerned with nurses’ “education for practice” (see the white paper on the development of the role). CNLs function at the unit level, coordinating care, working with staff, focusing on improving outcomes.

Described as “master’s-prepared advanced generalists,” CNLs now number about 1,300, according to Mary Stachowiak (see photo), president of the Clinical Nurse Leader Association (CNLA). There are currently about 100 institutions with master’s programs preparing CNLs and about 1,800 CNLs in programs.

AJN carried a short news article back in October 2004 noting the creation of the new role, and in December 2005 we reported on the controversy surrounding the role,  much of it coming from the National Association of Clinical Nurse Specialists (NACNS), who saw the role as duplicating some aspects of the CNS role in a way that might “disenfranchise” those who already had that credential.

More recently, our update in January 2010 showed that, while there still were some reservations about the role, broader support was emerging. The role has been widely implemented in the Veterans Administration (VA) health system; Cathy Ricks, chief nurse executive of the VA, has been a key supporter and received the first Visionary Leader Award at this meeting. (And it’s not just the VA that’s positive about the role; Baptist Health Systems in Florida, University of Maryland Medical Center—which has 59 CNLs—and others have embraced the role. At the meeting, a nursing recruiter for a Texas hospital system was there  looking to hire 50 CNLs over the coming year.)

After listening to Michael Bleich, dean of the school of nursing at Oregon Health and Science University in Portland, present the opening keynote around the recent Institute of Medicine Future of Nursing report (Bleich was on the committee), I couldn’t help thinking that CNLs, if they fulfill the promise and intent of the role, could become the critical piece that has been missing from professional nursing practice in hospitals. It could be that the CNL is that better educated nurse that the IOM has been calling for.

(My next visit, from which I hope to report as well, will be to the College of Nursing and Health Sciences at Florida International University and its state-of-the-art simulation lab.)