194 CLINICAL NURSE SPECIALIST™
Clinical Nurse Specialist
TM
Copyright © 2003 by Lippincott Williams & Wilkins, Inc.
From Winona State University, Rochester, Minn.
This project is/was supported by funds from the Division of Nursing (DN), Bureau of Health Profes-
sions (BHPr), Health Resources Services Administration (HRSA), Department of Health and Human
Services (DHHS), under grant number 5 D09 HP 00107-03 Post-Nursing Master’s CNS Certificate Pro-
gram in the amount of $729,764. The information or content and conclusions are those of the author
and should not be construed as the official position or policy of, nor should any endorsements be
inferred by the DN, BHPr, DHHS, or the US Government.
Corresponding author: Sharon Tucker, DNSc, RN, CNS, Mayo Clinic, Dept of Nursing, 200 First St SW,
Rochester, MN 55905 (e-mail: tucker.sharon@mayo.edu).
Preparing CNSs
for Prescriptive Authority
Winona State University
Model Course
SHARON TUCKER, DNSc, RN, CNS; LORI RHUDY, MS, RN, CNS, CNRN, CCRN
M
edical-surgical clinical nurse specialists (CNSs) have always been involved in treating
disease-based and nondisease-based health problems. Recently, expanding state nurse
practice acts have allowed medical-surgical CNSs to add pharmacologic agents to their arse-
nal of advanced practice interventions to best manage their patients’ complex healthcare
needs. This article discusses the history of prescriptive authority for medical-surgical CNSs,
describes a new university program for preparing CNSs for prescriptive authority, summarizes
interview responses of 4 students who have completed the university program, and highlights
implications for practice and education. The university program includes coursework and clin-
ical training and integrates distance-education strategies to reach students with diverse geo-
graphic and scheduling challenges. Themes from the 4 student interviews are positive and
support CNSs having prescriptive authority. Facilitators and barriers to actualizing CNS pre-
scriptive authority, implications for educational programs, and issues surrounding distance-
education and clinical training are highlighted.
Key Words: clinical nurse specialist, prescriptive authority
C
linical nurse specialists (CNSs) are important advanced practice providers who influ-
ence outcomes and costs for patients and their families, nursing practice and per-
sonnel, and systems/organizations. CNS activities that influence patient/family outcomes
are numerous and can include prescribing pharmacologic agents. Although historically
medical-surgical CNSs have, for the most part, not needed or demanded pharmacologic
feature article