Advanced Practice Nursing: Clinical Nurses Specialists' Spheres of Influence

摘要

Not one, but three opportunities afford Clinical Nurse Specialists (CNSs) ways to meet patients' spiritual care needs. Unique to CNS practice is a framework known as the three spheres of influence. The spheres are patient, nurse, and system (American Association of Colleges of Nursing [AACN], 2010). The work of a CNS is to identify and fix needs at the patient, nurse, and system levels of care. In the patient sphere, the CNS works directly with patients and families who have complex needs or complicated situations. In the nurse sphere, the CNS mentors and advocates for the needs of nurses and nursing practice. In the system sphere, the CNS leads quality improvement projects. Because selecting spiritual care interventions is an expected behavior of CNS practice (AACN, 2010), the CNS can meet patients' spiritual needs in direct care, indirect care through nurses, and as a system-level leader.