The Clinical Nursing Unit: Realisation of Excellence in Nursing Practice 

Sparacino (1983, 140) states that the “role of the clinical nurse specialist (CNS) is one which will ultimately affect the state of the art of clinical nursing practice.  The CNS can be the most appropriate means by which nursing practice is knowledgeably and accurately investigated and new nursing knowledge is introduced.” 

This paper disputes that statement at least in so far as the role has been enacted in North America.  Specifically the position, functions, education, value and inherent difficulties embodied in the North American version of the CNS role will be summarized.  A discussion of current New Zealand policy regarding clinical specialisation will follow, along with an overview of both strengths and limitations operating within the New Zealand nursing context.  The remainder of this paper will address possible ways of overcoming identified limitations and put forth on suggestion for beginning implementation of a clinical career structure in nursing that has as its focus the development, utilization and evaluation of nursing knowledge and its relation to client outcomes.