Future Implications Traditional roles of parent-child NPs and CNSs are already beginning to blur and it is thus time to merge the roles under one APN model. Those currently in the CNS role need to perfect assessment skills and primary care management techniques. Educational funding is being squeezed at both the federal level and at the employer level. Given cost and time constraints, the existing institutions of higher learning must construct curricula to meet the preparation needs of the new APN role. Those nurses currently designated as NPs and CNSs must be prepared to meet the demands for the new parent-child APN role with the most efficient use of time and money.
Legislation governing the practice of nursing exists in every state.
At least 18 states currently have either no title designation or have limited practice focus for the nurse in the CNS role. For those states which have defined the APN role with the designation of NP, CNS, NA, and NM, new legislative language must be enacted that supports the combined role concept. Provisions must be made to assess how the expanded APN role will affect a nurse's exposure to professional liability claims. The method by which reimbursement will be allocated for the nurse in the combined APN role must be examined. It is imperative that APNs identify and effect outcomes.