Dr. Sandra Lauck’s and Dr. Leah Lambert’s findings, released in January 2025, support the Policy Recommendations for Optimizing the Clinical Nurse Specialist Workforce in British Columbia outlining recommendations for enhancing the Clinical Nurse Specialist role.
March 18, 2025
Dr. Lambert and Dr. Lauck’s Summary of Research Findings is supported by a CIHR Policy Research for Workforce Transformation Grant, "Informing Policy to Optimize the Clinical Nurse Specialist Workforce: Advancing the Quadruple Aim and Health Equity.” This study aimed to inform policy development and strategic approaches to optimize the clinical nurse specialist (CNS) role in BC to ensure its effectiveness and long-term sustainability. The research suggests that although Clinical Nurse Specialists (CNSs) are highly trained nursing leaders, in British Columbia, their role remains underutilized and inconsistently implemented. Without a protected title in Canada, CNSs face barriers to full integration, highlighting the need for clearer recognition and stronger support to maximize their impact.
A particularly exciting development has been our engagement with Canada’s CNO, Dr. Leigh Chapman, who sees the BC model as a potential template for national policy discussions and has expressed interest in integrating this initiative into broader national efforts. Additionally, at a recent CIHR Policy Roundtable, the President of CIHR highlighted our study as one of six exemplary projects among the 60 funded teams.
~Dr. Leah Lambert and Dr. Sandra Lauck
The Clinical Nurse Specialist (CNS) is an advanced practice nurse with a master's or doctoral degree and expertise in a clinical specialty. CNSs play a critical role in health system transformation by improving patient outcomes, driving innovation, and advancing nursing excellence. Despite their leadership and specialized skills, the CNS workforce in British Columbia remains small, with approximately 100 professionals in diverse roles. However, the absence of a protected title in Canada has contributed to inconsistent utilization of CNSs across health authorities. To maximize their impact, a growing need has been recognized to clarify, support, and strengthen the role of CNSs at both provincial and national levels.
Three priority policy recommendations were outlined in the report:
- Clarify CNS education, training and responsibilities
- Optimize Integration of CNSs into Health Authority Systems
- Build robust systems of support, evaluation and accountability.
Drs. Lauck and Lambert have further broken down each recommendation into policies, and each of these five policies is further summarized, explained, and recommendations offered in its own section of the report. For example, priority #1 around education recognizes that the role of a CNS requires academic preparation and clinical expertise. “CNSs must be experts in the discipline of nursing to be effective leaders of nursing practice and in their clinical specialty,” the authors recommend. Further, CNSs must have a graduate degree in nursing and “demonstrate a strong track record of their specialized clinical expertise” and have plans in place to sustain these leadership requirements.
Other recommendations include a standardized job description, a CNS-specific professional development program, and insistence that CNSs be embedded in clinical care as leaders of nursing practice.
Over the course of this study, we have been struck by the timeliness of this initiative and the high level of engagement and interest it has generated. To build on this momentum, we were awarded a Michael Smith Health Research REACH grant to move this evidence into action. As part of this work, we are developing a comprehensive 'BC CNS Workforce Toolkit' and planning targeted implementation workshops across all BC health authorities to support the integration of these recommendations into practice.
~ Dr. Sandra Lauck and Dr. Leah Lambert
In short, this comprehensive and well-laid-out document is a must-read for those hoping to optimize not just the Clinical Nurse Specialist Workforce, but indeed, to optimize health care delivery in British Columbia and beyond.
