Cole Frank L
University of Texas-Houston School of Nursing, Houston, Texas, USA.
Emerg Nurse. 2003 Sep;11(5):22-5. doi: 10.7748/en2003.09.11.5.22.c1132.
The CNS role preceded that of the NP in the United States. While CNSs have always been educated to master's degree level, NP education has been more varied although it is now predominantly at this level too. An APN with a master's degree in nursing can attend a post-master's degree certificate programme to obtain education in a new specialty area or to change roles. Emergency care is one clinical specialty area in which NPs and CNSs can obtain education specific to their area of practice. To function in the APN role, nurses must be licensed as registered nurses, have graduated from a NP or CNS educational programme and then have obtained state approval. Certification in the specialty may be required to obtain state approval. Nurse practitioners in emergency care have a scope and standards of practice although these are currently under development for CNSs in emergency care. Nurse practitioners function in roles where they provide direct patients care. Since the CNS role focus is improving nursing care, these individuals typically provide direct care to patients with complex health problems but also focus on care systems.
在美国，临床护理专家（CNS）的角色早于护理实践医生（NP）。虽然临床护理专家一直接受硕士学位水平的教育，但护理实践医生的教育则更为多样，不过现在也主要是这个水平。拥有护理学硕士学位的高级实践护士（APN）可以参加硕士后证书课程，以获得新专业领域的教育或转换角色。急诊护理是临床护理专家和护理实践医生可以获得特定于其执业领域教育的一个专业领域。为了履行高级实践护士的职责，护士必须获得注册护士执照，毕业于护理实践医生或临床护理专家教育项目，然后获得州政府批准。可能需要专业认证才能获得州政府批准。急诊护理领域的护理实践医生有其执业范围和标准，尽管急诊护理领域的临床护理专家的相关标准目前正在制定中。护理实践医生在直接为患者提供护理的岗位上工作。由于临床护理专家的角色重点是改善护理，这些人员通常直接为患有复杂健康问题的患者提供护理，但也关注护理系统。
