Identifying competencies of clinical nurse specialists.

The performance of clinical nurse specialists (CNSs) is evaluated most often by quantitative checklists, peer review, self-evaluation, administrative review, or nursing audits. Observations of actual clinical and managerial competencies demonstrated by expert clinical nurse specialists seldom are used. An ethnographic study of the CNS role identified common competencies and skills that can be used by nurse administrators to justify the cost of the advanced practice role and its contributions to organizational goals, and to serve as criteria for job descriptions, performance evaluations, and predictors of employment success.