In 1956 Dr Hildegarde Peplau established the first Clinical Nurse Specialist (CNS) program, resulting in the first advanced practice nursing role. The CNS is one of 4 advanced practice registered nurse (APRN) roles prepared by education at the master’s or doctoral level. Clinical nurse specialists are APRNs who provide expert care with a population health focus and historically have practiced mostly in acute care environments including critical care, medical surgical care, maternal/child care, and mental health. The key responsibilities of the role are to assess, diagnose, and manage patient problems and to work with the health care team to manage the health care of a patient population. Inherent in this role is serving as an advocate, one who “proactively speaks for another to ensure certain needs or wishes are met.”

The American Nurses Association (ANA) promotes advocacy as a pillar of nursing. Additionally, the International Council...

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