The clinical nurse specialist: from the outside looking in.

This paper considers the role of the clinical nurse specialist (CNS) as portrayed in the literature. The historical development of the role is highlighted, rationale for preparation at an advanced level presented and controversy regarding placement of the CNS in a line or staff position outlined. Also discussed are the five commonly accepted sub-roles of the CNS (practitioner, educator, consultant, researcher and change agent) as well as a new role (staff advocate) which can be seen to be emerging in the literature. The author presents some of her observations of the role of the CNS at a large urban teaching hospital and concludes that congruence between the ideal role portrayed in the literature and the actual practice of the role is possible.