Demystifying the role of the ED Clinical Nurse Specialist

Kevin Dunshea2, Julia Morphet1, Tamsin Jones1

1Monash University, Frankston, Australia, 2Royal Darwin Hospital, Tiwi, Australia

The role of the Clinical Nurse Specialist (CNS) has long been associated with leadership throughout nursing. Advocating for their patients and peers within their organisation whilst exemplifying clinical expertise and practice at the bedside, bridging the gap between front line nurses and their managers.

Yet the constantly evolving needs and pressures of health care delivery globally have resulted in the proliferation of senior and advanced nursing roles and and increase in the local interpretation and contextualisation of the CNS role have made this role synonymous with ambiguity and confusion, with variation common to the role’s nomenclature, meaning, preparation and scope of practice. The extent that this inconsistency affects emergency practice in Australia however remains largely unknown.

Objective: This research aimed to elucidate the role of the Emergency Department (ED) CNS, by exploring the emergency nursing community’s collective position of the role as it stands in Australia.

Method: Three iterative surveys, following the electronic-Delphi (e-Delphi) methodology, were distributed nationally to members of the College of Emergency Nursing Australasia (CENA). After expressing their views of the role of the ED CNS, participants ranked the significance of their collective responses in subsequent surveys.

Results: A total of 445 comprehensive and diverse responses were collected throughout the study, as participants endeavoured to express their perception of the role. Collective consensus was evident regarding many aspects central to the ED CNS role. Most participants were familiar with the title ‘Clinical Nurse Specialist’ and many of their responses conveyed the significance of clinical expertise, leadership and a commitment to enhancing nursing practice to the ED CNS role.

Conclusions: Participants believed that the ED CNS role has a place in the future of emergency nursing practice. Their responses demonstrated that a common understanding of the role is shared by the emergency nursing community, irrespective of any variation that may exist between ED’s. Articulating this collective understanding enables a better understanding of the ED CNS role, while contributing their views to broader CNS discussion.


Kevin is currently a clinical nurse educator working with the Emergency Education Service in the NT’s Top End Health.  He has more than 10 years of Emergency and Critical care experience across NSW and the NT.  He values evidence based practice, endeavouring to consistently deliver quality client focused emergency care.  His role as an educator gives him the opportunity to contribute to the growth of his peers, where he hopes to foster a culture that promotes those leadership qualities and skills essential to our emerging nursing leaders whilst also recognising the unique contributions of the emergency nursing community.