Advanced practice nursing: merging the clinical nurse specialist and nurse practitioner roles.

Advanced practice nursing has taken a preeminent role in the recent reform of health care by fostering a perception of leadership, accountability, and responsibility in areas involving access to care, quality of care, and the cost of care. Despite this opportunity for recognition and advancement in the current healthcare system, variations in educational preparation, public confusion about the various roles and titles within advanced practice nursing, and differing professional certifications plague the opportunity for an elevated status of advanced practice nursing. In this article, the author addresses the issues related to merging the clinical nurse specialist and nurse practitioner roles. A review of the historical development of advanced practice nursing along with current practice issues and future needs is also presented.