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'Problematic': OMB Ignores Clinical Nurse Specialists' Request

Analysis  |  By Jennifer Thew RN  
   December 05, 2017

Despite a request to be classified as advanced practice registered nurses, the Office of Management and Budget once again categorizes clinical nurse specialists as general RNs.

Clinical nurse specialists are disappointed with the U.S. government's Office of Management and Budget. The office released its 2018 revisions to the Standard Occupational Classification System, and once again, CNSs are classified as general registered nurses rather than advanced practice registered nurses, despite a request for change from the National Association of Clinical Nurse Specialists.

When I wrote about this issue in 2016, the OMB had opened a second public comment period for input on its recommendations for revisions to the SOC. At that time, only nurse practitioners, certified nurse anesthetists, and certified nurse midwives were included in the APRN category. The NACNS, its members, and other nursing organizations submitted comments requesting CNSs be categorized as APRNs as well.

But those requests have gone unheeded.

"Sadly, yet again the Office of Management and Budget has incorrectly classified clinical nurse specialists as a title within the broad occupation of general registered nurses in the federal government's Standard Occupational Classification System's 2018 revision. NACNS had once again requested to be treated as other advanced practice registered nurses," Vince Holly, MSN, RN, CCRN, CCNS, ACNS-BC, president of the 2017-2018 NACNS Board of Directors says in a news statement.

The Dilemma of Inaccurate Data

The OMB's decision does not mesh with the policies of many other influential groups.

The National Council of State Boards of Nursing recognizes CNSs in its APRN Consensus Model. The VA extended full-practice authority to CNSs in January (though it did not do so for CRNAs).


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Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.

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