As mentioned, the CNS has many and varied roles. The title of this article speaks about the ‘lesser’ CNS roles. This is not to suggest that these roles are lesser in importance or impact but rather lesser in visibility. The clinical, educator and researcher roles are frequently explored and commented on in the literature [1
]. However the CNS does operate in many additional roles which greatly contribute to their work and patient care. Examples of the CNS work in these roles can be found in the literature but requires searching and is usually confined to literature on specific areas of practice. For example, in an interesting article on the CNS in pain management [13
], where Barrie speaks of CNS led clinics, case load management and coordinating services. All such work requiring the CNS to act in the roles mentioned above.
In their recent work Jokinieimi et al., [14
] found a ‘cautiousness to include leadership as a domain of CNS practice’ inferring it may lead to confusion between leadership and management roles [14
]. The implication being that the CNS management role should not be articulated. While agreeing CNS are not nursing managers, they do and should have a management role in their specialist practice. The strong clinical focus of the CNS may discourage administrative and managerial roles. However this risks little or no input from CNS in many important areas, such as policy and planning. Absence of the CNS in such areas is not beneficial. Their very clinical focus of the CNS puts them in an ideal position to contribute to future planning and decision-making relating to clinical matters.
Considering the CNS position, with up-to-date clinical expertise and close to the patient, the CNS are in an ideal position to contribute to the management process. Like the consultancy role, input into management and administration can benefit both patients and medical staff, and here again the specialist knowledge of the CNS needs to be utilised. Lack of activity by the CNS in the manager/administrator role – perhaps as it is n ot the expected 'norm' – will hinder the CNS in allowing their patients' voices to be heard and the utilisation of their unique clinical specialist experience.