Research shows the increasing part the Clinical Nurse Specialist (CNS) plays in healthcare today. But what does a CNS actually do in their day-to day-work? This study, set in the Republic of Ireland, aimed to explore the CNS and clinical midwife specialist (CMS) roles in practice. Quantitative methodology was used to explore the roles and activities of the CNS and CMS. Following ethics approval, a valid and reliable questionnaire was circulated to the total population of CNS/CMS in Ireland. The data were analysed using SPSS. This study articulates the individual role elements and activity level. The findings show the CNS/CMS to be active in the roles of researcher, educator, communicator, change agent, leader and clinical specialist, but the level of activity varies between different roles and individual role elements. The CNS/CMS is seen as a valuable resource in health care today and has potential to have a positive effect on patient care. The majority of CNS/CMSs are active in varying roles but the analysis shows lesser activity in some areas, such as research. The findings merit further study on role activity and possible variables that influence role activity.

Cancer is now often a chronic disease with 14.1 million new cases worldwide in 2012 (Torre et al., 2015). Cancer-related malnutrition is common and associated with greater treatment toxicity, lower quality of life and shorter survival. Yet, it is under-assessed and under-recognised (Aktas et al., 2017). Up to 85% of those with certain cancers, for example pancreas, lose weight during treatment (Argiles, 2005), and an estimated 20% die from malnutrition, not the malignancy (Capra, Ferguson, & Ried, 2001). Despite this, cancer patients are not routinely referred to dietetic services, and often only after significant weight loss (Platek, Johnson, Woolf, Makarem, & Ompad, 2015). Early nutrition interventions can improve outcomes (Paccagnella et al., 2010). Regular malnutrition screening of all cancer patients with timely referral to dietetic services appears wise (Arends et al., 2017). The specific nutrition needs in cancer vary by cancer type and phase, antitumour treatments and co-morbid illnesses. For example, metabolic syndrome, obesity and weight gain during treatment have been associated with disease progression and recurrence in breast

The findings merit further study on CNS role activity and possible variables that influence role activity.

The clinical specialist has tremendous potential for a positive impact on patient care in his or her education role. The majority are active in this role but the analysis shows there is room for growth. Combined with the finding that the level of activity rises with the level of formal education, this gives a strong reason why there should be continuing focus on further education and life-long learning.

No abstract