SACRAMENTO — At its Jan. 22 meeting, the Nurse Practice Committee of the California Board of Registered Nursing heard updates from Executive Officer Loretta Melby on ongoing work by advisory committees for clinical nurse specialists (CNS) and certified registered nurse anesthetists (CRNA).

Melby told the committee both advisory groups have formed subcommittees on public engagement, website updates and regulatory language and have reported work between meetings. The CNS advisory committee is developing draft regulatory language and seeking stakeholder feedback; when staff consider it ready, the draft will be reviewed by the Department of Consumer Affairs’ Regulatory Council before coming to the full board.

Melby highlighted a concern shared by advisory members that some employers use the title “clinical nurse specialist” for roles filled by staff who do not hold CNS licensure. “It is imperative that the titling is protected and that the public is aware,” Melby said, noting scope-of-practice differences across states and the variability in prescriptive authority.

Committee members also heard that national certifying organizations have discontinued several CNS population-focus exams (family, psychiatric, women’s health), leaving current national certification only in neonatal, pediatric and adult-geriatric population foci. Melby said some academic programs are offering those specialties as subspecialty training tied to existing national certifications so practitioners can obtain licensure in the meantime; national organizations are being urged to restore the prior exam options.

On CRNA matters, Melby reported discussion about licensure requirements for out-of-state and international graduates and reiterated that CRNA licensure in California requires national board certification and completion of an accredited program before state licensure can be granted.

Melby said staff will continue website updates and regulatory work and expects to bring proposed CRNA regulations to the committee and board for further consideration.