The unique role of the clinical nurse specialist is to: Integrate care across the continuum and through three spheres of impact: The patient; The nurse; and The system; and Ranges from: Wellness to illness; and Acute to chronic care. The clinical nurse specialist provides direct care to patients with complex needs, acts as a consultant, conducts research, and provides education and guidance for staff nurses. The practice of the clinical nurse specialist encompasses the continuous improvement of patient outcomes and nursing care. The clinical nurse specialist shall adhere to standards of clinical practice, scope of practice, and the standards of professional performance in accordance with this chapter. The scope of practice of the clinical nurse specialist includes, but is not limited to: Practicing with individual clients, families, groups, and populations of clients; Performing a comprehensive physical assessment of patients; Establishing medical diagnosis for common short-term and chronic stable health problems; Diagnosing, treating, and managing patients with acute and chronic illness or disease, or both; Ordering, performing, and interpreting laboratory tests; Ordering diagnostic tests and using the findings or results in the care of patients Initiating, monitoring, and altering appropriate therapies or treatments; Providing primary health care, including health promotion and disease prevention by assessing, educating, and providing referrals for the patient, family, and caregiver; Providing emergency care; Referring patients to appropriate licensed physicians or other health care providers as needed; Consulting or collaborating with a licensed physician or other health care provider as needed; and Creating therapeutic environments through mentoring and system changes to: Develop caring, evidence-based practices; Facilitate ethical decision making; Respond to diversity; and Alleviate patient distress.