Psychiatric CNS have been the leaders of Clinical responsility , leadership and Primary Patient care. The CNS in Psych has been broad and expert with the clinical skills of an NP subsumed under its broader reach. It was designed and executed as a Peer of MD and PHD alike. Having been qua;ified and certified as an Independent practitioner since the 1980's (we are not all dead like Florence ) APNA abandons the plan of supporting proper Title of license (NCD) with all the priveleges of Independent practice and urns us into second class providers again. We had a model that was as successful as a medical tract; but here we are with the enless school tract ; and worse Independent Practice is completely erased. In the jargon of "evidence-Based" the evidence is not ;ooking good for the patient or for the profession of nursing.