CNSs in clinical practice face various challenges. Depending on the situation, there are opportunities to use effective ways to untangle complex, organizational issues, or to experiment with novel approaches. CNSs are well qualified to respond with expertise in advanced nursing practice, knowledge of patient and family concerns, and systems thinking. Educators must consider these realities when developing didactic content, clinical practica, and other learning opportunities in order to adequately prepare CNSs for the complexities of a chaotic, ever changing healthcare system.