This article recognizes challenges facing the traditional clinical nurse specialist (CNS) role and supports the merger of the nurse practitioner (NP) and the CNS into a hybrid advanced practice registered nurse (APRN). A historical review of each role is presented, with justification for role merger. The focus of the article is to present a personal account of this author's successful reengineering of a traditional cardiovascular CNS role to conform to a new state and institutional APRN model and ultimately to better serve a population of post-myocardial infarction patients.