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- ArticleMurphy JF, Schmitz M.J Nurs Adm. 1979 Jan;9(1):29-31.The introduction of a clinical nurse specialist into a functioning patient care setting represents a major institutional change, and implementation of the role should involve all affected staff members. The authors describe how one nurse unilaterally negotiated her role using an exchange theory approach. They make recommendations to help nursing service administrators aid in role negotiation.