Medical-surgical clinical nurse specialists (CNSs) have always been involved in treating disease-based and nondisease-based health problems. Recently, expanding state nurse practice acts have allowed medical-surgical CNSs to add pharmacologic agents to their arsenal of advanced practice interventions to best manage their patients' complex healthcare needs. This article discusses the history of prescriptive authority for medical-surgical CNSs, describes a new university program for preparing CNSs for prescriptive authority, summarizes interview responses of 4 students who have completed the university program, and highlights implications for practice and education. The university program includes coursework and clinical training and integrates distance-education strategies to reach students with diverse geographic and scheduling challenges. Themes from the 4 student interviews are positive and support CNSs having prescriptive authority. Facilitators and barriers to actualizing CNS prescriptive authority, implications for educational programs, and issues surrounding distance-education and clinical training are highlighted.