But many nurses go beyond just compiling CEUs and actively seek certification in a number of specialties available to them, allowing them to place additional letters after the R.N.
“Certification (in a specialty) does not replace CEUs,” said Dr. Anne Russell, an Associate Professor at the Miami Valley College of Nursing and Health at Wright State University.
A newly graduated nurse is considered a ‘generalist,’ according to Russell. “Certification validates advanced clinical knowledge and competence in a particular specialty area,” she said. Russell, who holds a PhD in nursing is certified as a Clinical Nurse Specialist—Board Certified, which requires a master’s degree in Advanced Practice Nursing.
There are numerous specialties in which to become certified—such as Critical Care, Emergency Nursing, Oncology, Neuroscience, Ob/Gyn, Maternal, Neonatal and many, many others. The different clinical fields may also have multiple certifications available. For example, the Board of Certification for Emergency Nursing offers CEN (Certified Emergency Nurse) and CFRN (Certified Flight Registered Nurse).
“The process to successfully achieve certification varies across specialties but most are knowledge and practice-based,” Russell said. “To be eligible for certification, a nurse, in general, needs a minimum of two years of clinical experience in the specialty. The nurse then applies to take the certification examination, which is developed, tested and validated by a professional organization or a professional certifying body. The certification programs themselves apply for accreditation through either the National Commission for Certifying Agencies (NCCA) or the American Board of Nursing Specialties.
“Each certification is current for a specified number of years, at which time the nurse either must retake the certification examination or, in most cases, if the nurse meets the specified criteria (outlined by the granting organization), certification can be renewed,” Russell explained. “The renewal process generally is dependent on current clinical practice in the specialty area along with evidence of continuing education.
“Additionally, most granting organizations consider a variety of professional activities as evidence for continued learning and involvement to improve patient care. Such activities might include: standardized protocol development; quality improvement activities; mentoring novice nurses; professional publication; and research activities,” she said.
Some nurses go on to obtain certifications in multiple fields. Leslie Kahn, CEO of Cirrus Consulting—a staffing firm of medical professionals—thinks that that is a good idea.
“(Nurses) need to diversify their career path and background and not stay in one specialty area for more than three to five years before they try to get into another specialty area so that they are more diversified.
“I think that, as a nurse progresses in her career, that she needs to specialize but not get so specialized that you are stuck in a niche for 23 years and you get burnt out on (for example) Labor and Delivery or Surgery,” she explained. “I think you still need to kind of rotate every three to five years so that you are not pigeon-holed into something that you can never get out of.”
Russell says that multiple certifications is really dependent on the individual nurse and whether their clinical practice area includes more than one specialty. “Certifications can be costly to obtain and maintain so that may also be a factor,” she said.
Kahn said that a good reason for multiple certifications came to the forefront as she interviewed several nurses recently. “These big hospitals put them on the EPIC (an electronic medical record system) team on in health information systems. Once they got their whole hospital up and running on EPIC, then they didn’t need these nurses anymore and they tried to lay them off,” she explained.
“They have been on this health information system technology for the last three years and they haven’t worked on the floor. So, now, there’s no place for them in their home hospital. They left their floor or their specialty unit thinking ‘This is a great opportunity to get into health information because I’m getting burnt out on patient care and I’m excited about this chance to get into these jobs,’” she continued. “Now they don’t need them anymore because every nurse is proficient at (electronic records) and there is not that specialty for a nurse anymore.”
So, why train for a specialty?
“The benefits of certification for the nurse may include: realization that they have achieved the standard set by a particular professional organization; may involve monetary recognition and promotion; and recruitment and retention,” Russell said.
Recruitment and retention are noteworthy items, according to Kahn, whose Cirrus Consulting provides vetted medical personnel on either a 13-week contract or a per diem basis to medical institutions. “Those are where all my job orders are—with specialty nurses. I really can’t hire a new nurse—the hospitals won’t use (my company) if they are not specialty nurses,” she said.
“The top ones I am working right now are: open heart, operating room; critical care; endoscopy; and case management,” she explained.
And the benefit to the patient?
“Certification lets the consumer (patient) know that the nurse has advanced knowledge and has met the standards identified by a professional organization to achieve and be granted certification,” Russell said. “It also validates that the nurse has current knowledge and is concerned about the delivery of high quality patient care.”
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