By Larry Z. Slater, PhD, RN-BC, CNE
Clinical Assistant Professor
New York University Rory Meyers College of Nursing
New York, NY
In its landmark report on The Future of Nursing, the Institute of Medicine (IOM, 2010) advocated that the nursing profession “foster a culture of lifelong learning” (p. 14) in order to allow the nurses to be integral partners in meeting the nation’s current and future healthcare demands. Continuing education has been used by nurses over the course of their careers to maintain skills while also developing additional, necessary competencies to keep pace with a rapidly expanding healthcare landscape. Although not specifically identified in the IOM report, nursing certification may serve as an important means of promoting and fostering a lifelong learning culture through continuing education within healthcare organizations.
The American Board of Nursing Specialties (ABNS, 2005) defines certification as a “formal recognition of the specialized knowledge, skills, and experience demonstrated by the achievement of standards identified by a nursing specialty to promote optimal health outcomes.” The American Nurses Credentialing Center (ANCC, n.d.) states that certification “enables nurses to demonstrate their specialty expertise and validate their knowledge to employers and patients” while also “empower[ing] nurses with pride and professional satisfaction.” In addition, as more and more hospitals seek Magnet designation, nursing certification may help organizations meet multiple Magnet standards that demonstrate nursing excellence (Fritter & Shimp, 2016).
So what does this mean for the professional nurse? What are the pros and cons of certification? Fritter and Shimp (2016) summarized some of the benefits and perceived barriers for nursing certification from the nurse’s perspective. Benefits included feeling empowered to climb clinical ladders within an organization, increased confidence in patient care and interprofessional collaboration skills, an enhanced sense of autonomy, and a higher sense of professionalism and pride. Barriers to certification included a lack of institutional support, a lack of reward for becoming certified, the cost of the examination, and the length of time that a nurse has been out of school (typically due to fear of the examination process). Fritter and Shimp also highlighted benefits that certification brings to the organization. Certification of nurses not only helps with Magnet recognition, it can decrease nurse turnover and improve nurse satisfaction, while also improving patient outcomes and satisfaction. In a literature review on the impact of nursing certification, Martin, Arenas-Montoya, and Barnett (2015) reported a positive correlation between certification and selected patient indicators, with higher rates of certification related to lower patient fall rates, decreased rates of hospital acquired infections, and decreased mortality and failure to rescue events.
Nursing certification is available for almost every nursing specialty (see Additional Resources below for a comprehensive list of certifications by specialty organization). In order to become certified, a nurse must typically validate that they have achieved a certain number of clinical hours to demonstrate specialty experience, pay an examination/certification fee (with a discount if the nurse is a member of the specialty organization sponsoring the certification), and then pass a certification examination to demonstrate knowledge within the specialty. Once certification is achieved, the nurse is then able to place the provided credentials after their name. Certification is usually valid for 2 to 5 years, depending on the specialty. During that time, a nurse must maintain clinical practice and achieve a certain number of continuing education hours. In order to renew the certification, the nurse will have to validate clinical and continuing education hours and pay a renewal fee. If the nurse does not maintain clinical or educational competencies, then the certification will be lost.
In deciding whether or not to seek certification, a nurse should explore not only the certification requirements, but institutional factors related to certification. This includes whether or not the organization provides public recognition of certification (e.g., plaques on the unit, certification listed on name badge), financial remuneration (e.g., additional pay of $1 per hour if certified), and clinical advancement (e.g., promotion from Staff Nurse I to Staff Nurse II). In addition, some organizations may provide in-house examination preparation courses, reimburse for taking a course elsewhere, or reimburse for the cost of the examination (sometimes only if the individual passes the examination). However, even without organizational recognition or remuneration, the professional benefits, as well as positive impact on patient outcomes, cannot be ignored and may be the overriding factors in choosing to seek certification.
In order to heed the IOM’s (2010) call to promote a culture of lifelong learning, it is important for professional nurses to look to certification as a mechanism to improve nurse and patient satisfaction and outcomes. Whether a new graduate nurse or a nurse with many years of experience, it is never too early or too late to consider achieving certification in a nursing specialty. Together, certified nurses can impact The Future of Nursing and the future of healthcare in the U.S. and beyond.
· For additional information on nursing certification, ABNS provides a bibliography (http://www.nursingcertification.org/wp-content/uploads/2015/03/ABNS-Certification-Bibliography-2015.pdf) that includes studies and articles on the value of certification, including nurse and patient outcome studies.
· Wolters Kluwer maintains a list of Nursing Certification Boards by Specialty, that is updated regularly. The list can be found at http://www.nursingcenter.com/career/guideto-certification.
American Board of Nursing Specialties. (2005). A position statement on the value of specialty nursing education. Retrieved from http://www.nursingcertification.org/wp-content/uploads/2015/03/value_certification.pdf
American Nurses Credentialing Center. (n.d.). About ANCC. Retrieved from http://www.nursecredentialing.org/About-ANCC
Fritter, E., & Shimp, K. (2016). What does certification in professional nursing practice mean? MedSurg Matters, 25(2), 8-10.
Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Washington, DC: The National Academies Press.
Martin, L. C., Arenas-Montoya, N. M., & Barnett, T. O. (2015). Impact of nurse certification on patient satisfaction and outcomes: A literature review. The Journal of Continuing Nursing Education, 46(12), 549-554. doi:10.3928/00220124-20151112-06