Spelling Out a Course to Nursing Certification

The pursuit of continuing education is something that all healthcare professionals will be encouraged to consider during their careers. Generally speaking, the decision to seek this opportunity is the easy part. From there, narrowing in on a focus or specialty can cause providers to exhibit emotions ranging anywhere from confusion and uncertainty to feeling anxious or even downright overwhelmed. Deciphering the code of “alphabet soup” has become an increasingly daunting chore for providers, especially for nurses, who today work in an arena of healthcare that continues to become more specialized as the industry (and payers) emphasizes quality and value-based care versus volume-based care. Beginning in 2011, the number of nurses who earned a baccalaureate degree in the science of nursing (BSN) was higher than the number who earned a two-year associate degree in nursing (ADN), according to a study by Peter Buerhaus, PhD, RN, FAAN. By 2012, more nurses (53 percent) were earning four-year baccalaureate than two-year associate degrees (47 percent). Today, a growing trend includes the number of APRNs — advanced practice registered nurses (i.e., advanced practice nurses [APNs] — a class of professionals comprised of certified nurse practitioners (CNPs), certified registered nurse anesthetists (CRNAs), certified nurse midwives (CNMs), and clinical nurse specialists (CNSs). This article will share some insight on preparing for the advanced credential from an APRN nurse who holds an adult health CNS from the American Nurses Credentialing Center.

A Growing Group

According to the United States Department of Labor’s Bureau of Labor Statistics (BLS), the number of nurses working in the APRN capacity as of 2016 was nearly 204,000 and is expected to increase by nearly 65,000 by 2026. Kristi L. Reguin-Hartman, MSN, APRN, ACNS-BC, a director with the Academy of Medical-Surgical Nurses (AMSN),TM said she utilized review courses and referred to any online instructional videos, practice exams, and flashcards that she could find as she prepared for certification. (Valuable APRN resources include the American Association of Nurse Practitioners, American Nurses Association, American College of Nurse-Midwives, American Association of Nurse Anesthetists, and National Association of Clinical Nurse Specialists.) “This was very similar to how I prepared for the NCLEX exam,” said Reguin-Hartman, a staff nurse at WakeMed Health & Hospitals, Raleigh, NC. As defined by the American Nurses Association, the CNS provides diagnosis, treatment, and ongoing management of patients; lends expertise and support to nurses caring for patients; helps to drive practice changes; and ensures the use of best practices and evidence-based care to achieve the best possible patient outcomes. CNMs provide primary, gynecological, and reproductive healthcare; NPs provide primary, acute, and specialty healthcare through assessment, diagnosis, and treatment; and CRNAs provide a full range of anesthesia and pain management services. Beyond the four distinct APRN roles, nurses have the opportunity to gain specialized knowledge in one of six population foci, which include: family/individual across the lifespan, adult gerontology, neonatal, pediatrics, women’s health/gender-related care, and psychiatric-mental health.

The APRN role is defined and regulated by the APRN Consensus Model, which was devised by the National Council of State Boards of Nursing to create a consensus on licensure, accreditation, certification, and education for APRNs. Today, although many states have adopted the model and nursing organizations have endorsed it, fluctuation among certain states remains — so there is no uniform model of regulation for APRNs across the country, although all APRNs must hold at least a master’s degree to sit for examination. Continuing education requirements for APRNs depends on the specialization of the individual nurse.

In Reguin-Hartman’s state of North Carolina, APRNs must be certified to practice. “I have two pieces of advice for nurses navigating that tricky balance of professional and personal priorities,” she recently told ADVANCE. “The first is to ask for help from your supporters. Maybe it’s asking for help from a colleague who will hold you accountable to a study schedule or help from a neighbor to water your flowers once a week [to give you more time to study]. The second is to be willing and brave enough to ‘let some things go.’ The timeframe spent preparing for a certification exam has a window. During that window, send the store-bought cookies to the school function instead of the homemade ones and avoid the ‘volunteers needed’ sign-up sheet,” she said.

Seeing The Benefits

Certification of healthcare professionals is seen as beneficial to employers, patients, providers, and the industry as a whole — with little room for debate. Financially speaking, the 2017 median pay, according to the BLS, for an APRN was about $111,000 annually and more than $53 per hour compared to $70,000 per year and $33.65 per hour for RNs. But it is not all about the money, Reguin-Hartman said: “My career has evolved greatly since becoming an APRN. I have worked as a CNS at my healthcare system, focusing on improving care and safety for patients. I have taught courses in a graduate program. I have participated in state-level groups advocating for APRN practice. And I have recently become a director on the AMSN’s board of directors. All of these things have been made possible by pursuing advanced education and certification. I would encourage nurses to consider all the ways certification can benefit their careers and encourage them to read the literature on how certification benefits patient outcomes.”

And while there may not be any “bad reasons” for seeking advanced education and certification, Reguin-Hartman advises nurses to take certain circumstances into consideration before committing to following through with their credentialing.

“The process of certification takes time and resources,” she said. “I recommend nurses remain open to the idea that their certification needs might change over the course of their careers. While one may spend many years in advance practice, the future may include certifications as an executive, educator, or a new specialty not yet discovered.”

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