Nursing Certifications | Pathways to Advanced Nursing Practice

Nursing Certification Overview

Registered nurses are encouraged to engage in life-long learning and continuing education to enhance their practice and, thus, the quality of patient care. Beyond basic nursing education, registered nurses have several opportunities to acquire additional knowledge and skills in various specialties.

In general, there are two pathways to achieve certification:

1) Certification examination,

2) Advanced Nursing education at the Masters and Doctoral level.

1. Certification by Examination

A wide variety of nursing organizations in several specialties offer certification by examination. Though achieving a passing score on the examination is the ultimate determining factor for certification, most certifying organizations have additional requirements to achieve and maintain certification. These requirements may include:

1. Minimum years of experience in the given specialty.
2. Membership in the certifying organization.
3. Minimum number of CEUs offered by the certifying organization (certification and re-certification)

The listing of certifying organizations is dynamic, as new certifications are being developed over time. The following is a list of certifications and the certifying agency. Nurses wishing to pursue certification are encouraged to visit the respective organization’s website to review specific certification requirements.

List of Nursing Certifications

Why Should I Pursue Certification as a Nurse

In addition to providing more in-depth knowledge of a chosen specialty, preparation for and achievement of certification make a profound statement about the nurse’s commitment to life-long learning and professionalism.

This statement often suggests that the nurse has leadership potential and is committed to providing quality nursing care. In many organizations, specialty certification can contribute to higher compensation through clinical advancement programs.

Finally, certification achievement makes a nurse more marketable for specialty and leadership positions when available.

Advanced Nursing Education

Registered nurses have many options should they desire to advance their careers through graduate and post-graduate education.  Choosing one of these career options typically results in Advanced Practice RN (APRN) status, bringing specialized assessment and treatment skills in various specialties.  Below are some of the common APRN specialty programs available across the nation:

What Roles Do Advanced Practice Nurses Fulfill

The role of the APRN has evolved rapidly over the last decade.  This is primarily the result of the aging of America and. the increased incidence of chronic illnesses. These factors have increased the demand for primary care providers, exceeding the supply. Registered nurses with enhanced assessment and treatment skills are readily identified as a viable solution to this societal need (IOM Report “The Future of Nursing: Leading Change, Advancing Health” IOM Consensus Report October 2010)

Some APRNs provide services as “physician extenders”. In this capacity, the nurse works side-by-side with a physician and engages in advanced patient care tasks under the direction and supervision of the physician.

An example of this extender role could be an Orthopedic Nurse Practitioner who may reduce, at the physician’s direction, and immobilize the fracture based on protocols. Though this “extender” role exists, the APRN has limited autonomy and there is a mutually dependent relationship between the nurse and the physician.

Most APRNs function in a more autonomous role. The nurse exercises advanced assessment and treatment skills in these roles and manages a patient panel as an independent provider. In this capacity, the APRN may order diagnostic tests, interpret test results, prescribe treatments and medications and make referrals to specialists. Though regulations vary by state, most states require APRNS to be identified with a physician sponsor who provides supervision as necessary and serves as a mentor and resource for challenging cases.

APRNS, like their physician colleagues, must carry individual liability insurance. In addition, they must meet the Drug Enforcement Agency (DEA) and State Board of Pharmacy regulations that govern prescriptive authority.

Finally, in most settings where a hospital employs them, the hospital’s Medical Staff governs and overseers APRN practice. APRNs must apply for privileges to practice and meet criteria similar to those of their physician colleagues.  Furthermore, the APRN is subject to corrective and disciplinary action as outlined in the organization’s medical staff bylaws.

Why Should I Pursue APRN Credentials

Pursuing APRN credentials must be rooted in a passion for one’s specialty, a desire to enhance knowledge and skills, and a desire to have a more substantial impact on the health of communities. The desire for more autonomy, associated risks, and accountability for one’s actions are imperatives. The courses for study in most APRN programs are rigorous. The transition from following and carrying out provider orders as a bedside nurse to the provider who issues orders is a substantial one.

APRNs enjoy commensurate compensation for their knowledge, skill, and accountability. They may bill private and government payors for services rendered.

Depending upon their practice site, they will carry additional financial burdens associated with liability insurance, DEA, Board of Pharmacy and Medical Staff Application fees. With this being said, APRNs enjoy autonomy and personal and professional satisfaction related to directly impacting the health of individuals who seek their care as independent providers.

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