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Certification: A recognition of excellence
Ediforial
Certification: A recognition of excellence .
.
. For the recognition of professional achievement and the excellence of prac-
of excellence, whether it is ANA‘s program,
tice of nursing.
ing association’s program.
This i s the intent of the American Nurses’ Association’s new nationwide certification program. All nurses should welcome this opportunity to have concrete evidence of superior nursing skills that would be recognized in every state. However, there is a great deal of confusion about the term “certification”; much of it justified. Several avenues for certification of nurses already exist. Some state nursing associations offer certification programs through voluntary continuing education. Several of the specialty nursing organizations have certification programs, and at least one requires certification for entry into the organization. Also, many nurses confuse certification with the issue of state requirements for mandatory continuing education for relicensure. These state requirements can be regarded as minimum requirements for competency to practice, while certification i s recognition
a specialty group‘s program or a state nursWe had an opportunity to talk with Rosamand Gabrielson, president of ANA, and Eileen Jacobi, ANA‘s executive director, while they were in Denver for the meeting of the Federation of Specialty Nursing Organizations and ANA. Since the certification program is still in its infancy, there simply are not answers to many of the questions. Some answers will come from a meeting an certification that ANA is convening with the specialty nursing organizations. One of the objectives of meeting is to find out what the special nursing practice organizations are currently doing, and what they are planning in relation to certification. Then, a system can be developed that ”complements and supports” the activities of all the nursing organizations. The relationship between the several existing types of certification will be considered at the meeting, according to Dr Jacobi. ANA certification i s based primarily on
AORN Journal, August 1973, Vol 18, N o 2
237
an examination and i s not tied directly to continuing education. To be eligible for ANA certification, a nurse must submit a n application including evidence of (a) a current license to practice; (b) experience as a registered nurse in the area in which certification i s sought; (c) evidence of involvement in continuing education for practice. After she has established eligibility, the nurse must then achieve a satisfactory score on a national examination and also submit evidence supporting the claim to excellence as a practitioner. Such evidence includes descriptions of setting, context, and nature of practice experience; descriptions of a number of individual cases or other clinical data; reports of innovations or behavior illustrating the applicant's significant contributions to the total quality of patient care, and illustrations of continuing growth as a practitioner. These will not be easy standards to meet. To become a certified nurse will require more than passive classroom learning; i t demands that education and skills be put into practice. Interim certification boards have been set up by each of the ANA divisions on practice-community health, psychiatric/ mental health, geriatrics, medical/surgical and maternal and child health nursing. Criteria are now being established for the examinations in geriatrics, pediatrics and psychiatric nursing. Applications for certification in these areas will b e accepted in about six months. Steps for recertification have not been delineated a t this time. Whether operating room nurses will be included under the umbrella of medical/ surgical nursing has not been determined. This question may be examined a t ANA's meeting on certification. AORN i s not contemplating establishing i t s own certification system, but wants to have input into the A N A certification program.
238
It i s not necessary to be a member of A N A to b e certified. A t its May meeting, the A N A Board approved a fee scale of $50 for members; $75 for members of other nursing organizations; and $125 for nurses not holding membership in any nursing group.
How would the certified nurse be identified? To the potential employer, it can be stated on the application form. For the consumer of health care, it may be a pin with C N on it. This i s another detail that has not been resolved. What benefits would accrue to the certified nurse? For one, those nurses seeking employment would have a way of identifying excellence of practice-a strong asset to the mobile nursing population. The nurse would come to a new job already identified as a superior nurse, rather than having to prove herself on the job. A certified nurse should also have a n edge on the uncertified nurse in both p a y and promotion. Ms Gabrielson points out that nurses who have been superior and excellent in practice have not always been recognized or compensated proportionately for their
skills. Both Ms Gabrielson and Dr Jacobi see certification as relieving some of the pressure for state requirements for mandatory continuing education for relicensure. "Cettification," Dr Jacobi explains, "may reassure the state that the nurse i s competent in practice when her license i s renewed.'' "But most important," Dr Jacobi emphasized, "we see certification as professional responsibility to assure excellence in practice." W e agree wholeheartedly. Certification will strengthen the nurse's professional standing and will support her as she assumes greater responsibilities in the health care delivery system.
AORN Journal, August 1973, Vol 18, N o 2
Whether it will defuse the situation in states which are considering requirements for mandatory continuing education for relicensure i s another question. There will probably be continuing pressure at the state level to establish minimum requirements for relicensure of health professionals, in part,
Although it is not yet clear how operating room nurses will b e recognized i n the ANA certification program, we trust that AORN members will support the program and use it as an avenue to demonstrate their excellence in practice in operating room nursing.
Elinor S Schrader
because not all nurses seek professional and
Editor
educational growth.
Pharmacisfs discuss legislafion Members of the National Association of Retail Druggists (NARD) turned out i n record numbers for the fifth annual Washington Conference on National Legislation and Public Affairs. Highlights of the meeting were:
-NARD president George E Benson, Seattle, Wash, urged his audience to "see your senator and congressman and press for pharmacfs participation in Medicare home drugs on a fair and equitable basis, and the opportunity to negotiate the terms and conditions of third party drug programs.'' -Members of a panel, "Report from Bureau of Narcotics and Dangerous Drugs," said that the FDA has labeled almost all amphetamine combinations as ineffective. Massive recall looms, and procedures now are being worked out behveen suppliers. -The administration is trying t o cut health care costs by improving the efficiency of necessary programs, according to John Zapp, deputy assistant secretary for legislation, HEW. He reported that by 1974 HEW will be spending about $100 billion. He reported that 300 separate legislative authorities implement HEW programs. About 56 authorities overlap, and 64 have overlapped in special areas, he said. The speaker asserted that some programs are outmoded and the Hill-Burton Bill is becoming unneces sary. -William L Hungate, US Representative from Missouri and chairman of the small business committee, said "Estimates indicate that within five years, more than 60% of all prescribed drugs will be paid for under some type of prepaid program. Beneficial as they are, they have produced a multitude of problems.
. .''
-Jacob K Javits, United States Senator, New York, a member of the committee on labor and public welfare, and a member of the subcommittee on health, reported that 214 million prescriptions for psychoactive drugs were issued in 1970. "It is therefore urgent that we make a determination as to whether and under what circumstances drug-using behavior becomes a matter of social concern. For example, do the social policy implications of repeated use of barbiturates or minor tranquilizers depend solely on whether a physician has prescribed the drug or on the motivation for such use?"
240
AORN Journal, August 1973, Vol 18,N o 2
Certification: A recognition of excellence .
.
. For the recognition of professional achievement and the excellence of prac-
of excellence, whether it is ANA‘s program,
tice of nursing.
ing association’s program.
This i s the intent of the American Nurses’ Association’s new nationwide certification program. All nurses should welcome this opportunity to have concrete evidence of superior nursing skills that would be recognized in every state. However, there is a great deal of confusion about the term “certification”; much of it justified. Several avenues for certification of nurses already exist. Some state nursing associations offer certification programs through voluntary continuing education. Several of the specialty nursing organizations have certification programs, and at least one requires certification for entry into the organization. Also, many nurses confuse certification with the issue of state requirements for mandatory continuing education for relicensure. These state requirements can be regarded as minimum requirements for competency to practice, while certification i s recognition
a specialty group‘s program or a state nursWe had an opportunity to talk with Rosamand Gabrielson, president of ANA, and Eileen Jacobi, ANA‘s executive director, while they were in Denver for the meeting of the Federation of Specialty Nursing Organizations and ANA. Since the certification program is still in its infancy, there simply are not answers to many of the questions. Some answers will come from a meeting an certification that ANA is convening with the specialty nursing organizations. One of the objectives of meeting is to find out what the special nursing practice organizations are currently doing, and what they are planning in relation to certification. Then, a system can be developed that ”complements and supports” the activities of all the nursing organizations. The relationship between the several existing types of certification will be considered at the meeting, according to Dr Jacobi. ANA certification i s based primarily on
AORN Journal, August 1973, Vol 18, N o 2
237
an examination and i s not tied directly to continuing education. To be eligible for ANA certification, a nurse must submit a n application including evidence of (a) a current license to practice; (b) experience as a registered nurse in the area in which certification i s sought; (c) evidence of involvement in continuing education for practice. After she has established eligibility, the nurse must then achieve a satisfactory score on a national examination and also submit evidence supporting the claim to excellence as a practitioner. Such evidence includes descriptions of setting, context, and nature of practice experience; descriptions of a number of individual cases or other clinical data; reports of innovations or behavior illustrating the applicant's significant contributions to the total quality of patient care, and illustrations of continuing growth as a practitioner. These will not be easy standards to meet. To become a certified nurse will require more than passive classroom learning; i t demands that education and skills be put into practice. Interim certification boards have been set up by each of the ANA divisions on practice-community health, psychiatric/ mental health, geriatrics, medical/surgical and maternal and child health nursing. Criteria are now being established for the examinations in geriatrics, pediatrics and psychiatric nursing. Applications for certification in these areas will b e accepted in about six months. Steps for recertification have not been delineated a t this time. Whether operating room nurses will be included under the umbrella of medical/ surgical nursing has not been determined. This question may be examined a t ANA's meeting on certification. AORN i s not contemplating establishing i t s own certification system, but wants to have input into the A N A certification program.
238
It i s not necessary to be a member of A N A to b e certified. A t its May meeting, the A N A Board approved a fee scale of $50 for members; $75 for members of other nursing organizations; and $125 for nurses not holding membership in any nursing group.
How would the certified nurse be identified? To the potential employer, it can be stated on the application form. For the consumer of health care, it may be a pin with C N on it. This i s another detail that has not been resolved. What benefits would accrue to the certified nurse? For one, those nurses seeking employment would have a way of identifying excellence of practice-a strong asset to the mobile nursing population. The nurse would come to a new job already identified as a superior nurse, rather than having to prove herself on the job. A certified nurse should also have a n edge on the uncertified nurse in both p a y and promotion. Ms Gabrielson points out that nurses who have been superior and excellent in practice have not always been recognized or compensated proportionately for their
skills. Both Ms Gabrielson and Dr Jacobi see certification as relieving some of the pressure for state requirements for mandatory continuing education for relicensure. "Cettification," Dr Jacobi explains, "may reassure the state that the nurse i s competent in practice when her license i s renewed.'' "But most important," Dr Jacobi emphasized, "we see certification as professional responsibility to assure excellence in practice." W e agree wholeheartedly. Certification will strengthen the nurse's professional standing and will support her as she assumes greater responsibilities in the health care delivery system.
AORN Journal, August 1973, Vol 18, N o 2
Whether it will defuse the situation in states which are considering requirements for mandatory continuing education for relicensure i s another question. There will probably be continuing pressure at the state level to establish minimum requirements for relicensure of health professionals, in part,
Although it is not yet clear how operating room nurses will b e recognized i n the ANA certification program, we trust that AORN members will support the program and use it as an avenue to demonstrate their excellence in practice in operating room nursing.
Elinor S Schrader
because not all nurses seek professional and
Editor
educational growth.
Pharmacisfs discuss legislafion Members of the National Association of Retail Druggists (NARD) turned out i n record numbers for the fifth annual Washington Conference on National Legislation and Public Affairs. Highlights of the meeting were:
-NARD president George E Benson, Seattle, Wash, urged his audience to "see your senator and congressman and press for pharmacfs participation in Medicare home drugs on a fair and equitable basis, and the opportunity to negotiate the terms and conditions of third party drug programs.'' -Members of a panel, "Report from Bureau of Narcotics and Dangerous Drugs," said that the FDA has labeled almost all amphetamine combinations as ineffective. Massive recall looms, and procedures now are being worked out behveen suppliers. -The administration is trying t o cut health care costs by improving the efficiency of necessary programs, according to John Zapp, deputy assistant secretary for legislation, HEW. He reported that by 1974 HEW will be spending about $100 billion. He reported that 300 separate legislative authorities implement HEW programs. About 56 authorities overlap, and 64 have overlapped in special areas, he said. The speaker asserted that some programs are outmoded and the Hill-Burton Bill is becoming unneces sary. -William L Hungate, US Representative from Missouri and chairman of the small business committee, said "Estimates indicate that within five years, more than 60% of all prescribed drugs will be paid for under some type of prepaid program. Beneficial as they are, they have produced a multitude of problems.
. .''
-Jacob K Javits, United States Senator, New York, a member of the committee on labor and public welfare, and a member of the subcommittee on health, reported that 214 million prescriptions for psychoactive drugs were issued in 1970. "It is therefore urgent that we make a determination as to whether and under what circumstances drug-using behavior becomes a matter of social concern. For example, do the social policy implications of repeated use of barbiturates or minor tranquilizers depend solely on whether a physician has prescribed the drug or on the motivation for such use?"
240
AORN Journal, August 1973, Vol 18,N o 2