March 19th is Certified Nurses Day, the time to specifically honor nurses who have earned certifications. According to the American Association of Critical-Care Nurses, more than 768,917 nurses in the United States and Canada held certifications in 2016 (so said data collected by the American Board of Nursing Specialties).
Ever wonder why you might think about earning a certification? We asked Denise Buonocore, MSN, RN, APRN, ACNPC, ANP-BC, CCNS, CCRN, CHFN, an acute care nurse practitioner for Heart Failure Services at St. Vincent’s Medical Center in Bridgeport, Connecticut and the Chair-Elect of the AACN Certification Corporation board of directors for her thoughts on the matter.
What follows is an edited version of our Q&A.
How long have you been in the nursing field, and what certifications do you hold?
I’ve been a nurse for 38 years, with 25 of those years as an advanced practice nurse. I first became CCRN certified after working as an RN in critical care for two years. After completing graduate school and a post-master’s certificate program, I took certification exams for adult nurse practitioner (ANP-BC), acute care nurse practitioner (ACNPC), and clinical nurse specialist (CCNS). My subspecialty is heart failure, so I felt it was important to become heart failure certified (CHFN).
Why do you think it’s important for nurses to get certifications? What does it do for them? For the field?
It is important to become certified because it demonstrates to you, patients and families, and employers and teammates that you have the knowledge, skills, and abilities to meet national standards. Becoming a certified nurse is a mark of distinction and demonstrates excellence. Your RN license demonstrates entry-level competency. Certification validates specialty knowledge. Many employers—especially those on an excellence journey such as Magnet or Beacon—look to hire certified nurses or expect that nurses will become certified as part of the organization’s efforts to build an environment of professionalism and culture of retention.
On a personal level, being certified shows your deep commitment to your profession, lifelong learning, and personal improvement. By becoming certified, nurses may position themselves for appropriate recognition and advancement. As a certified nurse, you are a role model for professional practice and commitment to your team members, and it demonstrates dedication to patient safety and improving patient outcomes.
What’s the difference between board certification and being certified in a specialty?
Board certification is certification that meets the accepted criteria for state licensure. Examples of this are advanced practice exams. Specialty certifications are not required for licensure, but are important in demonstrating the knowledge in that specialty area.
How do you know you’re ready to become certified?
Start by reviewing the qualifying criteria for the certification you want to achieve. Most exams have a clinical practice requirement in the area of specialty before you can apply to take the exam. Then assess where you are on your personal learning journey in your specialty. I believe it is never too early to begin to study for the exam. I think the best part is finding out what you don’t know or what you need to improve on, formulating a plan for learning new information, and then applying new learnings in your clinical practice.
Do you need additional education to become certified? What are the requirements to apply?
RN specialty certifications such as CCRN and PCCN, or subspecialty certifications such as CMC and CSC, have core curriculum knowledge requirements in addition to practice hour requirements. There are many ways for you to gain this knowledge—attending conferences such as AACN’s National Teaching Institute & Critical Care Exposition, taking a live or online review course, reading review books or articles, and taking practice exams to build on your current knowledge and build confidence.
If you want to be certified as an advanced practice nurse (ACNPC-AG, ACCNS-AG, ACCNS-P, ACCNS-N) you will need to graduate from an accredited graduate-level advanced practice education program, and meet specific curriculum and clinical practice criteria to take the exam. The exam qualifying criteria can be found in the certification section of AACN’s website.
What does it take to maintain your certification?
Passing your certification exam is not the end of the road but rather the beginning. Recertification is just as important as your initial certification. It is the mark of true long-term commitment to lifelong learning and improvement. Each certification has specific renewal criteria. Most certifications require a combination of continuing education and professional activities that demonstrate your continuing competency.
What have been the greatest rewards for you that happened because you earned your certification?
The greatest reward for me personally in becoming certified was the validation of my knowledge and a deep sense of achievement and commitment. After I passed the CCRN exam, I remember feeling more confident in my ability to care for critically ill patients. I also felt connected to the community of certified nurses and potential certified nurses. I was fortunate that I had a few colleagues support and encourage me when I was considering taking my first exam. In turn, I have paid that forward to mentor and encourage the next group of potential certificants. That first certification was a catalyst to further my education eventually becoming a nurse practitioner and clinical nurse specialist.
What would you say to someone considering becoming certified in any field?
Do your homework! Look at the test plans, set aside specific time to study, determine how you want to study, and sign up for the exam. If you set up a test date, you are more likely to work toward it. Just do it!
For decades, scrubs have been used by nurses in health care. They replaced the image of a female nurse decked out in a white dress, with the sensible white shoes, stockings, and white hat. While originally used mainly by surgeons and surgical staff in operating rooms, they are now used by nurses, techs, and other health care workers.
Although you can now find scrubs in all the colors of the rainbow as well as with fun patterns on them—everything from cartoon characters to butterflies and flowers to shapes and the like—one thing has remained the same: they’ve tended to come in sizes small, medium, large, extra- large, and so on. They are comfortable, yet loose.
Now that’s all changed as some companies have started designing fitted scrubs for women and men.
Actress Sofia Vergara launched Careisma, a line of scrubs that is, as the website states, “contemporary medical apparel featuring bold colors, chic prints, and figure-flattering styles.” According to Vergara, Careisma is “designed to bring more personality and style to medical apparel. I’ve always admired nurses and health care workers…Health care professionals deserve fashion options that fit their personalities and figures.”
They come in a lot of unique patterns not normally seen, such as leopard print and lace. The colors are bright as well. The sizes still come in XS-XL, but the scrubs also contain spandex, which would make them more form fitting.
Frank Flores, the owner and co-founder of the FrankyRay line, has been in the medical apparel business for more than 13 years. According to the company’s website, the scrubs are made of premium fabrics, but what sets them most apart is the sizing: the men’s scrub pants have true waist and inseam sizing as well as a button and zipper. Scrub shirts that are athletic fit are also available. They are said to be “fashionable and functional.”
Whether you stick with your old scrubs or want to try something different, you now have more options.
How do you feel about form-fitting scrubs? Let us know in the comments!
A good friend of mine used to work shift work, and when the night shift rolled around, she always had problems eating. Some foods made her too tired, while others (like food or drinks with caffeine) gave her problems after her shift was over. She never quite got the balance that she had hoped for, and she also had no idea what to eat for snacks.
For all you nurses working the night shift—and especially those of you who are new to it—here are some ideas to keep in mind and some snacks that you can turn to that will help keep you moving and not make you feel tired.
Get Your Protein
You know that if you eat carb-rich foods or sugary beverages at the beginning of your shift, you will crash in no time. So when looking for snacks, choose those with lots of protein, such as:
- Peanut butter
- Turkey or chicken
- Hard boiled eggs
- Greek yogurt
- Tuna and crackers
- String cheese
Consider grabbing a handful of nuts at the beginning of your shift to help keep your energy up.
Suppose you took on an extra shift or an extra few hours and are now working at night? If you have time before the extra work, head to the cafeteria and get some high-protein snacks. And if you know about it ahead of time, always try to bring your snacks from home. If snacks from vending machines are your only option, go for the granola bars or even peanut butter crackers. While prepackaged foods aren’t the best, sometimes you have to go with them just to eat something to give your body fuel.
When you get home after a long night of work, then you can eat some carbs. If you want to have some cereal before you go to sleep, feel free. The carbs will help you to relax.
Surgeries often involve a number of nurses, all with specific duties to perform in order to ensure the safety and care of each patient. Theresa Clifford, MSN, RN, CPAN, CAPA, is the perioperative nurse manager at Mercy Hospital in Portland, Maine. In honor of PeriAnesthesia Nurse Awareness Week, she shares a little information about what it’s like to be a perianesthesia nurse.
As a perianesthesia nurse, what does your job entail? What do you do on a daily basis?
For the past 26 years, I have been privileged to call the PACU my “home” and have functioned in a variety of perianesthesia roles, including a clinical bedside nurse, a clinical resource nurse and most recently as a perianesthesia nurse manager.
As the manager for perioperative services, I am responsible for the staff and the quality of care that the staff provide throughout all phases of perianesthesia care. First, I manage the staff in a preoperative clinic. This unit is responsible for the preanesthesia assessment of all surgical patients. As soon as a surgery is booked, the work of putting together the preoperative story of the patient begins by a gathering of relevant patient data and calling the patient for an extensive nursing history. The workflow includes an algorithm that helps to identify patients at high risk for surgical or anesthesia-related complications. The main objective throughout this process is to help optimize the patient’s baseline status for the safest perianesthesia experience.
I also manage the staff in the same-day “Ambulatory Care Unit.” Here, we greet the patients on the day of their surgery and continue the process of providing high-quality preoperative care that includes verifying patient information, confirming surgical consents and procedures, and initiating the IV and preoperative therapies. Some of the preoperative interventions are aimed at preemptive pain management and include the provision of preoperative nerve blocks. This is also the unit where patients returning home on the same day of their procedure will be brought for discharge preparation and teaching following recovery from anesthesia (the Phase II unit).
The last unit I manage is the post-anesthesia care unit (PACU) where patients receive Phase I level of care. In the 1960s, the courts deemed the PACU as “the most important room in the hospital,” and I could not agree more! During this phase of care, the nurse is responsible for monitoring patients for airway, ventilation, and hemodynamic stability. In addition, the ongoing management of pain and comfort is actively carried out by the PACU nurses. Once the criteria for safely moving the patient from this intensive level of care has been met, the perianesthesia nurse will hand off care of the patient to the next level of care required.
Why did you choose this field of nursing?
“Curious indeed how these things happen. The wand chooses the wizard!” (J.K. Rowling). I always knew that I would be a nurse. My mother was an incredible nurse, and while I knew I didn’t want to work in her specialty field, I knew I wanted to grow up to be able to help people and touch their lives the way she did.
What are the biggest challenges of your job?
Honestly, the most difficult part of my job in health care today is remaining current with constant external and internal pressures to provide high quality, safe patient-oriented care within restrictive budgetary rules.
What are the greatest rewards?
The surgical experience for most patients is at the least, a memorable event, and at the most, life changing. It is a privilege to be able to participate in the experience as a guide, a knowledgeable professional, and as a source of compassion and care during a time when an individual can be most vulnerable.
What would you say to someone considering this type of nursing work?
I think perianesthesia nursing is a well-kept secret within the profession of nursing. There is a saying—do what you love, love what you do. There are a wide variety of opportunities within the perianesthesia practice to find a niche, a chance to “do what you love!”
Is there anything I haven’t asked you about being a perianesthesia nurse that is important for people to know?
It’s also important, as it is within any nursing specialty, to become aware of your specialty practice organization and to be an active member of your local and institutional work teams. The network built among specialty practice nurses, like perianesthesia nurses, allows for the opportunity to share knowledge and experiences and to participate in best practice and educational programs. The American Society of PeriAnesthesia Nurses (ASPAN), is the premiere organization for this specialty and provides an incredible source of information and support for the practice.
There are a lot of actresses and actors who have played nurses or a nursing assistant at one point in their careers. Then there are the celebrities who have actually been one.
We found a number of celebrities who either were nurses or had been studying to be one. Although we’re glad they pursued their other careers—as the entertainment world would be different without them—it’s fun to think that they could have been working side-by-side nurses in health care facilities today.
Here are just some of the ones we found:
- Tina Turner
Before she became a singer (and an amazing one at that!), Tina Turner was planning to become a nurse and even worked as a nurse’s aide in a local hospital. Can you imagine someone else singing her version of Proud Mary while shaking that spangled dress? No, neither can we.
- Bonnie Hunt
While she’s known as an actress, producer, director, and voiceover artist, Bonnie Hunt began her career path as a nurse. Although she really wanted to act, her father told her that she should become a nurse. Having been a candy striper in high school, Hunt listened to him. After graduating from nursing school, she worked for five years at Northwestern University Hospital and spent her nights performing at Second City improv troupe. Finally, she moved to Los Angeles and landed her first role as a waitress in the Barry Levinson movie Rain Man, starring Dustin Hoffman and Tom Cruise. Since then, she’s starred in movies such as Cheaper by the Dozen, had her own TV show, and entered the voiceover realm. She’ll once again provide the voice for Dolly in the next Toy Story movie, Toy Story 4. In the past, she voiced characters in A Bug’s Life and Monsters, Inc, among many others.
- Adrian Holmes
You may know Adrian Holmes as Lt. Frank Pike in the TV series Arrow, as Nick Barron in the series 19-2, or in many other roles he’s played on TV or in movies. But did you know that he started out as a nurse?
Nursing was a big part of his life while growing up because his mom worked as a nurse, and his parents ran a nursing home. Although acting called to him, Holmes earned his RN. Funny thing is that just after he graduated from nursing school, his acting career began to take off.
- Naomi Judd
Before she began performing with her daughter Wynonna to become one of country music’s biggest duos, Naomi Judd worked as a nurse. When Wynonna and Judd’s other daughter, actress and activist Ashley were growing up, Naomi supported their family by working as a nurse in the ICU.
While she stopped performing with her daughter more than five years ago, Judd still gives talks about hepatitis C, and she published her memoir River of Time, in which she discusses her battle with depression.