Nurses go through years of hands-on training and academic courses to become a nurse and then excel at their profession. And when nurses find a nursing specialty that is especially rewarding to them, becoming certified is the next step for highly motivated nurses.
On today’s Certified Nurses Day, nurses who take on additional work to become certified in their specialty are honored for their pursuit of excellence.
As a nurse, certification is a signal to your professional community and to your community of patients that you have done all you can to achieve the latest knowledge. That means a nurse’s training and understanding of the most recent evidence-based practices is current.
Making the decision to become certified and then taking the actual steps to make that happen requires both dedication and focus. Nurses generally must complete a certain amount of hours within a specialty before sitting for the certification exam. That process helps give them a solid foundation of the skills and processes needed to specialize in their chosen area. But the time spent working in one area also helps nurses decide if that is the path that is right for their career goals and professional aspirations.
The American Nurses Credentialing Center offers a wealth of resources and various certification exams for nurses. A nurse certified in a particular specialty is one who wants to have all the tools possible to provide the highest standard of patient care. And certification isn’t limited to one area. For instance, specialty certified emergency, trauma, transport, and burn nurses often take the Board of Certification for Emergency Nursing’sCertified Emergency Nurse (CEN) exam, and they might also want to consider the Certified Burn Registered Nurse (CBRN) or the Certified Pediatric Emergency Nurse (CPEN) as well. No matter what area a nurse works in, taking the time and effort to earn a certification is noticed, and even sometimes celebrated, within the organization where they work. Certified nurses often are seen as experts in their areas and so are excellent resources for their teams and also mentors to other nurses.
Some nurses say the fear of failure keeps them from taking a certification exam. But from the perspective of many certified nurses, the information on the exam is information that is part of their daily work responsibilities already. That doesn’t mean exam preparation and studying isn’t necessary, but it does mean that many nurses find they are familiar with the information that they will be tested on.
Combined with preparing for the exam, that existing professional knowledge boosts their chances of success. And if fear of failure is a real roadblock, nurses don’t have to tell anyone that they are taking the exam. Their organization won’t know they are taking it, so if they don’t pass on the first try, it won’t be noticed at work. And if the first try doesn’t go as planned, taking the exam again is worthwhile. Having that additional understanding and the certification to show your dedication to nursing knowledge and process is a significant professional achievement.
Today’s Certified Nurses Day honors all the hard work nurses do to provide top-notch care and also to signal their commitment to the nursing profession as a whole.
Whether nurses think their job includes data informatics or not, it does in one way or another. For almost any nurse, data is a touch point in their day, whether they work at the bedside, in an independent office, or a boardroom.
“Data is critical,” says Andrew Awoniyi, ND, RN, NI-BC, education director and board member of the American Nursing Informatics Association (ANIA). “It underlies everything we do.” When a fellowship experience revealed the way technology could have a positive and significant impact on healthcare, Awoniyi says he developed a new understanding of how nurses can use it. “It opened my eyes to how you deliver the best healthcare,” he says.
Many nurses hear informatics and think it does not apply to their jobs, but the opposite is true, says Awoniyi. “There’s a school of thought that all nurses are nurse informaticists,” he says. “Everyone is using data whether they fully understand it or not.”
Often, a nurse’s day includes responsibilities unrelated to numbers or patterns in data. Still, those responsibilities and the equipment or directions they rely on are a direct result of information that has been collected and analyzed.
It’s All About Data
“When a new initiative comes out, or there is a new process or new product, that is all because of data,” says Kathleen Ulanday, MBA, MHA, BSN, RN, NI-BC, CPHIMS, and a senior clinical informatics specialist at Texas Children’s Hospital. For example, a new process that aims to solve an identified workflow issue is often found because measurements indicate needed improvement. Once implemented, the new process will be measured as well. All the data produced during those assessments reveals patterns or other information that can influence everything from how nurses dispense medication to shift adjustments.
The most basic nursing process of identifying a problem, assessing what is being done, intervening, and evaluating all relies on some collection of information, Awoniyi says. Assessing a patient uses the data produced through vitals, lab results, and tests, so everyone from a bedside nurse to a chief nursing officer knows how to check those results to help direct patient needs. “Nursing is holistic, and everything we do around that involves data,” he says. “It is not foreign to us.”
Ideally, nurses work more efficiently when any change is implemented to improve an outcome because they gain fact-based information that can be applied broadly, says Ulanday. If a new process has a more significant positive impact on a cardiovascular patient population than a gastro one, there’s an opportunity to learn why. “Nurses might notice those patients go home quicker and ask why is that,” she says. That discrepancy can trigger a deeper investigation into new areas needing attention.
Informatics Isn’t Just Computers
Nurses who are especially drawn to the idea of working as a nurse informaticist might be happy to know that gathering data doesn’t mean sitting in front of a computer all day. Data, Awoniyi says, has a way of helping nurses when the results are interpreted and applied. And with artificial intelligence leading to advances in medical robotics and more targeted applications, nursing informatics is advancing rapidly. It can be a significant factor in closing gaps in healthcare access. The recent expansion of telehealth shows how technology expands potential. As the population shifts and more people are living longer and with more complex conditions, data, says Awoniyi, can help close the gap in healthcare because it can offer healthcare in settings that are located far from high-tech hospitals.
While data is something that nurses can point to as proof of something working (or not), there’s another unexpected benefit to using data to help guide how nurses perform their jobs and care for patients in any setting. Compliance with a new process can improve a workflow, says Ulanday. When nurses see that improvement, their motivation and morale increase.
An In-demand Career Path
As data output grows, the industry needs nurses who use data efficiently and know how to interpret and apply the data to different nursing scenarios. “There’s a lot of data that is generated,” Awoniyi says, “and we must understand that.”
Whether they want to switch careers or not, Awoniyi recommends that nurses understand how and why technology is incorporated into healthcare processes and settings. “Be willing to contribute,” he says. Partner with other nurses, look at how new systems impact nursing workflows and offer feedback on what might improve the process or quality.
Informatics opens up nursing jobs for everything from a nursing informatics specialist or clinical informatics specialist to that of a professor or educator. According to the Healthcare Information and Management Systems Society (HIMSS) 2022 Nursing Informatics Workforce Survey, 60 percent of the 1,118 respondents reported annual salaries of at least $100,000. The survey also showed how nursing informatics roles are positioned in organizations, with 34% of respondents reporting to information systems/technology, 33% to informatics, and 30% to nursing. Reflecting on this kind of role’s medical and technical aspects, most respondents said they report to two departments more often than just one.
How Data and Healthcare Work Together
Even as informatics helps nurses and patients, it does require time and investment, so backing from leadership is critical, say Awoniyi and Ulanday. At Texas Children’s Hospital, Ulanday says the Magnet® status of the hospital requires that the perspective and experiences of bedside nurses, who give hands-on patient care and know how a workflow is helping or not, are included in leadership’s decision-making.
Nurses who are interested in learning more can start by reaching out to their organization’s technical team to ask questions and gain insight into how technology impacts healthcare, says Ulanday. She says to join a professional organization like ANIA to hear about the latest developments and bring those back to leadership.
Ulanday says nurses know it takes time to learn and adapt to new technology, but they also find it will save them time in the long run. It also has a significant safety impact, as data can improve how something is done. Implementing a new workflow based on those findings can eliminate outdated processes and improve patient safety and outcomes.
“As we look to the future, data needs to be a critical part of that,” says Awoniyi. “Understand how data is collected, analyzed, and interpreted. It’s then about how to leverage that data to bring about change.”
Nurses help people all day long. Whether it’s a colleague who needs a hand or a patient who needs support, a nurse will evaluate what’s needed and find a way to make that happen.
But when nurses need something, they are frequently reluctant to ask for help. But a nurse’s human resources (HR) department can help with professional help and often has extensive assistance available. One of the most important tasks a nurse can complete professionally is to have a thorough awareness and understanding of what an HR department offers.
Here are a few things to consider when you need help from HR:
Know Your Benefits
Benefits are much more than health insurance and vacation time. Benefits encompass everything from short- and long-term disability to wellness reimbursements to parental leave policies. The HR benefits manual or explanations your organization has on file are worth reading and understanding. There could be hidden discounts that you aren’t aware of or nuances to emergency time off that you should familiarize yourself with. Your benefits can help you pay for additional education and might have excellent professional development resources you weren’t aware of.
Understand What Happens in an Emergency
Nurses know that life can change in a second. So if something happens in your own life that can impact your job attendance or performance, you shouldn’t have to scramble to find out what you need to do. Does your company have a waiting policy before you take any kind of disability? What happens if you need time to recover from a health emergency? If a family member needs your care, does your organization have any time available for you to take off to help? You’ll want to know about bereavement time as well.
Determine the Complaint Process
No one likes to have problems at work, and it’s a frequent reason that employees leave companies. Whether it’s a problem with a colleague, a supervisor, an annual review process, salary questions, or a scheduling issue, resolving it to your satisfaction is important. It might not always be possible, but understanding how your HR department deals with complaints is good information to have. Is there an ombudsperson or a neutral mediator in your organization who can help?
Figure Out Retirement Options Good retirement options are a key part of any benefits package, but it’s up to you to know what it includes and how it can best apply to your own situation. No matter how close to or far away from retirement you are, having a good understanding of what is offered will pay off in the long term. Does your company offer a retirement plan? Is there a retirement match and is there a minimum employee contribution required? What happens if you need help with making decisions? All of these are questions you can pose to HR to find out how any of the offered benefits can increase your own retirement savings. And if you are close to retirement age, it helps to understand the process for when you want to retire. If there are timelines involved or steps you will need to take as you ready for retirement, you will need to work with HR for a smooth transition.
HR departments offer so much information that employees might not be aware of. Take the time to find out what might be available for you.
Nurses put a priority on keeping their patients safe and Patient Safety Awareness Week, which takes place March 10-16 this year, helps focus attention on this important part of any healthcare provider’s job. No matter how much attention nurses give to patient safety, there is always room to make improvements.
But there’s more to patient safety than knowing and following procedures and protocols, says Kathy Wire, JD, MBA, CPPS, CPHRM, FASHRM, executive director of the Center for Patient Safety. The complexities of patient safety and how it is incorporated, monitored, and managed in any healthcare organization are real. Patient safety isn’t just limited to healthcare providers–it also involves the patient and the patient’s loved ones, too.
The overall organizational culture often sets the tone around patient safety. “A culture develops as a result of attitudes and related behaviors,” says Wire. “The underlying components of safety culture are well known. Some require action from senior leadership; others fit nicely in unit-based efforts. For example, supervisors can encourage non-punitive responses to errors, focusing on addressing underlying system issues and acknowledging human fallibility.”
Nurses often look to leadership to implement processes in which questioning a decision or a process is supported. If nurses push back on something that appears unsafe, they need to know they will have a manager’s support, she says. And this kind of transparency is in the best interests of any organization as patient safety is often tied to nurse safety. “A lack of patient safety can lead to errors and near misses that any conscientious nurse will find disturbing,” says Wire. “Even minor events can trigger this ‘second victim’ phenomenon. Many provider organizations have developed programs to address this trauma in their staff, but isn’t it better to prevent the issue in the first place?” And in the high-stress situations when loved ones are concerned about the care being given, anger and fear can spark threats to nurses, so open communication is essential, she says.
A patient’s family and loved ones contribute immensely to patient safety, says Wire. As nurses need to feel comfortable about being vocal about safety, loved ones also need to be heard and feel they can raise questions safely. Nurses also can trust that those closest to the patient can be advocates and have information the nurse might not. “Helping them understand planned nursing interventions and treatments while encouraging them to ask questions will establish that relationship,” says Wire. “We must let them know that an additional, dedicated set of eyes and ears can help busy nurses provide the best care. For example, family members can often recognize subtle changes in the patient’s condition that may be more difficult for a nurse to see.”
Even the best environment can’t prevent all errors. “Good safety culture tells us that people make mistakes and can drift from the ‘standard,'” says Wire. “Reporting mistakes and errors helps the organization learn about gaps in policy and how well it is supporting its nurses, and it also helps all nurses benefit from the learning that a reported event can generate.”
The highly tuned ability that nurses have in assessing a situation and evaluating the needs in the current moment can also help reveal problems, even problems that were never there before. “It can also bring mistakes and near misses to light, avoiding unnecessary injury to patients,” says Wire. “They must know that safety is not a condition or a statistic. Patient safety is an ongoing set of activities, and a state of mind focused on recognizing risk and generating improvement. It doesn’t care what you did last week.”
Nurses considering a career in nurse anesthesiology know the role is complex and demands a high level of critical thinking and commitment. The career path, in which many certified registered nurse anesthetists (CRNAs) obtain a doctor of nursing practice degree, also offers a high salary and an upward projection of job openings. With a dynamic mix of clinical practice and the capability to work in many settings, nurse anesthetists find a rewarding career.
How did your career path lead to nursing and becoming a CRNA? During my final year in college, I battled severe bronchitis and sought help at the health clinic. The provider who attended to me was not a doctor but a nurse practitioner, displaying both kindness and extensive knowledge. This encounter sparked a conversation about her nursing career, introducing me to the world of advanced practice nursing. This pivotal moment inspired me to explore nursing as a career path.
Upon college graduation, despite my Indian parents’ desire for me to pursue medical school, I knew I wanted a profession that combined science, pharmacology, and interpersonal interactions. Armed with a bachelor’s degree in cellular biology, I promptly earned another Bachelor of Nursing within a year. Upon graduation, I entered the field of critical care nursing, working in the most acute critical care unit settings such as burn, cardiac, and transplant ICUs. It was during my time at Northwestern Memorial Hospital’s Neurospine ICU that I witnessed the role of CRNAs. This experience solidified my decision to pursue a career as a CRNA.
I earned my Master of Science in Anesthesia Nursing from Rush University in Chicago in 2005. In 2021, I received my Doctorate of Nursing from University of North Florida, and in 2022 I received my Global Health Leadership Certification from Northwestern University. I have participated in numerous global mission trips and currently co-chair the AANA’s Diversity Equity and Inclusion (DEI) Committee. I am also the chair of the Illinois Association of Nurse Anesthesiology’s DEI committee. I am passionate about healthcare equity and access and have my own nonprofit called Citizens For Humanity which addresses social determinants of health.
Do you specialize in a certain area or population? Numerous healthcare environments rely on anesthesia services, encompassing fields such as dentistry, podiatry, surgery, obstetrics, and pain management. In my professional journey as a CRNA, I have experienced diverse settings, including community hospitals, ambulatory surgical centers, and plastic surgery centers, and participation in large teaching hospitals as part of an Anesthesia Care Team. The degree of autonomy varies across these settings, ranging from those with no supervision to those adopting a more interdependent model. I have experience working with diverse patient populations, including pediatric, low-income, and critically ill individuals.
What part of your job is particularly meaningful to you? The profession of nurse anesthesiology offers a richly diverse and demanding path. In the clinical realm, you have the profound privilege of impacting individuals during their most vulnerable moments. A significant aspect of the gratification derived from administering anesthesia lies in the opportunity to support individuals through what may be the most daunting day of their lives. They grapple with fear of diagnosis, anticipation of pain, and uncertainties ahead. Your presence as a reassuring figure by their side during this critical juncture becomes paramount. While your expertise and competence in ensuring their safety throughout the procedure are undeniably vital, it is the compassion and humanity you extend that hold greater significance than any medication you administer.
Is there something or someone that helped you in your career that others thinking of this career path will find helpful? My foremost recommendation is to shadow multiple CRNAs across various cases. This immersive experience will provide a comprehensive understanding of what lies ahead. Engage in conversations with current students to gain insights into the rigorous nature of anesthesia school. Recognize that anesthesia training demands significant dedication; therefore, it’s prudent to prepare financially by saving diligently.
Building a robust financial cushion alleviates stress and minimizes post-graduation debt, especially considering the constraints on working while in school. Enhance your academic foundation by enrolling in graduate-level courses in anatomy and physiology, pathophysiology, and pharmacology. This not only demonstrates your commitment but also strengthens your candidacy, particularly if your undergraduate GPA is subpar. While these courses may not be transferrable to most anesthesia programs, they serve to fortify your knowledge base and reacquaint you with the rigors of student life.
What would you like others to know about a being a CRNA? I believe that aspiring RNs should possess a robust grasp of physiology, pathophysiology, and pharmacology prior to embarking on anesthesia school. Embracing challenging assignments, volunteering for cases involving the most critically ill patients, and delving deeply into the rationale behind every action are crucial steps in nurturing a profound understanding of patient care. This comprehension extends to the selection of medications and interventions, ensuring that aspiring CRNAs are well-prepared for the demanding journey ahead. The ability to think critically is paramount in the delivery of safe anesthesia.
CRNAs must excel as problem solvers and keen observers, interpreting data independently and making informed decisions that can profoundly impact patient outcomes. The weight of responsibility underscores the imperative of being both accurate and decisive, recognizing that lives hinge on the choices made in the operating room.
What is your advice for RNs considering a career as a CRNA? Research various CRNA programs to find the one that best suits your needs. Consider factors such as clinical opportunities, cultural diversity, and program structure. Make an informed decision based on your personal preferences and goals.
Once enrolled in a program, maximize every educational opportunity, even if it seems insignificant. Graduate-level education requires proactive engagement, and your dedication will determine the quality of your learning experience. Learn from every case and practitioner, embracing the lessons they offer.
Collaborate with CRNAs who may be perceived as challenging, as they often uphold high standards and offer valuable insights. Maintain a positive attitude and remain open to feedback to maximize your learning potential. Avoid being labeled as unteachable, as it can hinder your educational progress.
