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.
Barbara Bosah, MS, RN, PCCN, is a highly skilled nurse manager in the thoracic and surgical intermediate care unit and vascular progressive care unit at the University of Maryland Medical Center (UMMC), downtown campus in Baltimore, MD.
With over 14 years of experience leading care teams for patients with complex medical conditions, she is passionate nursing leader who fosters dynamic and supportive work environments that encourage continuous learning and professional growth.
Bosah has been recognized for leading several important nursing initiatives at UMMC that have positively impacted quality and patient experience.
She is particularly proud of her role as a founding leader for the Academy of Clinical Essentials initiative. This revolutionary academic-practice partnership model has been implemented at the University of Maryland Medical System (UMMS) and has resulted in intentional support for new graduate nurses as they prepare for and transition into clinical practice.
Bosah’s contributions to the nursing field have earned her a spot in the Champions of Nursing Diversity Series 2024. This series highlights healthcare leaders who are making significant changes in the nursing field and are prominent figures in their organizations
Meet Barbara Bosah, MS, RN, PCCN, nurse manager in the thoracic and surgical intermediate care unit and vascular progressive care unit at the University of Maryland Medical Center.
Talk about your role in nursing.
I am the Nurse Manager for the Surgical and Thoracic Intermediate Care & Vascular Surgery Progressive Care units. Our unit specializes in providing care for some of the sickest patients within the Maryland region. These patients are admitted to our unit after undergoing surgery. As a Nurse Manager, I lead our team of dedicated nurses. Our primary focus is to provide high-quality and patient-centric care. This involves ensuring that all staff members are well-trained and equipped to handle the complex needs of our patients.
Additionally, I oversee the allocation of staff and financial resources to ensure the effective operations of our unit. By carefully managing these resources, we can maintain a safe environment for our patients while delivering exceptional care. Our team is committed to staying up-to-date with the latest surgical and thoracic care advancements. We regularly participate in professional development activities and collaborate with other healthcare professionals to provide the best possible outcomes for our patients. My role as the Nurse Manager involves overseeing our unit’s day-to-day operations and creating an environment that promotes collaboration, excellence, and compassionate care.
How long have you worked in the nursing field?
Nursing is my second career. Before pursuing nursing, I obtained my Bachelor of Science in Business Administration with a focus in Marketing and a minor in International Business from the University of Louisville in Louisville, KY. Following my passion for healthcare, I furthered my education and earned a Bachelor of Science in Nursing from Bellarmine University in Louisville, KY.
In 2005, I began my nursing career at UMMC as a new graduate nurse in the Surgical Intermediate Care Unit. Over the past 19 years, I have dedicated my professional life to serving patients at UMMC, gaining valuable experience, and honing my nursing skills. I take great pride in my journey from business administration to nursing and the diverse skillset it has provided me. Through my years of experience at UMMC, I have developed a deep understanding of the healthcare industry and a genuine passion for delivering high-quality care to those in need.
Why did you become a nurse?
I choose to pursue a career in nursing because I find fulfillment in assisting patients and their families during difficult times. I thrive in situations where the outcomes are unpredictable, and I can provide the necessary support and guidance. It is gratifying to ensure that their journey through the hospital is as seamless as possible, and I strive to treat each patient and their family with utmost respect and care.
My approach involves delivering high-quality, empathetic, and compassionate services. Moreover, I believe in establishing a personal connection with them and valuing them as individuals rather than just patients. They become part of my extended family in my care, and I am committed to meeting their needs and advocating for their well-being.
What are the most important attributes of today’s nursing leaders?
I firmly believe that nursing leaders are crucial in addressing staffing challenges. They need key attributes to be effective. First, they must be transformational leaders who inspire and empower their staff. A clear vision is essential for navigating complex situations and guiding teams towards success. Accessibility promotes open communication and collaboration. Empathy fosters a supportive work environment.
Lastly, a passion for mentoring and developing nurses is essential for continuous growth. By embodying these attributes, nursing leaders can lead their teams, inspire excellence, and drive growth.
What does being a nursing leader mean to you, and what are you most proud of?
I am honored to serve as a nurse leader, particularly as a minority nurse leader, at UMMC. I have the privilege of contributing to the future growth and development of new nurses entering the profession and mentoring experienced nurses to strive for advancement in their careers, whether as a clinical nurse, an Advanced Practice Provider, or a nurse leader.
While I thoroughly enjoy working with patients and their families, I am incredibly proud of the exceptional team I work with on the Surgical & Thoracic IMC and Vascular Surgery PCU. Our team demonstrates remarkable resilience and delivers outstanding patient care while supporting one another. The collaboration and teamwork within our team are truly impressive, as we care for some of the most critically ill patients in the Maryland Region. I am inspired to come to work each day because of the unwavering dedication of this remarkable team, as each staff member contributes to the mission and vision of UMMC. I am incredibly proud and humbled to be their leader.
Tell us about your career path and how you ascended to that role.
I started my career as a new graduate nurse in the Surgical Intermediate Care Unit. Initially, I was still determining what my career path would be. However, I approached each day with dedication and focused on providing the best possible care to my patients. Although I was unsure if there was room for growth as a nurse then, I was determined to make the most of my past experiences and leverage my background in business and marketing. I set goals and developed a vision for my career to ensure that I had a clear direction. One area that I had always been passionate about was quality and performance improvement.
Fortunately, my nurse leader, Cindy Dove, MSN, RN, Director at UMMC, recognized my passion and took me under her wing. She became my mentor and played a crucial role in my leadership development. Thanks to her guidance and support, I was able to advance through the Professional Advancement Model (PAM) from Clinical Nurse I to Senior Clinical Nurse II, and I currently hold the position of Nurse Manager.
This journey has spanned 19 years, during which I have continuously grown professionally and personally. Looking back, I am grateful for the opportunities to expand my horizons and make a difference in nursing. I am excited to see what the future holds and how I can continue contributing to nursing.
What is the most significant challenge facing nursing today?
One of the most critical issues currently confronting the nursing profession is the persistent problem of staffing constraints and burnout. This challenge has been further exacerbated after the COVID-19 pandemic, which has left nurses exhausted and overwhelmed. The shortage of qualified nursing staff has put immense pressure on healthcare systems, leading to increased workloads and reduced quality of patient care. The demanding nature of nursing work, coupled with the long hours and high stress levels, has dramatically increased burnout rates among nurses. This not only affects the well-being and job satisfaction of nurses but also directly impacts patient outcomes and overall healthcare system effectiveness.
Therefore, addressing staffing constraints and burnout is of utmost importance to ensure the sustainability and effectiveness of nursing care in the present and future. Efforts should be made to implement strategies such as increasing the recruitment and retention of nurses, improving working conditions, and providing adequate support and resources to prevent burnout and promote the well-being of nurses. By addressing these challenges, we can create a more resilient and robust nursing workforce that can deliver high-quality care to patients and contribute to the overall improvement of healthcare systems.
As a nursing leader, how are you working to overcome this challenge?
As a nurse leader, overcoming the challenges in nursing has been quite difficult. It requires a lot of patience, as sometimes it may seem like no end in sight. However, it is important to remain hopeful and continuously review the current best practices to combat these constraints effectively.
One way to address these challenges is by actively listening to the concerns and needs of the bedside staff. We can create a more supportive and empowering work environment by advocating for their needs and ensuring that their voices are heard. Additionally, reviewing and implementing wellness programs specifically designed to support the staff is crucial. Encouraging participation from the entire team by forming task forces can help us successfully enact these changes.
Furthermore, it is essential to focus on the recruitment and retention of nurses. By actively promoting the profession and fostering a healthy work environment, we can attract and retain talented individuals passionate about providing high-quality care. This can ultimately contribute to our nursing practice’s overall success and improvement.
What nursing leader inspires you the most and why?
The saying “It takes a village to raise a child” resonates with me as I reflect on my journey from being a new graduate nurse 19 years ago at UMMC. Throughout my career, I have been fortunate to have the support and guidance of numerous UMMC leaders who have inspired me. Being a nurse goes beyond the technical aspects of the job; it involves working with phenomenal stakeholders and partners across various departments such as Rehab (Physical Therapy & Respiratory), Case Management, Hospital Operations, and Pastoral Care. However, I must highlight the significant impact that the Surgery and Neuroscience division’s nurse managers, Cindy Dove and Ruth Lee (VP of Patient Care Services), have had on me. Their leadership and dedication have been a constant source of inspiration, and I consider them part of my extended family within the hospital.
What inspirational message would you like to share with the next generation of nurses?
As a proud member of Delta Sigma Theta, Inc., the quote by our dynamic Soror Nikki Giovanni resonates with me, and I hope it will inspire you!
“A lot of people resist transition and therefore never allow themselves to enjoy who they are. Embrace the change, no matter what it is; once you do, you can learn about the new world you’re in and take advantage of it.” – Nikki Giovanni
Is there anything else you’d like to share with our readers?
I am incredibly grateful and deeply honored to have this fantastic opportunity to share my journey with you. It fills my heart with immense joy to connect with you and inspire you. I want to emphasize the importance of staying true to yourself and embracing self-love. Remember, you can shape your destiny and create the life you desire. Cherish every moment of your journey, and let your inner light guide you towards greatness.
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.”
Springer Publishing launched a new monthly health care podcast series, Conversations About Health Care Delivery in the United States, featuring discussions with prominent experts, innovators, and leaders in the health sector available on Spotify, Apple Podcasts, and Amazon Music starting on March 7.
The podcast series is hosted by Jim Knickman, the former Robert Derzon Chair at the NYU Wagner Graduate School of Public Service, and Brian Elbel, MPH, Professor of Population Health and Health Policy at NYU Wagner and the NYU Grossman School of Medicine. The series dives into complex and challenging issues affecting the U.S. health care system, its workforce, and the populations interacting with it, covering topics like health management, public health, health behavior, population health, healthcare quality, and health economics.
Knickman and Elbel engage with guests who are leaders in the health sector, from aging services to health policy, to learn more about the key drivers shaping the health care system, challenges and complexities related to health inequities, and the exciting career opportunities available to future health care professionals and leaders.
The podcast series is a companion to the 13th edition of Jonas and Kovner’s Health Care Delivery in the United States, as each episode has ties to essential concepts, challenges, complexities, and themes in the textbook.
Podcast Episode
How the U.S. Health Care Systems is Preparing for the Demographic Cliff features Ramsey Alwin, President and CEO of the National Council on Aging, and Kathleen Cameron, Senior Director of the National Council on Aging’s Center for Healthy Aging.
The episode offers an in-depth discussion about the demographic shift, how the roles of families and social systems have evolved, federal and state-level programs for seniors, social isolation and inequities in the aging population, healthy aging, and exciting career opportunities in aging services.
The podcast series also features a supplemental instructor guide for anyone using the textbook that provides learning activities, discussion questions, and other guidance to engage with each episode, delivering practical and engaging content to learners and professionals in the health care space.
