Meet Occupational Health Nurse Dr. Betty Sanisidro

Meet Occupational Health Nurse Dr. Betty Sanisidro

For nurses who enjoy both nursing and business, occupational health nursing is a career that combines both interests. While the majority of nurses work in medical care facilities or settings, occupational health nurses work in an office setting and care for employees of a company.

According to Betty Sanisidro, DNP, MSN, COHN-S, APHN-BC and the executive director of the American Board for Occupational Health Nurses, occupational health nursing is one of the nursing industry’s undiscovered secrets.

Nursing, says Sanisidro, was a calling she recognized from an early age. “When I was young, every time someone was hurt, I was the first to go to the rescue,” she says. After considering a premed path, Sanisidro says nursing offered her something she knew would be essential to her own career satisfaction–high patient contact.

“But I had no idea occupational health nursing was even an option,” she says. She was disillusioned by her current nursing role and didn’t feel like she was able to make the impact she wanted or expected. When a professional contact mentioned a job at a large corporation and noted that Sanisidro’s nursing background and bilingual skills were ideal for the role, she applied. With her strong medical base and her understanding of workplace safety and preventative care, Sanisidro says she realized the role would allow her to flourish, and she accepted the role when it was offered.

With that introduction to occupational health nursing, Sanisidro never looked back and appreciates the variety of her work and the relationships with the people she cares for. “You never know what will walk in the door,” she says. “I have to stay on top of my game. I felt like I hit the Disneyland of occupations.”

The job also offers opportunities for nurses to gain essential business skills they might not have in traditional medical settings. As a liaison to the leadership, occupational health nurses are relied on to give concise presentations and gather and report on data. For those reasons, Sanisidro says advanced degrees will benefit nurses. Even if an advanced degree isn’t required, she encourages nurses to pursue them. Certification in occupational health nursing is also valuable, and certification for this niche is for entry-level skills, so new nurses are able to take the exam. “The most important attributes in an occupational health setting are those that can’t necessarily be taught,” Sanisidro says. “It’s having that desire, care, and compassion. You can’t teach that.”

Unlike many medical centers, save for long-term care options, employees are generally with a company for a long time. And nurses gain deep knowledge of the business aspects of a company so they become experts at about compliance and keep detailed records about visits. Although occupational health nurses have specific daily, weekly, and monthly tasks to track, the day-to-day work is unpredictable. “There’s no typical week,” she says. “And that’s the exciting part of it.”

As a nurse within a corporate setting, occupational health nurses’ duties are broad. They can be counted on to give hearing conservation testing, eye exams, and preventative programs including biometric testing, health coaching, and nutritional counseling. There will be biosafety questionnaires and follow up exams. Nurses in this role can also see emergencies like a cardiac event, seizures, or anaphylaxis or less traumatic problems of something in an eye, a rolled ankle, an abrasion, or checking an unusual mole or suspicious skin lesion.

Occupational health nursing is sometimes confused with occupational therapy, which is distinctly different. But many people aren’t familiar with occupational health nursing–even many nurses. “It’s not a specialty reviewed in most nursing programs,” says Sanisidro. “But once nurses find the niche, they stay for a long time.”

Another difference that many occupational health nurses find is that there is funding in the specialty. Corporations that have occupational nursing staff are making a purposeful, direct investment in the employees’ health and well-being. “We may not generate revenue, but we can demonstrate what was utilized this month and if visits were for personal medical or occupational reasons,” she says. “You have to get comfortable with public speaking, PowerPoint presentations, and speaking the lingo of business, because businesses listen to dollar signs.” Occupational health nurses are also advocates for employees, so they are comfortable alerting the company to a workplace safety issue or a strange odor before it becomes a larger problem.

Employees, in turn, appreciate the convenience of health care in the workplace with someone they recognize and trust. “You develop a rapport and trust with them,” says Sanisidro. “They can just pop in and say hello.”

If occupational health nursing interests you, Sanisidro recommends reaching out to an occupational nurse for a conversation, shadowing a nurse to see what the role is like, or even picking up some per diem jobs through an agency to get a feel for the position. “If they love helping others and are caring and compassionate nurses,” she says, “everything else can be taught.”

Full Practice Authority Gains Ground in 26 States: What This Means for Nurse Practitioners 

Full Practice Authority Gains Ground in 26 States: What This Means for Nurse Practitioners 

In the long struggle to gain full practice authority (FPA), nurse practitioners (NPs) can point to notable advances in the last few years. Now, patients in more than half of the states, the District of Columbia, and two U.S. territories have full, direct healthcare access from NPs.

In April 2022, New York and Kansas granted FPA to NPs. That brings to 26 the number of states where NPs can practice to the top of their license without restriction. In this article, we’ll look at how that progress was made, the impact of COVID, and how newly proposed federal legislation would strengthen NP practice. But first, let’s have a look at what FPA means.

Defining FPA

 

“Full practice authority is essentially that the nurse practitioner can practice to the full extent of their education and training,” says April N. Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN, president of the American Association of Nurse Practitioners (AANP). “Nurse practitioners are trained to evaluate patients, make diagnoses, order and interpret tests, prescribe medications, coordinate care, and educate. We are educated and trained to do these things,” says Kapu.

In the past few years, the pace has “really picked up as we have seen more and more states move to full practice authority,” according to Kapu. She notes that four states moved to full practice authority through the pandemic: Delaware and Massachusetts in 2021 and New York and Kansas in 2022. “It’s because we demonstrate our commitment to quality and equitable care and ensuring care is provided in all communities.”

In states that have moved to full practice authority, “we’ve seen improved patient care outcomes. We’ve seen an increase in the workforce. We’ve seen an increase in nurse practitioners working in historically underserved urban and rural areas,” Kapu says.

FPA, COVID and Care

While devastating, COVID helped bring to light the high-quality care that NPs provide and boosted efforts to gain FPA. In some states where NPs worked under less than full practice authority, the governors signed executive orders waiving various restrictions, notes Kapu.

“That’s where we saw the opportunity for nurse practitioners to continue providing care. They provided very high-quality care. They were able to provide more accessible care. As you saw throughout the pandemic, they were in communities and churches, going door to door, seeing patients in their homes, and doing everything they did in the hospital and the ICUs. So we demonstrated that continued quality of care. And that is what quickened the momentum during the pandemic; the executive orders provided that opportunity,” Kapu says.

Ohio Experience

In Ohio, a reduced practice state, an emergency authorization during COVID allowed NPs to deliver care via telehealth, notes Evelyn Duffy, DNP, AGPCNP-BC, APRN-NP. However, she notes that NPs can still practice via telehealth, and that ability is no longer contingent on the emergency authorization. Based in Cleveland, Duffy is an NP in the University Hospitals Geriatric Medical Group and a professor at the Frances Payne Bolton School of Nursing.

An NP since 1981, Duffy notes that “we’ve come a long way in Ohio. We got full prescriptive authority at the end of the 1990s.”

However, like all Ohio NPs, Duffy needs a collaborative agreement with a doctor. “Ohio is in the reduced practice category,” she notes. “Not a lot obstructs me from doing what I want. The only thing that gets in the way is having to make that collaborative arrangement.”

Overcoming Obstacles

Kapu stresses the need to get out the message that laws limiting NP practice need to be revised. Laws need to be updated to “allow NPs to practice to the extent of their education and training, not beyond that, but to the extent of their education and training, as they are very capable of doing and have decades and decades of evidence demonstrating their quality-of-care outcomes. So it’s getting that message out that all we have to do is update those laws. It’s no cost or delay and can be put into place, and you would see much-increased access.”

Kapu points to Arizona as an example of what may happen for states that grant FPA. Arizona, she notes, moved to FPA in 2001.  Five years later, the NP workforce doubled, and rural areas saw a 70% increase in NPs.

FPA Federal Legislation

On the federal level, new legislation, the Improving Care and Access to Nurses (ICAN) Act, was introduced in September in the House of Representatives. Supported by the AANP and other major nursing organizations, the act would update Medicare and Medicaid to enable advanced practice nurses to practice to the top of their education and clinical training, according to a press release from the American Nurses Association.

Maintaining Momentum

Although getting FPA in all states has taken a little longer than wanted, “we have momentum,” says Kapu. “I believe we’ll get there, especially with the increasing access to care needs that we’re seeing in the United States today.”

Celebrate Certified Nurses Day on March 19

Celebrate Certified Nurses Day on March 19

In honor of Certified Nurses Day (on March 19), Minority Nurse interviewed Katherine Houle, MSN, APRN, FNP-BC, CNN-NP and executive director of the Nephrology Nursing Certification Commission (NNCC) and Sandy Bodin, MA, RN, CNN and president of NNCC, to find out why certification is such an essential component of career growth and excellent patient care.

Certification helps nurses achieve an expertise level of understanding of a specialty topic. Whether it’s a nursing student planning out a long career or an experienced nurse who wants to advance to a new level, understanding the benefits of  certification is part of a nurse’s career journey.

“Nurses are first introduced to the importance of certification in their nursing program at college when they are taught about the concepts of life-long learning and professionalism,” says Houle. “Typically, as nurses begin their careers, they tend to gravitate toward a specialty. As they become more proficient in that specialty, they often choose to become certified.”

Nurses may choose certification in more than one specialty as each shows a commitment and a proficiency to their roles and their patients. The credential is also a way to outwardly acknowledge a nurse’s advanced skill set and knowledge in a particular area. That easy-to-see credential is valuable to anyone the nurse may interact with–patients, peers, leadership, and the wider nursing community. “This certification enables nurses to demonstrate their expertise in that specialty and validate their knowledge to employers and patients,” says Bodin.

Because certification is confirmation of a nurse’s proficiency in a specialty, patients find credentials signal professional expertise. And nurses take pride in knowing they are taking extra steps to provide the most advanced and up-to-date patient care possible. “Researchers have found a positive relationship between nurse certification, patient satisfaction, and patient outcomes,” says Houle. “Certified nurses report increased confidence, competence, credibility, and control.” And fellow nurses also look to their certified peers as leaders and experts in their specialty. That expectation can open the doors to professional opportunities and collaborations that benefit the nursing industry as a whole.

Nurses are also aware that as a whole, the more certification among a team, the better patient outcomes will be. “The purpose of certification in nursing includes protecting the public from unsafe and incompetent providers, giving consumers more choices in selecting health care providers, distinguishing among levels of caregivers, and giving better-trained providers a competitive advantage,” says Bodin. “Certification has been shown to positively affect patients and nurses.”

The process of becoming certified does take work, and nurses may find taking on extra work daunting, especially when their work is demanding. But many nursing leaders want to remind nurses that the certification exam requires a certain amount of real-world experience before it can be taken. By that point, nurses known the information as they are likely doing the work every day. “Most certification programs require a certain number of hours worked in the specialty prior to applying for certification,” says Bodin.

Nurses dedicated to the credentialing process understand that they need to dedicate some time to the process.  “There is a significant commitment in time and effort to become certified,” says Houle. “It takes time to gain expertise in the nursing specialty and an effort to obtain advanced nursing knowledge to demonstrate the skills needed for certification.” Like many other credentials across different industries, once nurses are certified, they should plan to renew that credential as required (the length of time a certification is valid differs by specialty). “Continuing education hours, along with current, ongoing work experience is needed to maintain certification,” she says. “This ensures that the nurse is keeping up with rapid changes in the field.”

When nurses look at long-term career growth, certification offers many benefits. Like a degree, certification isn’t tied to a certain role or organization. As a nurse changes jobs, that certification continues to signal a commitment to professionalism and providing the best patient care. A certification may not bring an instant salary boost, but it can be used as leveraging power during a review or when applying for a different position.

Many organizations also celebrate nurses as they earn their certification as a way to show public recognition of and appreciation for the extra work that a certification requires. This week’s Certified Nurses Day is one way to recognize all that extra work.

Pediatric Nurses Week: Advocating for Children’s Health

Pediatric Nurses Week: Advocating for Children’s Health

This week’s celebration of Pediatric Nurses Week (October 4-8) is a reminder of the specialized work these dedicated nurses offer to their young patients.

For anyone interested in a career as a pediatric nurse, it’s helpful to know the responsibilities of this job. Nurses who work with children are the biggest advocates for their young patients. From toddlers to teenagers, pediatric nurses will become familiar with, and fluent in, the issues facing these ages.

Nurses who work with children will have an understanding of everything from toilet training and toddler play habits to social media and adolescent decision making habits. Pediatric nurses will see children for well visits, minor illness like a stomach flu, and life-threatening diseases including cancer.

Because of the range of ages, potential conditions, and situations, pediatric nurses have to know myriad relevant medical information and also how any issues or concerns will impact the family. Working with so many different families while focusing on a young patient can be challenging for pediatric nurses. Families are also the best advocates for the child and so creating a good working relationship with families is especially helpful. Compassion and understanding go a long way, but calling attention to concerns is also a pediatric nurse’s responsibility.

The Society of Pediatric Nurses is an excellent resource for nurses who work with children and their families. It offers guidance on education, advocacy, and clinical information to cover the needs of just about any pediatric nurse.

Nurses in this specialty are in high demand and can find a satisfying career in one office or by changing the focus of their career. They can find work in a family practice, a specialty practice, a hospital, an outpatient or surgical clinic, schools, or even rehabilitation centers.

Gaining certification is a professional development step that will give pediatric nurses a more complete and current skill set. The Pediatric Nursing Certification Board offers exams for initial or renewal certification as a Certified Pediatric Nurse (CPN) or as a Certified Pediatric Nurse Practitioner-Acute Care (CPNP-AC). Nurses who earn certification status help their careers and their patients.

By taking the exam, nurses are proving they have the most updated knowledge on evidence-based practices and on treating their young patients. This helps them give the best care possible as this specialty changes rapidly. Nurses who become certified are also demonstrating a specific commitment to being the best nurses they can and to gaining the tools necessary to make that happen. For a career move, this extra level is frequently noticed by your peers, supervisors, and organization. Nurses who are certified and keep their certification current are the nurse leaders organizations look for and depend on.

Happy Pediatric Nurses Week!

March 19 Celebrates Certified Nurses Day

March 19 Celebrates Certified Nurses Day

On March 19, nurses around the nation are celebrated for earning a nursing certification distinction in a specialty field. Each year on this day, the American Nurses Credentialing Center supports Certified Nurses Day recognizes the dedication of nurses who pursue additional training in their area of expertise so they can provide the best patient care possible.

Certified Nurses Day falls on the birthday of Margretta Madden Styles, RN, EdD, FAAN, a nurse leader and educator who is considered the driving force in nursing certification. Styles was a pioneer in drawing attention to the importance of nurse certification and what is means for high-quality nursing practices and  improved patient outcomes. A 1954 Yale graduate, Styles, who was known as Gretta, eventually served as the dean of the School of Nursing for the University of California San Francisco, and gained international acclaim for her advocacy for certification to advance the nursing practice. Styles died in 2005, but her legacy continues to inspire the certified nurses in the United States to this day.

Nursing certifications improve nurses’ skill sets, expand their employment prospects, raise their salary potential, and also elevate the nursing industry as a whole. Individually, nurses who are certified are recognized for the additional time and effort they spend to gain more knowledge in their specialty. And nurses are able to obtain many certifications—they are not limited to just one. Certification helps bring you the understanding you’ll need around practices and processes in whatever area you choose. For instance you may decide to obtain certification in adult gerontology, oncology, nurse leadership, gastroenterology, med-surg,  wound care, or diabetes care. The dozens upon dozens of choices available will likely meet whatever interest or specialty you’d want.

To become certified, you’ll need to be a licensed RN. Depending on the certification you are going for, other prerequisites vary by program and by state. In some instances you’ll need to have an advanced degree or a certain number of practice hours in that specialty. Each certification will cost a fee to take, and some employers will cover this fee, or part of it, if you ask. And because certification is based on the idea that having up-to-date knowledge is crucial to excellence in nursing, you’ll need to renew your certification periodically (and that also varies with the specific certification).

Lots of nurses worry that certification is a long process or that they could suffer professional backlash if they don’t pass the exam. As a nurse, you can choose to seek certification without your employer knowing your plan, so you won’t have to worry about telling your supervisor the results. On the other hand, oftentimes the encouragement you’ll receive from your colleagues can inspire you to continue on this path and get through the hard times. And lastly, when you are taking a certification exam, you’re being tests in areas that are already familiar to you.

As a nurse, certification boosts the knowledge you already have and sharpens your skills so you’ll improve your own nursing practice on a daily basis. In the larger picture, as a professional, you’ll gain specific expertise in your area of practice and thus you’ll be looked to as a leader in that area. As you gain a higher professional standing, more opportunities for additional responsibilities and leadership positions may open up for you as well.

On this year’s Certified Nurses Day, celebrate the efforts of nurses who have become certified and have improved their work and their patient outcomes each day. If you’re thinking of becoming certified but are delaying starting the process, the best time to begin is now.

BCEN Celebrates 40 Years of the CEN

BCEN Celebrates 40 Years of the CEN

Milestones are a big deal, and they are often times of celebration. Throughout July, that’s exactly what the Board of Certification for Emergency Nursing (BCEN) has done. This month marks the 40th of the Certified Emergency Nurse (CEN) as well as of the emergency nursing specialty certification. What makes this all even more significant is that the CEN was the first emergency nursing specialty certification offered anywhere in the world.

“As emergency medicine was becoming recognized as a specialty, emergency nurses formed the Emergency Department Nurses Association (today’s Emergency Nurses Association) and in the mid- to late-1970s recognized the need for a certification program for emergency nurses. Thanks to the forethought and efforts of the association and some extraordinary nurse-pioneers, the Board of Certification for Emergency Nursing (BCEN) came into being and several years after its creation was purposefully separated from the professional association to become a fully independent certification body,” explains Janie Schumaker, MBA, BSN, RN, CEN, CENP, CPHA, FABC, the Executive Director of BCEN, which is based in Oak Brook, Illinois.

Taking that first CEN exam was much different than it is today. “During BCEN’s first full year of operations in 1980, the very first emergency certification exam was offered on July 19 at over 30 sites around the country, including Alaska,” says Schumaker. “More than 1,400 RNs took the four-hour, 250-item, pencil-and-paper exam. After waiting several weeks for notification by mail, 1,274 nurses received the news that they had passed and became the first RNs to earn the Certified Emergency Nurse (CEN) credential.

“While BCEN has operated independently from ENA for many decades, we support each other and strongly believe professional membership and board certification are both important for RN success and to advance nursing excellence across every nursing specialty.”

Two years later, in 1982, that number of nurses who held the CEN had increased to 6,000. By 2005, 23,000 nurses held a CEN. By the end of 2020, BCEN expects to have 40,000 CENs.

“As the years went by and emergency nursing knowledge and patient care needs evolved, for instance with the introduction of medevac flights and taking into the consideration the unique physiology of pediatric patients, BCEN developed and introduced certification programs for flight nurses, the Certified Flight Registered Nurse (CFRN®) in 1993, the Certified Transport Registered Nurse (CTRN®) in 2006 for critical care ground transport nurses, and the Certified Pediatric Registered Nurse (CPEN®) in 2009. BCEN’s newest certification, introduced a little over 4 years ago (in 2016) is the Trauma Certified Registered Nurse (TCRN®) for nurses who practice across the trauma continuum from prehospital care to rehabilitation and including injury prevention. This is our fastest growing certification program, which is not surprising given that trauma is a major public health issue affecting people of all ages,” says Schumaker.

And BCEN keeps making sure that nurses can learn more. This past May, it began offering its first certificate program BCEN EDvantage.

Schumaker, a certified nurse, says that she is sure the skills she learned through becoming certified saved lives. “Once the connection between my knowledge, the care I was providing, and the correlation to studying for the Certified Emergency Nurses exam was clear to me, I became a lifelong certification advocate. I have since become certified in other areas of practice that have been a part of my career. Certification has helped ensure I have the knowledge and expertise to do the best possible job in my given role,” says Schumaker. “To me that is huge because I want to be a strong contributor and make a difference.”

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