Many nurses are pursuing certification due to pressure from their
employer who is striving for magnet status, or for financial
incentives that come as a result of having certification in their
specialty field. An unintended but positive consequence of nurses
seeking certification is that we are developing a reliable standard
for excellence in care.

For centuries, nurses and physicians have pursued their profession as
craftsmen. Some nurses are better at clinical skills while others
are better at assessment and still others better at dealing with
patients and patients' families. Encouraging different levels of
satisfactory care actually decreases the level of safety we have in
our institution. Those systems that are very safe have a
standardized level of care that is not dependent upon individual
preferences.

For example, the airline industry has a very safe level of service
and is highly standardized. Very few people know, or care, who the
pilot is that is flying their plane. However, most people choose a
physician based on their personality or anticipated skill set and
believe that the outcome of their care will be dependent upon that
physician's personal skill. When we encourage different levels of
skill in nursing, we are encouraging mistakes and errors to occur.
By standardizing the knowledge skill and basic levels of care
required of nurses, safety will be improved.

An argument could be made that nursing is an art and certain nursing
behaviors cannot be standardized. On the other hand, landing a plane
is an art that requires hours and hours of practice and is done a
little bit differently from one pilot to the next. However, certain
standards were developed and maintained in order to assure safety in
the airline industry.

Professional certification helps to validate the knowledge and skills
of the practitioner. Recent efforts to increase the number of
certified nurses in our hospitals will also help improve safety by
standardizing the basic knowledge and skills required in a specialty
area. Imagine the level of care that would be delivered by a team of
certified nurses if every nurse on a particular floor was required to
achieve specialty certification. This goal does not require having
to hire experienced nurses. Junior nurses could be hired in,
trained, and get their experience on the floor while being mentored
by a more experienced nurse.

In the airline industry, they have a pilot and a co pilot. The pilot
is typically the captain. The captain has achieved a higher ranking
than the co pilot due to more years of experience and additional
certifications. They fly and work together in order to make the
flight a successful one. The co pilot is being mentored by the
captain until she reaches the point where she could become captain.
A similar system could be set up on your floor. Junior nurses would
always be assigned a senior nurse who would be working along with
them; giving them guidance and direction when necessary.

The airline example is much different than our system where we teach
junior nurses to call if they have any problems; this would be
similar to sending the co pilot up in the plane alone with a radio so
he could call if he had any problems. Having an assigned mentor
assumes a relationship where both the mentor and mentee are working
together on a consistent basis and learning from each other.

I propose using the system of certification as a basis for improving
care and healthcare safety. The content areas on the exam have been
researched by nursing experts and determined that those are the most
important things that nurses in a particular area should know. This
is a great framework for building excellence in your nurses. The
exam blueprint consists of the concepts that nurses need to be
taught. A certification exam is designed to be able to validate
whether the nurse actually knows the information or not, and if they
are able to use it. Certification is a great validation tool for
determining your nurses' knowledge and skills.

Lastly, your nurses who have achieved certification should be
mentoring those who have not; with the expected goal that those
nurses will pursue and achieve certification to validate their
knowledge and experience as well. Anticipate that you will meet some
resistance initially. Nurses have been trained that they do not need
specialty certification in order to work. However, if we make
certification an expectation and pursue that expectation with every
staff member, we will find that eventually it will become well-
accepted. In fact, your peers will take pride in the fact that you
have an all-certified nurse unit.

Specialty certification has been known to improve confidence, to
decrease errors and improve patient satisfaction with nursing care.
It is also a marvelous design for building more educated and
competent nurses and standardizing the level of care that is
delivered in your unit or on your floor.

Help us to empower 100K nurses to become certified in their specialty
area by the year 2010. Visit www.100k-Certified-Nurses.com

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com