Author's note: The figure in the article title refers to the percentage growth/change recorded as a result of this initiative. The number of nurses certified increased by 130%.
Nurses master their specialty's knowledge, skills, and abilities while demonstrating their commitment to ongoing professional development by obtaining specialty certification. Nurses, organizations—such as American Nurses Credentialing Center Magnet®-designated hospitals—and patients benefit from a professional’s commitment to achieving and maintaining specialty certifications.
Why Should Nurses Obtain Specialty Certification?
Nurses with specialty certification describe the achievement as a personal success that supports their professional development (Halm, 2021; Whitehead et al., 2019). Organizations have found that nurses with specialty certification report higher job satisfaction and lower turnover (Halm, 2021; Whitehead et al., 2019). In addition, the achievement of specialty certification has been associated with a focus on quality and safety, resulting in lower rates of nurse-sensitive indicators and complications (Coelho, 2020; Halm, 2021; Whitehead et al., 2019). As a result, the Magnet recognition program continues to recognize the empowerment of professional board certification.
Investing in Nursing Future Through Specialty Certification
At a Magnet-designated, large, acute care, academic organization, nurses and leaders' commitment to nursing excellence embraces the professional development of nurses at all levels. After exceeding Magnet Program and Institute of Medicine (IOM) recommendations for degree rates prior to 2020, the organization has sustained a baccalaureate degree or higher rate of 80%. Due to this success, the team shifted their focus to achieving the Magnet recommendation of improving nurses' specialty board certification for eligible registered nurses and obtaining a certification rate of 51% or greater. To align with this goal, the nurse coordinator, medical-surgical specialist (nurse specialist), was tasked with identifying and monitoring the certification rate for the medical-surgical service line. In 2020, the baseline specialty certification for the service line was 32.5%. In collaboration with the nursing professional development team, the nurse coordinator and the team identified the learning needs to create an education plan to support the service line in obtaining certification. Nurses were not motivated or aware of the importance of obtaining their specialty certification and the impact of their professional development on their patients’ outcomes. Awareness sessions were initiated during staff and unit-based council meetings, explaining the importance of obtaining specialty certification and the simplified process of obtaining medical-surgical board certification.
As the education plan was finalized, the organization’s nursing leadership encouraged certifications by demonstrating their commitment to professional development and obtaining professional specialty board certification in their specialty. Leadership reinforced the personal, professional, and organizational benefits of obtaining certification and partnered with key stakeholders and nursing councils to promote the organizational resource, “ANCC success pays” for selected specialty certification vouchers. Within the medical-surgical service line, the nurse specialist integrated into the medical-surgical certification preparation course the steps to request a voucher code to register for the exam for free, resources available to study, and developed a review course tailored towards enhancing independent learning. This strategy empowered nurses to participate actively in professional development, understand the need and benefits of obtaining specialty board certification, and complete specialty certification registration on the ANCC website through this simplified step-by-step process. The nurse specialist facilitated the medical-surgical certification preparation course by updating the educational information and providing five courses yearly for more learning opportunities for nurses. The nurse is encouraged to complete one review course, which consists of two 4-hour study sessions, before planning the exam date. The nurse participates in an active question-and-answer session, discussing the rationales behind each answer as an active learning method. After completing the course, the nurse specialist serves as a coach throughout the certification process, monitoring examination challenges and successes, and recognizing those who successfully obtained their certification.
The Certification Journey
In 2020, the medical-surgical service line set the goal of increasing specialty certification by 1% annually. The nurse specialist collaborated with formal nursing leaders and shared decision-making leaders to promote and support nurses through the journey to certification. The teams would share resources, provide guidance through the certification process, and celebrate certification achievements.
By December 2021, the medical-surgical service line percentage had increased to 53.0% from a baseline of 32.5%. By December 2022, the medical-surgical service line percentage had increased to 54.7%; by November 2023, the percentage had increased to 59.1%; by November 2024, the percentage had increased to 65.7% (See Table 1). This tremendous improvement was achieved around/after the COVID-19 pandemic and during a timeframe that the organization experienced an increase in nursing turnover rate within the medical-surgical service line. To date, the nurse specialist continues to provide support for the certification process and facilitates preparation courses available to all nurses within the organization.
Celebrating and Highlighting Medical-Surgical Certified Nurses
As a Magnet organization aligned with sustaining a culture of nursing excellence, the achievement of specialty certification is celebrated to recognize this professional achievement. The organization recognizes and honors nurses for their accomplishments through emails and formal awards presented at the unit and service line levels. In addition to being supported in obtaining certification, nurses who obtain or maintain professional board certifications are recognized with certification badges, unit displays of certified nurses through posters, and an annual financial incentive. The nurse clinical ladder program also recognizes nursing professional development and certification. The organization’s highest level, clinical level IV, requires nurses to be certified for advancement. At all clinical ladder program levels, the professional development activities used to obtain certification and achieve one or more specialty certifications can be included in the application process. These incentives encourage nurses to pursue board certification.
Furthermore, certified nurses inspire and support their colleagues to pursue specialty certification by encouraging each other and supporting them with a study plan. These unit-level and service-level recognitions helped the medical-surgical service line increase and sustain a more than 51% increase in alignment with the medical-surgical service line and the Magnet set goals. The medical-surgical service line emphasizes the importance and benefits of board certification to newly qualified nurses, encouraging them to plan their professional development actively. The common vision and goal fostered shared decision-making, ultimately increasing the service line's certification rate.
In addition to unit-level and service-level recognitions, annually, in March, nursing leaders and selected nursing councils celebrate Certified Nurses Day by publicly displaying banners, hosting celebration activities, distributing a certified nurse token of appreciation, and using unit-based rounding to recognize certified nurses while providing resource materials for those interested in obtaining certification. Leader and peer support, and recognition demonstrate the organization’s commitment to professional development, which is ingrained in the culture of nursing excellence.
The medical-surgical service line has seen tremendous growth at both personal and professional levels among all certified nurses. This growth, in return, improves the quality of care nurses provide at the bedside, improving outcomes, challenging the status quo, investing in nursing excellence, inquiry of new knowledge, and improving the nursing future.
Table 1: Professional Nursing Certification Rates
References
American Nurses Credentialing Center [ANCC]. (2024a). Magnet recognition program: 2019 Magnet application manual updates and FAQs: Structural empowerment. https://www.nursingworld.org/organizational-programs/magnet/magnet-manual-updates-and-faqs/2019-magnet-manual-updates-and-faqs/
American Nurses Credentialing Center [ANCC]. (2024b). Magnet recognition program: 2023 Magnet application manual updates and FAQs: Structural empowerment. https://www.nursingworld.org/organizational-programs/magnet/magnet-manual-updates-and-faqs/2023-magnet-manual-updaes-and-faqs/#SE3
Coelho, P. (2020). Relationship between nurse certification and clinical patient outcomes: A systematic literature review. Journal of Nursing Care Quality, 35(1), E1-E5. https://doi.org/10.1097/NCQ.0000000000000397
Halm, M. A. (2021). Specialty certification: A path to improving outcomes. American Journal of Critical Care, 30(2), 156–160. https://doi.org/10.4037/ajcc2021569
Whitehead, L., Ghosh, M., Walker, D. K., Bloxsome, D., Vafeas, C. & Wilkinson, A. (2019). The relationship between specialty nurse certification and patient, nurse, and organizational outcomes: A systematic review. International Journal of Nursing Studies, pp. 93, 1–11. https://doi.org/10.1016/j.ijnurstu.2019.02.001
Disclaimer: The views and opinions expressed in this article are solely those of the contributor and do not necessarily reflect the official policy or position of ANPD.
Serpouhi Vartivarian, DNP, RN, MEDSURG-BC, GERO-BC, GRN
Nurse Coordinator Medical-Surgical Specialist, Hackensack Meridian University Medical Center
Serpouhi Vartivarian is the nurse coordinator medical-surgical specialist of the medical-surgical, orthopedic, and behavioral health service line at Hackensack Meridian Hackensack University Medical Center(HUMC). Vartivarian has 15 years of nursing experience. She oversees all new graduates in their residency program and supports their professional development.
Vartivarian received her bachelor’s and master’s degrees in nursing at the American University of Beirut, Lebanon. She received her doctoral degree in nursing practice at Monmouth University. She is nationally certified in medical-surgical and gerontological nursing and is a geriatric resource nurse (GRN). She serves as a member of several shared governance platforms at HUMC and chairs the Nursing Research and Innovation Council. Vartivarian received the Excellence in New Knowledge, Innovation, and Improvement Magnet Pathway Award in 2020, the Excellence in Empirical Outcomes Magnet Pathway Award in 2021, and the Excellence in New Knowledge, Innovation, and Improvement Magnet Pathway Award in 2024.
Bridget Wertz, DNP, RN, CCRN, NE-BC
Co-Magnet Program Director, Hackensack Meridian University Medical Center
Over the past 20 years, Bridget Wertz has worked in acute care, academic, and leadership settings within nursing. Her educational preparation was completed within the state of New Jersey with her undergraduate and master’s in nursing education from Rutgers School of Nursing and her doctorate in nursing practice from Monmouth University in 2022. She has maintained her specialty nursing certifications in critical care and nurse executive. Wertz joined Hackensack Meridian Hackensack University Medical Center in 2004 on the medical stepdown unit and has experience in stepdown, critical care and clinical education. In 2019, she became the Co-Magnet program director and in collaboration with the nursing team led the organization’s seventh Magnet designation. In her current role, she supports over 2,000 nurses throughout the organization in sustaining a culture of excellence that advances nursing practice and improves outcomes.