editorial Certification: What Does It Mean To You, The Candidate?

When you read about nurse certification or hear someone talk about certifying OGN nurses, what does it mean to you? What is your interpretation of nurse certification, a term we have been hearing with increasing frequency in past months?

When I think of certification, I think of certified public accountants, certificates of deposit, certificates of incorporation, even certified letters. In the medical field, certified physician specialists, certified nurse-midwives, certified nurse anesthetists come to mind. All have in common a document attesting to the fulfillment of specified requirements. The significance lies not in the document, but in the specific requirements met by the individual. I believe ‘certification for the nurse means that she has met specific educational and practical requirements for practice in a specialized area in an expanded role-for practice in a special way that is different from the practice of uncertified nurses.

The day has passed when all nurses were considered prepared to function in all areas of nursing or to practice in an expanded role. In the past, when we completed our basic nursing education and went out to practice, we did cast our lot (for whatever reason) for a specialty area: pediatric nursing, operating room nursing, obstetric, gynecologic or nursery nursing, psychiatric nursing, etc.

Specialty practice was learned, refined, and expanded on the job. Many excellent nurses learned to function in an expanded role under these conditions. But what ready proaf of their qualifications could they present? What guarantee did their patients h w of their qualifications?

On-the-job leaining experiences differ from one hospital to another, even from one situation to the next within the same hospital. Among hospitals, there are no standard criteria for the educational prerequisites to specialty practice or for proficiency in clinical skills. Therefore, there is no way of knowing who is properly prepared for specialty practice or for accepting the additional responsibilities inherent in the expanded role.

We need an “insurance policy” to better insure that the holder has the additional knowledge and skills, the necessary level of educational preparation and clinical practice, which are necessary for safe practice in a specialty area of nursing ‘in an expanded role.

Certification for entry into specialty practice would be insurance that the nurse has attained a specific level od prepariition and competence. The credentials of a certified nurse would then receive the same interpretation in nursing circles and among physicians, employers, and

patients. Certification would also elevate standards of education for specialty practice. Specialty practice with high standards, adequate preparation, increased responsibility, and an expanded role-this is what I’ve heard you ask for. These are commendable goals, and a certification program could provide the educational and practical experiences to allow all specialty practitioners to achieve these desired goals. An OGN nurse ccEuld participate in the type of certification program I envision after she completes basic nursing education (until basic nursing education prepares specialty practitioners). The programs would consist of short-term education in theory and clinical application of theory and skills necessary for specialty practice in an expanded role. Let’s call these educational programs modules. Each module would cover one area in which OGN nurses practice: antepartal, intrapartal, postpartal, gynecologic, family planning, etc. After completing one module, the nurse would then take the related certification exam and become certified in that area of OGN nursing. The nurse who believes she is proficient in one specialty area after many years of practice might become certified if she achieves a satisfactory level on the certification examination. Education modules might be set up so that a nurse could complete as many m d d e s as she likes. The program could be geared to career mobility so that the nurse who completed all OGN educational modules could receive credit for this education toward certification in midwifery Isn’t midwifery really the sum total of OGN nursing in the expanded role? It is also conceivable that academic credit might be given for completion of an education module. Right now, NAACOG is preparing guidelines for certification of OGN nurses. They could encompass modules of learning, with classes for specialty practice within OGN nursing, a certifying exam, and periodic recertificationall planned and implemented by the OGN health care team with NAACOG having a saong voice in both planning and implementation. The program will only be effective if it reflects your interpretation of ctrtification. You are the practicing OGN nurse, the future candidate for certification. Members of the NAACOG Committee for Certification would like your ideas on the subject. They welcome your comments, care of JOGN Nursing.

EDITOR

januaty/February 1974 JOGN Nursing ‘3