New nursing certifications poise practice for growth
The number of certified RNs is on the rise
Karen Schmidt, RN
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Each year, new certifications become available to nurses in many specializations, enabling greater breadth of practice and expertise. Demand for certified nurses is growing and will continue to grow, said Nadine Salmon, MSN, RN-BC, IBCLC, because society and healthcare systems are aiming for safer and more professional nursing care.
Certification offers nurses formal recognition of specialized knowledge, skills and experience. According to the 2015 OnCourse Learning white paper on nurses, healthcare employers and patients, certification is equated with professionalism and “advancing the nursing profession by encouraging and recognizing professional achievement.” The report also stated more than 800,000 nurses are certified by the American Board of Nursing Specialties, with the number increasing annually. Salmon, clinical director of CE programs for healthcare with OnCourse Learning, has observed new types of advanced certifications gaining traction among nurses. “The overall numbers of nurses acquiring initial certification and maintaining a nursing certification is definitely on an upward trend,” she said. Among the newer certifications that Salmon has observed a recent growth in popularity are
Care Coordination and Transition Manager
Clinical Documentation Improvement Specialist
, and
Trauma Certified Registered Nurses certification

“The overall numbers of nurses acquiring initial certification and maintaining a nursing certification is definitely on an upward trend.”
— Nadine Salmon, RN
Many reasons, both personal and professional, prompt nurses to gain specialty certification. A certification demonstrates one’s competence in a specialty area and demands that nurses keep up with developments and new knowledge in their area. A wider choice of jobs is available to nurses with certifications, and typically those nurses have a clear advantage over non-certified nurses for a position. Studies cited by the American Board of Nursing Specialties showed nearly 90% of nurse managers would hire a certified applicant rather than one who is not certified. Salaries are also higher for nurses who attain and maintain certification.
Research has shown
that the greater the number of certified nurses, the better the patient outcomes. Falls, hospital-acquired infections, and the odds of death all were demonstrated to be lower when nursing care was provided by a higher number of certified nurses.
Trauma certification has wide appeal
Sara Daykin, RN
Sara Daykin, MSN, CPEN, TCRN, CPST, a unit-based educator for urgent care, ED, observation and pediatric emergency units at the University of New Mexico at Albuquerque, wrote a continuing education course on the TCRN certification for
Pearls Review
a few years ago, and believes it is useful to a wide range of nurses, not just those working the emergency department.
Daykin said the
CEN (certified emergency nurse) certification
is very specific to the ED, but TCRN covers a much broader spectrum, including care for patients before they are hospitalized, in the ER and trauma rooms as well as in other units where patients with trauma might be under care, all the way to provision of health promotion and safety education outside the healthcare environment. “The thing I love is that the TCRN opportunity opens certification up to more people, not just the nurse in a trauma center, but anyone who looks after a trauma patient,” Daykin said. The trauma event doesn’t have to be a catastrophic one. It might be a person with a broken arm, Daykin explained. At her facility, Daykin said nurses who have sought out the TCRN certification work in step down units, the trauma ICU and the ED.
More nurse practitioners seek NP certification
Becky O’Shea, RN
Among the certifications Salmon has seen growing are those in oncology, including the advanced oncology certified nurse practitioner. Becky O’Shea, APRN, OCN, AOCNS, CBCN, CNS, is an oncology clinical nurse specialist and cancer program coordinator/navigator at Texas Health Presbyterian Hospital in Denton and president of the Oncology Nursing Certification Corporation.
O’Shea said the AOCNP certification is in demand and is expected to continue to grow along with the role of APNs. Historically, the advanced certification was for clinical nurse specialists. That exam was retired in 2017, according to O’Shea, because of the decreasing volume of nurses interested. Nurses who hold a certification that is retired can continue to carry it if they maintain the CE requirements, but the certification is not offered as a new one. “The trend now is that when nurses go back for their advanced degrees, we see a decrease in number of programs for clinical nurse specialists and more programs for nurse practitioners,” O’Shea said. Most nurses seeking or holding the AOCNP certification are nurse practitioners working in ambulatory care settings. “In oncology patient care, you must continue your education because things are evolving so quickly in cancer care,” O’Shea said. “Every day there are changes and new treatment approaches. Nurses who want to be certified want to keep on the cutting edge of things and this enhances patient and family support.” O’Shea added that NPs with advanced oncology certification are able to work with patients who in the past would not have survived, but now need symptom management and also psychosocial care. “This is care that extends from cancer screening all the way to the end of life; it’s a lengthy continuum,” she said.
It's a positive influence on the profession
Salmon sees many reasons the certification trend will continue. “I believe nursing certifications positively influence nursing practice by empowering nurses and protecting health systems and patients,” she said. As more nurses become certified, she noted, standards of care improve and nurses gain more personal and professional satisfaction while patients enjoy a better care experience and healthcare organizations experience a lower incident reporting rate along with greater nursing staff retention rates. From a healthcare systems perspective, the more certified nurses in a system positively correlates to accreditation by The Joint Commission and with grant funding. Salmon also pointed to the trend for hospitals to achieve Magnet recognition, which supports and encourages nurses to gain and maintain certification in their specialty area. O’Shea succinctly summarized the reason for attaining and maintaining certification. “You can’t be a nurse and not keep up,” she said. “It’s a duty to our patients and their families that we continue our education, so they can benefit from excellent care.”
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Karen Schmidt, RN, is a freelance writer.