M Ediforial

On certification, Board listens to members' concerns A New England town meeting i s democracy in action-a vibrant and often crusty dis- cussion of local issues. At Congress, there was lively debate at the House of Dele- gates meeting on the American Nurses' Association (ANA) program for certification for excellence in practice. That discussion reminded me in some ways of the tradi- tional New England town meeting.

After listening to a town meeting discus- sion, you usually have a pretty good idea about how people feel about an issue.

The purpose of discussion on certifica- tion at Congress was to give the AORN Board of Directors an indication of the in- terest of AORN members in participating in ANA's certification program for recog- nition of excellence in practice. This i s quite different from certification required for entry into practice. No one would be re- quired to participate in the ANA program; i t i s strictly a voluntary activity.

During the past year, AORN and ANA have been discussing the inclusion of an OR module in the medical/surgical exam- ination that i s part of the certification process in medical/surgical nursing. This would permit AORN members to be cer- tified as excellent practitioners in operat- ing room nursing.

Originally, ANA had planned to develop an OR module in 1975 but because of budget cuts was not able to do so, nor could it make a commitment for 1976. The question has been raised whether AORN

would be willing to fund the development of the module.

What the Board wanted to know was, How many OR nurses would be interested in the ANA certification program if an OR module was available?

It was clear from the discussion that some nurses felt intimidated by certification. As one member put it, "Certification is a threat to many of us-the goals are so far above us.'' Another questioned, "Will i t have a bearing on future promotion?" And, "Why can't AORN develop its own certification program?"

Much time and money has gone into the ANA certification program. For AORN to develop a similar certification program would be costly and time consuming. To the Board, it seemed better to take advantage of the work that ANA had already done. Moreover, a multitude of certification pro- grams among the specialty nursing groups would be confusing to both consumer and employers.

Although the first ANA certification of nurses was completed last year, the pro- gram has been 15 years in the making. In 1974, pediatric nurse practitioners in am- bulatory health care and geriatric nurses were certified. Of the 350 nurses who started the certification process and took the examination in these two areas, 99 were certified-less than 30 percent. The examination in psychiatric and mental health nursing was offered last year, but the process of certification has not been completed.

Certification i s now available in com- munity health nursing, medical/surgical nursing, and maternity nursing. If you are interested in taking the med/surg examina- tion in December of this year, you must

AORN Journal, July 1975, Vol 22, N o 1 15

file your application before Aug 31. Each area of practice has different cri-

teria. Criteria for certification in medical/ surgical nursing include the examination, a description of education and experience and work setting, as well as references from colleagues. It will not include case studies or innovative projects as does cer- tification in psychiatric and mental health nursing.

The basic qualifications for med/surg certification are current licensure and two years of full-time practice in medical/ surgical nursing immediately prior to ap- plication. Full-time practice i s defined as an average of a t least 16 hours weekly of direct patient care to individuals or groups.

Are scrubbing and circulating considered direct patient care? Yes, according to Jean Quigley, coordinator for certification; but, she adds, excellence in practice for oper- ating room nursing should involve more than just scrubbing and circulating. It should include all aspects of patient care including preoperative counseling and post- operative follow-up.

Whether an operating room supervisor would qualify for certification depends on what she does. If she spends a t least 16 hours of her week in direct patient care, which might include patient counseling, screening, follow-up care, as well as cir- culating or scrubbing, then she would be eligible. Educators, inservice instructors, and administrators are not eligible.

The intention of the certification pro- gram i s to recognize the practitioner, the nurse who is giving patient care. In nursing, advancement usually means a move into supervisory position away from the patient. ANA’s certification is a means of profes- sional advancement for the nurse who is directly involved in patient care.

You do not need to have a master’s de- gree to apply for certification. In fact, you do not have to have a baccalaureate de- gree.

In listening to the discussion a t Congress, we sensed that there was confusion on this

point and we could understand why. There are two categories of certification-as a generalist and as a specialist. The term spe- cialist refers to the ANA definition of the term clinical nurse specialist-a clinician “with a high degree of specialized knowl- edge, skill, and competence in a specialized area of nursing” who holds a master’s.

To be certified a s a specialist, you must have a master’s degree and score higher on the examination and be able to answer specialist questions. Both the morning sec- tion of the examination (multiple choice) and the afternoon modules will contain specialist and generalist questions.

One question on many OR nurses‘ minds is, After many years in the operating room, how can I possibly cope with a test on medical/surgical nursing? For operating room nurses who have been out of school for five or more years, i t may well be dif- ficult depending on how much basic nurs- ing they have forgotten.

The ANA certification board believes that to be an excellent practitioner in a specialty area, a nurse should have a core of knowledge on which to build her spe- cialty practice.

What are the benefits of certification? According to ANA, the certified nurse will be identified as a nurse who can serve as a role model for excellence in clinical prac- tice. Certification will motivate her to con- tinued superior performance. It will offer

her a means of self-evaluation as well as tangible evidence of high professional standards. For the profession, certification will help to maintain high standards of

nursing practice. It i s a challenging program. AORN will

continue to explore with ANA the possibil- ities of developing an OR module, but no commitment has been made at this time.

As the New England town meeting re- flects the wishes of the townspeople, the Board’s decisions will be based on the in- terests of the membership.

Elinor S Schrader Editor

16 AORN Journal, July 1975, Vol 22, No 1