Why Would I Need More Than One Nursing Certification?
In 2020, the American Board of Nursing Specialities reported that there were over 1 million specialty-certified registered nurses in the U.S. and Canada. As of 2024, approximately 44 boards of nursing certification offer more than 150 different nursing certifications, with the data unknown regarding those holding two or more nursing certifications. Once we achieve our first certification, we may think we won’t need to earn more in the future. However, that is often not the case given the wide variety of our roles throughout our nursing careers and the continuing advancements in our profession.
Before we explore whether multiple certifications are necessary, it is important to define the term nursing specialty. The American Nurses Association (ANA) has strict criteria for what constitutes a nursing specialty. For example, to be recognized by ANA as a nursing specialty, it must have scope and standards of practice, educational requirements, a dedicated professional association and the word “nurse” in its title. The American Association of Critical-Care Nurses (AACN) and the Association for Nursing Professional Development (ANPD) serve as the two professional associations for their respective specialties and thus advocate for them.
One important reason to seek multiple certifications is that our roles change over time as we progress in our nursing career journeys. The following stories illustrate different professional journeys and how certification has played an important role in expanding their career opportunities.
Jo-Ann’s Story
When my colleague Mary and I completed our nursing degrees and got our nursing licenses 30-plus years ago, certification was quite different and has evolved since starting in the 1960s. When I was contemplating my first clinical certification, I was a registered nurse with over 10 years of experience in practice who had left my first specialty in oncology nursing to work in labor and delivery. As an oncology bedside nurse, I didn’t have the confidence to consider certification. At that time, cancer treatments were changing regularly, and bone marrow transplants were evolving. The benefits of seeking certification were mostly personal, since healthcare organizations didn’t recognize them, require them for job positions or offer financial incentives. I viewed certification as a personal achievement with the benefit to validate my knowledge base, clinical judgment and competence in my specialty and learn about my gaps in practice.
Possible Barriers to Obtaining Certification
The barriers that I had to overcome are the same ones that many nurses still face today. I asked myself if I had enough time and energy to study between work, family and personal obligations. I questioned if I had the money to pay for the certification exam and maintain it with continuing nursing education. Now you must also consider the cost of certification courses and preparation materials that weren’t available then. And, of course, the age-old question “What if I fail?”
Today, these concerns still exist. Certification bodies such as the American Nurses Credentialing Center and AACN have created employer-assisted prepaid voucher programs, so the nurse does not have to pay out of pocket or wait for reimbursement from their employer. These programs eliminate financial barriers, reduce anxiety by allowing more than one opportunity for taking the exam, and include both initial certification and renewals.
Once I decided to take my first specialty certification exam in inpatient obstetrics via the National Certification Corporation, I committed the time to prepare and felt so proud to pass the exam and achieve this recognition. My initial thought was, “I did it, I’m certified and now one and done.” This was until I became a nursing professional development (NPD) practitioner, formerly called a nurse educator, in the Women & Children’s Service using my specialty certification in a new role with so many additional responsibilities. I contemplated if an additional certification would truly benefit my practice. Of course, the barriers that I mentioned about certification were once again a concern. I wondered if I needed a practice specialty certification too, and are they equally important?
The answer is yes and yes! Certification in NPD does recognize practitioners who meet high standards and have experience in the field. Both a clinical specialty certification and an NPD specialty are equally important to validate the level of knowledge necessary for both certifications in dual roles. I achieved my NPD certification and have used my new skill set to advance my profession and assist colleagues as a resource and mentor while influencing other nurses and organizations. It has opened many professional doors and I have never looked back.
After obtaining my NPD certification, I asked our senior leadership team for financial support and resources for our nurses to obtain certification in various clinical specialties and in NPD. With their support, I developed specialty certification review courses and study booklets. Then one day I answered a call to become an NPD certification instructor for the ANPD certification preparation course. I believed in the benefits of certification and was passionate about helping other NPD practitioners have the resources to achieve certification that I didn’t.
Becoming a certification preparation instructor created other opportunities to advance both my clinical and NPD specialties. I became an intermediate and advanced fetal monitoring instructor and an instructor for the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN). I presented at local and national conferences for AWHONN and ANPD. In addition, I authored journal articles, recorded podcasts, authored book chapters and was chairperson for ANPD’s annual national conference.
Mary’s Story
Like Jo-Ann, I contemplated earning my first clinical certification as I worked in critical care and was actively involved with AACN, both locally and nationally. Although I started studying the content for a CCRN, I moved out of direct care for patients after two and half years and started working in nursing education (now called nursing professional development). At that point, I did not have the clinical practice hours to sit for the CCRN exam. Essentially, I had switched to a different nursing specialty, although the language was not fully delineated at the time.
In my education role, I served our health system’s heart center as that was my clinical area of expertise, having worked in our cardiothoracic ICU. As a paramedic, I also taught emergency courses including American Heart Association classes. I loved education (and still do!) but considered my specialty to be critical care. I served on the national AACN board of directors and AACN Certification Corporation board of directors during this time and have always been proud of my critical care background, even though I did not qualify for certification. Through conversations with others in similar education roles, I discovered the National Nursing Staff Development Organization, which is now ANPD. I joined the organization and promptly sat for certification. I was thrilled when I passed and, looking back, I believe that was a turning point for me in realizing that even though my clinical background was critical care, my specialty was education and NPD. I have since earned advanced NPD certification and other education-focused credentials. Along with Jo-Ann, I teach NPD certification preparation courses and enjoy helping others see the importance of this role in our healthcare environment.
How has my AACN involvement influenced my NPD practice? I would say it has influenced it on many levels. For example, the NPD Scope and Standards have standards regarding leadership and ensuring a healthy work environment. I continually reference the AACN Healthy Work Environment Standards as the basis for what we all should be doing in our workplaces. Since NPD practitioners develop and implement educational programs, I have often integrated the Healthy Work Environment Standards into educational offerings, so that they reach a broader audience beyond those who work in acute and critical care. There are numerous opportunities for combining critical care and NPD knowledge, skills and abilities to optimize learning facilitation in the clinical environment.
Dual Certifications for Nurses: Combining Specialties
Nurses require more specialized knowledge to provide safe, high-quality care/excellent patient care to our patient population, especially since healthcare is ever-changing. While the demand for ICU nurses continues, so does the need for NPD practitioners to lead and facilitate new nurses onboarding to the specialty. NPD is defined as “a specialized nursing practice that facilitates the professional role development and growth of nurses and other healthcare personnel along the continuum from novice to expert.” In addition to onboarding and orientation, their responsibilities include education, competency management, role development, collaborative partnerships and inquiry.
NPD practitioners are often considered the ones who organize competency skills fairs and make sure employees are current in basic life support. Although these are all important responsibilities, the NPD Scope and Standards of Practice delineate many more roles and responsibilities. The NPD Scope and Standards of Practice (2022) also delineates seven roles for NPD practitioners that reflect the broader scope of this nursing specialty: leader, mentor, learning facilitator, change agent, champion for scientific inquiry, partner for practice transitions and advocate for the NPD specialty. NPD practitioners collaborate with others throughout the interprofessional learning environment to ensure that all those who serve in healthcare have the knowledge, skills and abilities to lead our patient population and family members safely through the complex healthcare system.
Pamela’s Story
We interviewed Pamela, who has proudly achieved and maintained dual certifications in CCRN and NPD. As an RN who obtained a CCRN in 1990 while working in the ICU, she achieved certification as a personal goal to validate her knowledge and practice while establishing her credibility in the specialty. Her role as a preceptor in the ICU transitioned into becoming an NPD practitioner. When asked why she decided to become certified in NPD, she replied, “Dual certification gave me the tools to combine my critical care knowledge and experience with my NPD skills to lead and advance both specialties in my organization. My opinion became respected as an expert. I was soon invited to be on committees and influence change.” She believes that she was able to show the importance of having both a clinical specialty and an NPD certification in her organization, making the way for more opportunities for others. Her hospital system recognizes dual certifications and provides financial incentives.
Celebrating NPD Week
We have maintained our NPD as well as clinical certifications and serve as speakers and content reviewers for ANPD’s certification preparation review program. In addition to being actively involved in advancing our clinical specialties, our love for the nursing profession along with these specialties has remained constant throughout our careers. During the annual NPD week, we should recognize our colleagues who have committed to NPD certification and for their exceptional work in advancing nursing as well as all the certified nurses who represent the many nursing specialties in the field.
Visit these websites to learn more about their certifications:
- American Association of Critical-Care Nurses (AACN)
- American Academy of Nurse Practitioners Certification Board (AANP)
- American Association of Neuroscience Nurses (AANN)
- American Nurses Credentialing Center (ANCC)
- Board of Certification for Emergency Nursing
- Oncology Nursing Certification Corporation (ONCC)
- American Burn Association (ABA)
- Academy of Medical-Surgical Nurses (AMSN)
- Association of periOperative Registered Nurses (AORN)
- National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA)
- National Certification Corporation (NCC)
Special Acknowledgements
I acknowledge and thank my co-author, Mary Edel Holtschneider, MEd, MPA, BSN, RN, NPDA-BC, NREMT-P, CPTD, (she/her), co-director, Interprofessional Advanced Fellowship in Clinical Simulation, Durham, North Carolina Veterans Affairs Health Care System, and nursing program manager, Duke University Area Health Education Center, Durham, North Carolina, for contributing to the development of this blog. My co-author and I acknowledge and thank Pamela Pascarelli, DNP, RN, NPD-BC, CCRN, clinical education manager at Hackensack University Medical Center, New Jersey, who shared her experiences and perspectives on dual nursing certification.
Are you certified in your specialty? If so, what benefits have you experienced? If not, what are your plans to pursue certification?
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