APRN LACE dialogue for CNSs

Blog is about the changes and updates related to the implementation of the Advanced Practice Registered Nurse Consensus Model for Regulation and the Licensure, Accreditation, Certification and Education changes that will need to take place over the next few years.

Saturday, November 19, 2011

Certification issues...interesting dialogue
I know that many of you are certified by ANCC as a CNS...did you get the information in the mail this week like I did? I am excited by the changes they are making that will clearly align their examinations with the APRN Consensus Model but they are a little scary too!
Essentially if you are currently certified by them you are good to go! Just maintain your certification and you will have no difficulties with the model or the pending need for licensure to have certification. If you let it lapse however you will need to meet the current requirements for certification. That's the scary part!
That is tough since many of us were educated in "the dark ages." There are three things that will hold you back from retaking the certification exams if you let current certification lapse:
1) your education must have included pathophysiology, pharmacology and physical/health assessment (the Three P's). Typically these were not a standard part of CNS education in the past.
2) You must also have been clearly (i.e. on your transcript) identified as being educated in one of the six population foci as articulated in the APRN Consensus Model. I personally take issue with this one for those of us who are in current practice...how can we be expected to conform to an educational model that did not exist when we were being educated? I am going to be asking about this one and the "grandfather" clause that was discussed at the time of the creation of the model.
3) Also, with the new model comes new educational requirements for specific coursework and clinical hours in the population of focus. Again, those of us educated long ago may have done more than 500 hours of clinical...or we may not...but in either case it is unlikely it was recorded on our transcripts!
The devil is in the details isn't it? Bottom line...if you currently have certification keep it current or face having to go back to school. There is no waiver for experience...
They are going to be launching the new exams for Adult-Gero CNS in 2014 with an expected retirement of the current Adult Health CNS and Gerontological CNS certification exams being retired the same year. 
So what about the other big certifier..American Association of Critical Care Nurses (AACN)? They have tried to change the focus of their exams by calling themselves acute care...to me there are two issues with this premise:
1) Acute care does not truly describe the population they are interested in...acute care is any hospitalization and includes more than just the critical care environment...or perhaps that "scope creep" is intentional so they can capture a larger market share of the cash cow that is certification?
2) Perhaps even more glaring is the fact that Acute Care...no matter how you define it...is not one of the populations in the model. The Acute Care certifications truly fit into the realm of a specialty (again...regardless of how you define it) and do not fit the regulatory model as currently defined.
Now let me clarify...I truly believe that specialty is and always will be a cornerstone of the CNS role. We must protect it as an element of who we are and I will defend that to the end. The model was set up specifically to allow specialty to flourish OUTSIDE of the realm of regulation. Individuals can achieve specialty in as many areas as they need to in order to meet the needs of their specific population...for example a critical care nurse can become certified in diabetes care...two specialties that are much needed in the care of the critically ill individual. They must be under the umbrella of a defined population in the model though.  This means that that they can do the specialites under the umbrella of a pediatric population or an adult-gero population.
What do you think?