"Certification is the process by which a nongovernmental agency or an association grants recognition to an individual who has met certain predetermined qualifications. Certification can be used for entry into practice, validation of competence, recognition of excellence, and/or for regulation. It can be mandatory or voluntary. Certification validates an individual's knowledge and skills in a defined role and clinical area of practice, based on predetermined standards."1(p678) Encouraging nurses to pursue specialty certification is important to the nursing profession and especially to patients. Dr Margretta "Gretta" Madden Styles, EdD, RN, FAAN, was an early leader in the development and promotion of nursing certification. A visionary, she identified the value of nurse credentialing long before it became part of the nursing vocabulary.2 As a primary contributor to the development of the 1st comprehensive study of nurse credentialing in the 1970s, she pioneered the development and implementation of standards and credentials for nurses. She had a global impact on the nursing profession. Dr Styles was an innovator and a driving force in the creation of the American Nurses Credentialing Center (ANCC). I was inspired by her legacy while working at ANCC as the director of the Credentialing Knowledge Center. My responsibilities included oversight of the development and execution of education that supported organizational credentials, such as the Magnet(R) and Pathway to Excellence(R) programs, as well as individual nursing specialty and advance practice certifications. I felt that we needed to recognize Dr Style's work and celebrate nurses who are certified in all areas of specialty and practice. I envisioned "Certified Nurse's Day" to be celebrated on March 19, Dr Styles' birthday. ANCC adopted the idea and thus Certified Nurse's Day was born. Certified Nurse's Day has provided the opportunity to recognize nurses who achieve certification in their area of expertise. It has been 10 years since the inception of Certified Nurse's Day, with many organizations acknowledging and now celebrating this demonstration of nursing excellence.
As we look forward to celebrating the 10th year of Certified Nurse's Day, I would like to acknowledge ANCC's support of nurses who are recognized with The DAISY Award. ANCC has provided direct support to DAISY nurses who meet the certification requirements and are interested in achieving certification. Many DAISY nurses have achieved their certification as a result of this support. Here are a few of the stories of compassionate and extraordinary care of DAISY nurses who have achieved an ANCC certification. These are the nomination stories submitted by patients, families, and colleagues to recognize these nurses with The DAISY Award.
Cynthia was assigned to a 20-year-old patient, R., with Batten disease with comorbidities of blindness, quadriplegia, and intermittent seizures. The family had decided on palliative care, making R. a partial code with no intubation or chest compressions, but other aggressive care was to continue. R. required frequent medication for her seizures, frequent assessment of the respiratory status, and oxygen adjustment. Cynthia cared for R. for three 12-hour shifts. Cynthia was also the preceptor for new grad during these shifts. By the 3rd day, R. had deteriorated to the point of having frequent seizures and not responding to the Ativan dose usually received. Cynthia worked with the family to explain the continued deterioration in R.'s condition in their native language. The family decided to remove the BIPAP (bilevel positive airway pressure). R. was given several doses of morphine for comfort. The patient passed away at the end of Cynthia's shift. Cynthia's dedication to keeping the patient safe and comfortable and ensuring the family understood the dying process helped the family finally let go and allow R. a comfortable passing. While it was emotionally upsetting for Cynthia to care for this young dying patient, she handled it with the compassion and empathy the family needed. Cynthia was able to guide the new grad in the care of R. in a thoughtful, caring way.
The beauty of nursing as a profession is that it can take on many forms and function in many areas of expertise. This story recognizes the skilled care of medical-surgical nurses. Nursing practices and specialties are wide ranging and diverse in their reach. The following DAISY nomination holds up as a model, the care of a nurse certified as an expert clinician in psychiatric care, as seen through the eyes of the patient.
Nancy was my admitting RN on the 4th floor in the neuropsychiatric hospital unit. As scared, anxious and nervous as I was, she (Nancy) maintained a calm and supportive demeanor throughout the process. She checked on me through the night and said goodbye to me in the morning. She noted that I answered that I am Christian, and faith helps my safety in life. Upon returning to work, she sought me out and brought me something by her own accord-Our Daily Bread, a prayer journal. I was graciously humbled by a stranger nurturing to me. I'd almost forgotten what that feels like. Throughout my stay, I used the journal to practice keeping calm and documenting my care and tools learned. During my hospitalization, Nancy checked on me even when she was not my primary RN, never overly intrusive but gently nurturing. I'm nominating this extraordinary nurse as she has not only exemplified compassionate care, but she is also a role model for the compassion that is representative of a professional nurse. Thank you, Nancy! You are a bright and blooming Daisy!
Certification acknowledges not only expert clinicians in a particular specialty, but also those who are providers of care as advanced practice nurses. Clinical nurse specialists and nurse practitioners are examples of these primary provider care roles, and each holds a special place in the healthcare delivery system. The following is the nomination of a family nurse practitioner, honored as a DAISY Award recipient. This story is from the perspective of a colleague:
Every patient Lindsay has gets top-notch compassion, treatment, and care coordination. She goes out of her way to make sure that clinically we can give the most accurate information, but she can deliver the worst news and diagnostics in the most caring way. Her patients love her, almost as much as her coworkers and physicians. Lindsay has wheeled patients over into other hospitals (quite a trek with a patient in labor!). She visits her babies and mothers in the neonatal ICU. She frequently helps provide bus tokens or snacks to some of our needier patients. She is a fierce advocate for the vulnerable populations we treat and befriends each patient. We, and our patients, are lucky to have her.
It is significant in reviewing these DAISY nominations that a common theme emerges. Providing care whether in a medical unit, a surgical unit, a neonatal intensive care unit, or a psychiatric unit, expert clinical care is required. The thread that transcends each specialty or advanced practice skill set across all of these settings is the notion of compassion. Recognizing the dedication and clinical expertise of nurses who meet the rigorous process to become certified is cause to celebrate. Combining the requisite knowledge skills and abilities of a highly competent nurse through certification delivered with compassion is the kind of care we would all wish for ourselves and our loved ones. Certification and The DAISY Award are both powerful forms of recognition!
References