New York does not require national certification for licensure and practice nor evidence of a minimum number of earned continuing education (CE) credits for RN or NP license renewals. My personal choice to obtain and retain national certification as a family nurse practitioner (FNP) has been driven by a belief that learning is a life-long process that never ends. Being part of such an evolving field as healthcare, change is the one constant we can depend upon. After passing the certification examination, I vowed that I would never have occasion to write the exam again and opted to revalidate my qualifications and competence each time through the CE alternative. Every 5 years, I am expected to demonstrate through various ways continued learning, growth, and competence in areas relevant to my credentials of APRN and FNP.
Lost Knowing
The focus of FNP education is broad-and encompasses the care of individuals across the lifespan. As a FNP working in a college setting, however, I am not privileged to care for the very young or the very old on a regular basis. I am the first to admit to some degree of "lost knowing" with these two populations. A few months ago, I did agree to see the 3-year-old son of a faculty member. From the exam room, I could hear the commotion in the clinic waiting area when mother and child arrived so I prepared myself for the unknown. The mother said he was "pulling at his left ear." I thought, "This is manageable". But while taking the history, I learned that the child is autistic, has tubes in both ears, and had just started a gluten-free diet 5 days earlier. She timidly expressed the anxiety and daily stress she experiences as a single mother working full-time while raising a child with special needs on her own. Alarm button!! An inner voice prompted me to take a deep breath, relax, reach into the deep recesses of my memory, recall information I had not used in a long time, and proceed. Fortunately, the child was cooperative and the visit ended with the mother and me satisfied that he had received the appropriate care for otitis media with effusion, and a planned follow-up with his ENT specialist. When you deal with adults most of the time, it is easy to forget that your client can be a dyad-both a child and parent. This changes the dynamics of the visit and possibly the approach or strategies to assessment.
Nothing Learned is Wasted
This month's CE offering on pediatric attention deficit hyperactivity disorder made me vividly remember that visit.
Have you ever experienced this "lost knowing?" Nursing students are held accountable for and tested on their knowledge of physical and behavioral conditions of the human experience even if they do not personally encounter them during any clinical training. Graduates are tested on an extensive body of knowledge before being licensed. What about practicing NPs? Can we still be held accountable for all we are supposed to know based on our certification title? Nurse practitioners are challenged to maintain currency in their actual practice specialty, and even more so for the full role of their major certification as an APN. The Nurse Practitioner journal offers a range of CE topics that are of interest to all NPs. Be venturesome and participate in one that does not appear to be relevant to your specialty practice. Remember, learning never ceases and nothing learned is wasted; all knowledge is applicable in some way to your life and/or practice. Options abound for APNs and the NP role offers a professional experience rich in diversity and opportunity. The diversity of NP specialties has expanded our roles and narrowed individual focus, therefore, we must always be cognizant of our basic APN preparation and strive to stay informed in the requisite knowledge established for that title.