Bob Dylan once heralded a call to adapt to flooding waters of change or be "drenched to the bone" and "sink like a stone" in his song "The Times They Are A-Changin'." Today's healthcare waters of change are no less tumultuous. The U.S. economy has hit a record low and is beginning a slow recovery. Unemployment remains at a record high across the country. Although healthcare employment is more robust, nursing and nurse manager positions are being closely scrutinized. And influences of evolving healthcare reform remain uncertain.
Although it's important to master a specific set of skills and competencies that are required in particular nursing roles, in times of downsizing or layoffs it becomes critical to develop new abilities and talents to provide greater job security and role flexibility. One of the wonderful characteristics of the nursing profession is a broad, general preparation, allowing nurses to perform in a wide variety of specialty areas, work settings, and client groups. With slight retooling of their skills, nurses can transition to other areas of interest, and with focused development of additional skills move themselves toward their chosen career path.
As a nurse manager, you've already moved toward an administrative career path by developing additional skill sets that allow you to manage resources, staff, schedules, and units. Nurse managers, just like everyone else in today's economy, are being asked to do more with less. Healthcare environments are ever changing and more complex. You may want to develop skills that assist you to become more efficient or effective with your staff. You may be interested in acquiring expertise that allows you to adapt to evolving healthcare trends. Your goal may be to further your career in administration. Or you may feel the need to branch from your current career path and move toward advanced practice, education, research, or some other area. No matter your rationale, additional skills and competencies can boost your self-confidence, improve personal autonomy, increase job flexibility, and enhance career satisfaction.
Certification and credentialing
Certifications and/or credentialing can be a helpful tool to review and validate your managerial skills and competencies. Basically, after you meet specific criteria, you conduct a review session either in a workbook or online and successfully complete a computerized exam. You're then certified, or receive a certification that provides additional credentials. The terms "certification" and "credentialing" are used interchangeably by different nursing organizations. Nurse managers may qualify for one or more certifications; however, due to cost, you may choose to select the certification that best meets your personal eligibility criteria and the set of skills and competencies being used in your managerial or executive role.
The American Organization of Nurse Executives Credentialing Center (AONE-CC), in partnership with the American Association of Critical-Care Nurses, offers a Certified Nurse Manager and Leader, or CNML, certification to nurses with a bachelor's of science degree and 2 years of nurse manager experience; a nonnursing bachelor's degree with 3 years of nurse manager experience; or a diploma or associate's degree with 5 years of nurse manager experience. AONE-CC also offers a Certified in Executive Nursing Practice, or CENP, certification to nurses with a master's degree or higher with 2 years of executive nursing role experience or a bachelor's of nursing (BSN) degree with 4 years of executive nursing role experience.1
The American Nurses Credentialing Center (ANCC), a division of the American Nurses Association, provides a Nurse Executive (Board Certified), or NE-BC, credential. Eligibility criteria include a bachelor's degree or higher in nursing; holding a nurse manager, executive consultant, or administrative position at the nurse executive level for at least 24 months in the last 5 years; and having completed 30 hours of nursing administration continuing education in the last 3 years (this requirement is waived if you have a master's degree in nursing administration).2 ANCC also offers a Nurse Executive Advanced (Board Certified), or NEA-BC, credential. Eligibility criteria for this credential include at least a master's in nursing (MSN) degree (or a BSN and master's degree in another field); holding a nurse executive administrative position or a faculty position in executive-level nursing administration at the graduate level for at least 24 months in the last 5 years; and having completed 30 hours of nursing administration continuing education in the last 3 years (this requirement is waived if you have a master's degree in nursing administration).3
Certification can be helpful in reviewing and validating your managerial skills and competencies. The emphasis of certification isn't on the development of new skills and competencies, but rather the validation of skills and competencies that you're already using in your current role. Some organizations provide additional pay for certifications/credentials and many require, and more often will be requiring, certification as a prerequisite for nurse manager positions.
Nurse manager certificate programs
A certificate can be a helpful solution to broadening and bolstering your managerial skills, and a number of organizations offer them. Certificate programs usually include course work focused on a specific area of study. Universities or colleges offering certificate programs may include a number of formal courses; other educational organizations may provide access to continuing education courses or modules as a certificate program.
Sigma Theta Tau International offers a Nurse Manager Certificate program that consists of 17 online courses/modules focusing on acquisition of nurse manager skills. When 70 hours of course work are completed, a certificate of completion is awarded.4
Online formats and offerings are making both continuing education and formal coursework much more accessible because they save travel time and allow nurses to fit study and course work completion time into busy work schedules. Certificate programs offered by universities and colleges are gaining popularity because they provide the flexibility of being able to apply course credit to a future bachelor's or master's course of study.
Degree education programs
Some nurse managers may be interested in furthering their formal education. After acquiring the BSN, there are several advanced degree programs that can lead to endless possibilities for nurses and nurse managers. The MSN provides training that fortifies core nursing skills and offers insight into advanced roles in nursing leadership and clinical specialties. Obtaining an MSN typically requires a BSN degree from an accredited school of nursing, a current nonrestricted RN license, a minimum grade point average, a minimum score on either the scholastic aptitude test or the graduate record exam, and an 18- to 24-month commitment. The MSN can be obtained in many specialty areas, including administration, education, and advanced practice.
Generally, the MSN in nursing administration and nursing education includes a clinical nursing focus. The MSN with the advanced practice concentration allows nurses to choose a clinical area of concentration from one of the four advanced practice categories: nurse practitioner, certified nurse-midwife, clinical nurse specialist, and certified RN anesthetist.5 Each advanced practice concentration requires certification before practicing.
Many schools offer a dual degree program, which marries two specialty areas: one in nursing and one in a related discipline such as public health, information science, business administration, or health service administration. These dual degree programs not only allow the nurse to complete both master's degrees at one time but also increase job marketability. Dual degrees in nursing administration and business administration are of special interest to nurse managers.
For associate's degree nurses who'd like to fast-forward to the advanced practice level, some accelerated or bridge programs move students through the bachelor's and master's degrees at one time. These programs typically require at least a 3-year commitment.6 Likewise, there are some direct-entry MSN programs that cater to nonnursing degree professionals who wish to enter into the nursing profession at the master's level.
Doctoral degrees offer an additional level of specialization. Nurses may choose from several types of nursing doctoral programs, including the doctor of nursing education (ND), the doctor of nursing science (DNS), the doctor of philosophy (PhD), and the doctor of nursing practice (DNP). Each program offers training in research methods, the history and philosophy of nursing science, and leadership skills.5,7 The ND focuses on developing advanced practice nurse specialist skills. The DNS prepares the nurse to become a scientist with research, clinical, and leadership skills. Common areas of focus for the DNS include informatics, statistical analysis, healthcare economics, and health outcomes management.8
The PhD prepares nurse scholars and researchers to produce scholarly research that will advance nursing's theoretical foundations and healthcare delivery. Although the doctorate is known as the terminal degree, by 2015 the DNP will be the entry point for all advanced nursing practice roles.5 The DNP prepares nurses to develop systems of care based on research utilization. DNP graduates won't only implement, manage, and evaluate healthcare for clients, but they'll also be experts at maintaining a balance between quality of care, access, and fiscal responsibilities.6 If you're considering a career change into nursing education, you may choose the doctorate in education, or EdD, which will provide you with the foundations of education and principals of teaching and learning.
Regardless of the doctoral program chosen, each has rigorous curricula and requires 4 to 6 years to complete, which means a significant commitment. Furthering your formal education through a degree program requires considerable time, energy, and resources. Think about how the degree will help to move you forward on your selected career path and give thoughtful deliberation as to how the program will develop skills and competencies that allow you to successfully address evolving healthcare changes.
Thriving in a changing environment
Although no one knows precisely what changes will occur in healthcare, you can begin now to develop additional skills and competencies that will assist you to adapt and thrive in tomorrow's work environment. Whether you choose to add additional skills or competencies, a certification, a continuing education or certificate program, or to continue your formal education, you'll want to equip yourself with the expertise needed to successfully navigate yourself, your units, and your organization through the tumultuous waters of healthcare change.
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