Why CNRN?
What Being a CNRN Means to Me
Lynn C. Goodloe, ABNN 2002-2003 President
I had been a neuroscience nurse for 10 years before I decided to take the national certification examination. Even though I began my nursing career in an intensive care unit and knew that my knowledge base was strong, I believed all the rumors about the examination. I was told early on by my colleagues that very few nurses ever passed the examination. It wasn't until I was a nurse manager on an acute neuroscience unit and one of my staff members successfully challenged the examination that I knew I had to try. I registered for the next examination date and began to prepare. I took the exam at my hospital with two other nurses in March 1997.
I waited for weeks, checking the mail every day for my examination scores. It was almost 8 weeks before I received the news that I had passed the examination. When I opened the envelope and read my scores, I was even more proud than the day that I became an RN. I immediately called my nursing friends and my boss to tell them the news. I gladly turned in my old nametag for a new one that said CNRN behind my name. I updated my resume. I looked forward to the first patient or family that would ask me what those letters behind my name meant.
It wasn't long before doctors, nurses, patients and families were asking me to explain what CNRN meant. Each time I explained the national examination process, I began to understand how important certification was to me personally as well as professionally. It not only demonstrated my expertise in neuroscience nursing but also distinguished nursing as a profession. Certification was, and still is, a nationally accepted "mark of excellence." As a nurse manager, I knew that I had to encourage each of the RNs that I worked with to challenge the exam. Over the last 5 years, I have continued to promote the national certification examination and am proud to wear my CNRN pin. I challenge each of you to take the examination and be recognized for your expertise as a neuroscience nurse.
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Take Pride in Your CNRN Credential
Tess Slazinski
The hospital where I work recently interviewed a physician candidate for the neurological intensivist position. He inquired about the education of the nursing staff and I told him that I was proud of our professional development, because three staff members were interested in sitting for the certified neuroscience registered nurse (CNRN) examination. To my surprise, he exclaimed, "I did not know that neuroscience nurses had their own board examination." I retorted, "Don't neurologists have a board examination?" Physicians and consumer groups advocate for medical specialty board examinations, why isn't it just as important for nursing specialties? Patients are leery about undergoing surgery performed by a physician who is not board certified, yet they are not concerned about the monitoring of complex postoperative equipment by a nurse who is not board certified.
A few of the arguments against certification come from nurses themselves. One argument suggests that board certification does not make you a competent bedside nurse. That statement is correct; board examinations test knowledge and it is the responsibility of hospital preceptors/educators/clinical nurse specialists to test bedside competence. I would, however, argue that knowledge contributes positively to bedside nursing practice. First, performing exquisite serial neurological assessments is a prerequisite for our jobs as neuroscience nurses, but we must know what we are testing.
For example, why do we test for a pronator drift in a patient who has suffered a middle cerebral artery (MCA) ischemic stroke? Why do we test cerebellar function in a patient who has had a posterior inferior cerebellar artery (PICA) ischemic stroke? Second, performing tasks is a job requirement, but we must know why we are performing them. For example, when family members watch us draining the external ventricular drainage device buretrol for an hourly output recording and ask, "How much drainage do you expect to see?" is it better to say, "Approximately 22 cc per hour or 500 cc per day," or say, "I do not know, you will have to ask the doctor"? Our knowledge assists patients and their significant others in their understanding of neuroscience patients. The institution where I work has tangible evidence of the importance of knowledge from the letters that staff nurses receive from patients' families. The letters consistently thank the nurses not only for caring but also for imparting their vast knowledge.
Some nurses do feel strongly about board certification. For example, a few states have mandated that their critical care nursing staff become board certified as soon as they are eligible to do so. The hospital where I work recently decided to reimburse nurses who pass their respective specialty board examinations. How have nurses accomplished this? Nurses have demonstrated better patient outcomes and satisfaction through patient surveys, decreased hospital length of stay, and decreased iatrogenic complications, among other things. You may be asking, how can I influence hospital administrators and encourage my nursing colleagues to become board certified? Take charge! Get the word out! Deposit CNRN pamphlets throughout your unit!
I will leave you with one last thought. I was a neuroscience nurse for 5 years before taking the CNRN examination. I studied for the test for a year. I traveled to another state to sit for the examination. When I received the notice in the mail that I had passed, I was relieved, and then an overwhelming feeling of pride came over me. I have never forgotten that moment. If you have not taken the CNRN examination, I encourage you to do so, and you too can take pride in your accomplishment.
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