Certification FAIL!

A co worker of mine recently got a specialty certification.  It really doesn’t matter which one.  Prior to taking the certification exam, she paid good money to take a review course, and had planned her testing for the day after she took the class.


They class she took is a nationally recognized course, presented by a well known nurse, who is very knowledgable.  She learned a LOT of really neat stuff, and a few things I didn’t know about.


Let me tell you a little about this nurse.  She’s 24 and graduated from nursing school a little over a year ago.  She started on the floor and per her words “Hated It” She’s been working in the ED here for about 7 months.   We’re a 4 bed ED that see’s on an average of 18 pt’s a day.   (A far cry from the 122K in my last ED)  We see a STEMI about once every 3-4 months, almost no trauma.  Over the past 7 months as far as I can tell, she’s never opened a book. I loaned her a couple of books, but they stayed in the department and I eventually took them back so they wouldn’t disappear.  She took the course, and now has her specialty certification.  I don’t begrudge her the certification, I question how she got there, and how the system is failing.


She has the knowledge of the important stuff.  But here is a list of things she didn’t know.   On the DKA patient, she didn’t know to prime the insulin line before starting the insulin drip,  She didn’t have a grasp that once the patients rate (A-Fib with RVR) was controlled the BP was going to go up, so not to worry so much about the fact that the med MIGHT lower the already lower BP,  A new midlevel ordered VitK in a patient with a St Jude heart valve for an INR of 10.9 without active bleeding any were.  She gave it without questioning.  Now don’t get me wrong, she is a good nurse, just inexperienced.


Where is the fail?  I’m thinking it’s in the system.  The system that chooses what is important for testing in certification exams, The system that seems to encourage CRAMMING for an exam. Maybe even the whole concept of specialty certification!


I don’t have any answers but I think there needs to be some discussion on the subject.  Anyone have anything to add?

About craigb.rn

An aging health care provider thoughts on life, love and 30 years of wiping butts. I have a passion for both critical care and education, and my co-workers think I fall into lecture mode way to often.
This entry was posted in Certification, Education, Opinion. Bookmark the permalink.

2 Responses to Certification FAIL!

  1. Pookariah says:

    I am a new nurse, about 9 months into my first job. I am constantly encountering things that I’ve never seen or done before, but there is a first time for everything, right? How do I learn and grow professionally otherwise? It seems that many veteran nurses feel that newer nurses don’t know enough, and are constantly asserting that their training and certifications are superior to what is offered to students now. I work with several nurses who act like they came out of the womb with all of their nursing knowledge, rather than remember the likely reality that they had to spend some time ramping up too. I got my ACLS, and all I heard about was how their ACLS was better because it was done over a 2 day course and how mine was inadequate because the classroom portion was done online. It can be really spirit crushing to a new nurse, I am trying to increase my skills in a relevant way with the resources available to me and I am just met with tons of negativity. I have to wonder if that will be my attitude in the next 10 years, or will I remember that there is a huge learning curve from the classroom to the real world and would never in a million years make a new nurse feel bad for not knowing something that maybe they’ve never encountered before.

    • craigbrn says:

      You have to remember that some people need to do that to give themselves some self worth. Yes I to remember those days when ACLS was a week long and you sweated over everything. All that taught me was to be a cook and follow a recipiet. Later as I learned, I could start to apply the concepts and move from their. I’d hazard to guess that most of those who are telling you things like that area stuck at the level of expertise they are at now. To get my P Benner plug in they are at competent or maybe even only advanced beginners.

      You have to learn to ignore them, Find yourself a mentor, someone tho is will to help you thread that gauntlet. Set yourself a plan of action and go forth. I was fortunate. I had someone who constantly raised the bar but then had no problem whacking me on the side of the head when I got to big for my britches.

      Just quietly develop into a quite competent nurses. Read constantly, ask questions, and focus on you and what you are doing. Not what they think. When your bored. Go look up the Dunning-Kruger effect when you get a chance.

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