I just received an official notice from ANCC that my credential will be “retired.” My credential is “Adult Nurse Practitioner,” but other credentials on the chopping block are ACNP, Adult and Child PMHNP and CNS, and GNP and CNS. The rationale is because “ANCC will not offer certifications that fail to meet the requirements of the new regulatory model.” The ANCC will review the FNP, PNP, Family PMHNP, and Pediatric CNS on its next review cycle, in three years.
ANCC is referring to the APRN consensus model, a model that I support for full integration of appropriate life-span treatment, but not at the expense of throwing out the current model in favor of a revamped shiny new credential under the auspices of the “Old credential +Gerontology NP.” I image adding on the word Gerontology to each new credential is in the future, except pediatrics.
I was in favor of restructuring NP education back to where it was when I completed my Adult NP program, when the program was a true two-year curriculum, and was inclusive of aged 16 to tomb. At that time, the FNP was womb to tomb. I agree some current NP programs have become too splintered and focused, and this could be a problem in the future. America does have an aging population, and that is a very significant fact. These issues should be addressed.
I do not understand, nor do I agree with, throwing out the current credentials. There is no evidence, absolutely NONE, indicating that the current Adult NP and Acute NP role is “failing” to meet the demands of our patient population and society. In fact, all quality outcomes studies on NPs have indicated that NPs are highly competent providers with excellent patient satisfaction and health outcomes. These studies did not suggest improvements in patient care and outcomes were needed by changing our current role.
The Consensus Model is meant to streamline nursing education and titling and delineate commonalities and differences in roles (not further confuse it). To me, it is sensible to streamline roles and determine that all NP programs are meeting the educational requirements within their respective curriculums. In a study funded by NONPF, it was found that NPs who were credentialed broadly, such as an FNP or ANP, were more marketable in certain areas, such as the Midwest. This is very logical. So why change the most marketable credentials?
The ANCC will throw the baby out with the bath water and dump the well-known Adult NP credential. This is likely the fate of the well-known FNP credential as well. This is very confusing to me, and will likely be equally confusing for our colleagues in health care, and similarly to the public at large. This leaves the impression that nursing does not know what it is doing, and since we are radically changing our credentialing structure, we must not have had it correct in the first place. This is not true, and no studies suggest that the current broadly trained NP role is inadequate.
If nursing wishes to address the aging population in the curriculum, then we should do this head-on. We can do this by changing the graduate school curriculum going forward, and asking the currently credentialed NPs obtain a certain level of continuing education specific to the aged population by their next certification cycle. This is how medicine is approaching this issue. Board certified Family practice physicians are asked to take a 2 to 3 day seminar and complete a few case studies specific to the geriatric population. What family practice physicians are NOT doing is throwing out the family practice board as a whole, and telling their constituents that they are no longer adequate.
Why does this matter? Well, we will have a whole new cadre of alphabet soup, such as ANP, ACNP, and FNP plus the new AGNP, ACGNP, and FGNP. It all seems rather redundant, and makes nursing look bad. As long as the 200,000-ish NPs currently in practice do not allow their credential to lapse, they will be fine. However, if your credential lapses due to any reason, such as taking time off to raise a family, work in quality assurance, perform research, take care of an elderly family member, or have an extended personal illness, you will not have a test to take. Additionally, you will likely be told that your previous formal education is no longer adequate to sit for these new credentials. However, you can go back to school for additional formal education which is more expensive and time consuming than attending re-entry seminar/c.e. and shadowing to address those rusty skills. Colleges benefit from this, but not society and certainly not nurses.
It seems ANCC has already made this change, but all bad decisions can be reversed. Hopefully, AANP will not make the same jump in logic, and will keep the ANP and FNP intact while adjusting credentialing and continuing education to include the elderly population. For those NP programs that are not including geriatric concepts in their curriculum, they should be dealt with individually. In the meantime, all currently credentialed NPs and NP students who plan to graduate and sit for boards soon should contact the ANCC and the AANP group about your concerns. If one group rescinds this absurdity, and the other refuses, then vote with your feet and move to the credentialing board that meets your needs. Please notify your NP friends and colleagues and ask them to object to being relegated to obscurity.
I am starting a Facebook page, called “Occupy ANCC. Say NO to retiring your NP credential.” Please join, and lets become a force to be dealt with…An ANCC official has joined my page. Please come and address your concerns.
ANCC will say, all currently practicing NP will be fine, but the fine print states, as long as you never lose your certification. This means we will have various classes of credentialed NPs, "us" and the new NPs after 2014. Additionally, all credentialed NPs must NEVER allow their certification to lapse for any reason, be it for research, raising a family, caring for an elderly parent, or a personal illness. If your current credential expires, you will not have a test to take, and you cannot take the new exam. You will be required to return to school for a graduate certificate because ANCC has deemed all ANP programs, up to this date, as inadequate for this new credential. This metric will apply to all NP programs as well.
I do not know of any ANP, graduating from a reputable university, who was not trained to care for the elderly client. The adult NP credential, by all logic, is inclusive of geriatric clients. No ANP would refuse to treat an elderly patient. If this new credential is necessary for greater clarity, all current ANP and ACNPs should be rolled into the new credential, even if it meant completing a mandatory educational module on geriatric clients prior to one's next credentialing cycle.
Adult NPs trained at the graduate level should not be required to obtain additional graduate education that could delay re-entry to practice, in the event of a certification lapse. This process could delay re-entry for greater than one year - inclusive of the time to find a program and sequence the application (and you may not gain admission b/c too few faculty/mentors), and then complete one to two terms of academic semesters.
I know many of you feel this does not apply to you, as you will never allow your credential to lapse. No one plans for traumatic life events, but they do occur. This new process, that is not founded on ANY evidence-based data, has the potential to be a huge hindrance to ANY currently credentialed nurse practitioners. All of us are on the chopping block for no good reason, and without any recourse. For those of you close to retirement, and feel this does not apply to you, consider that you will need us younger NPs to meet your health care needs.
I hope AANP does not leave us hanging as ANCC has opted to do.
Come support view the occupy ANCC, say NO to occupying your NP credential!
I appreciate your support,
Rodney Fox, PhD, ANP, BC, NP-C
