Certifications in the ED

[traumaRUs, MSN, APRN]

What certifications are needed/desired in the ED?

This is a question that comes up often. I work as an APN in a community hospital ED and we were discussing this last night. All of the ED RNs are required to have BLS, ACLS and a peds certification. Trauma certification, i.e., TNCC or TNS (Trauma Nurse Specialist – an IL-only certification) is preferred and CEN is icing on the cake. However, when I was discussing these certs with the nurses, the issue was that since there was no additional pay or benefits to additional certifications, that most preferred to do the minimum required.

However, should we be doing the minimum to get by? Shouldn’t we, as professionals, strive continuously to a higher standard? I know that when I was a new ED nurse, I wanted all the alphabet soup I could get – lol – I did learn better though! My personal opinion is that BLS, ACLS, a peds cert and a trauma cert should be mandatory.

CEN however, is not to be overlooked. It is a national certification that proves basic competency as an ED RN. EDs should reimburse for the test and study materials as well as pay at least $1.00/hour extra for those that choose to go the extra mile.

[diane227, LPN, RN]

CEN, PALS, ACLS, TNCC, EMT (preferred), CCRN if you get a lot of critical care patients who stay in your ED for a long time waiting for a critical care bed.

[SKYABOVEBLUE]

Initially to start some ER's will let you ride in with just your' CPR card and valid RN degree. Most require at least an ACLS to get in and then get ready. Within the fisrt year and definitely by the second you havr ACLS, BTLS, TNCC, PALS, ECRN which comes later to answer the radio and if you decide to stay hopefully your' Trauma Nurse Specialty. It;s a crazy and great place to work!!

[loricatus]

I went for my CEN because that is considered to be board certification in emergency nursing. TNCC, ENPC, ACLS, etc are competency type of credentials; but, not equivalent to board certification. If there is to be a differential, it should be for CEN; but, that should also accompany giving the nurse a greater responsibility because of the certification. As it stands in most ERs I have been in, certification may get you a differential; however, there is nothing tangible related obtaining it, except maybe a few dollars additional (usually in a yearly lump sum).

[SKYABOVEBLUE]

Well depending on the state that you live in and the facility in which you choose to work in those are not competencies they are certifications that most places require. In illinois TNS is our specialty but TNCC is the standard in most other states. So it really depends on the state and facility in which you choose to practice. Good Luck.

[Connie Elder]

What a hot topic. As a travel nurse I have worked in some real large and very busy ER/Trauma Centers. From what I have seen, the hospital sometimes requires you to have the certifications that are listed here but you don't always get paid for them. Very few states have the TNS. Some don't even know what it is. I have worked with nurses who have the TNS or the CEN. I don't recall CEN having anything to do with the Kreb's Cycle, etc but the TNS does. TNS yes is state specific. So maybe you loricatus can explain to us why there are more nurses out there with certifications other then CEN?

[Connie Elder]

Oop's I forgot to mention that when I worked at a hospital in Illinois, they wouldn't let you even take care of trauma pts. if you didn't have your TNS. I've never heard that about the CEN.

[loricatus]

So maybe you loricatus can explain to us why there are more nurses out there with certifications other then CEN?

Maybe because they have to pass a test that has a high failure rate, is specific for emergency nursing and is expensive to take???

http://www.ena.org/bcen/cen/CENdefault.asp

[Connie Elder]

I don't know which one has the higher failure rate, TNS or CEN but I think it might be the TNS. All I know is that I had a notebook with 3 inch rings in it that was full of papers, etc to study for the TNS. It had things from the cellular level. TNS is an extremely difficult test to take and from what I have heard is has a high failure rate. It has classes that are all day, lasting several weeks, mayeb one to two days a week. These classes are taught by nurses that have degrees, trauma experience, lot's of ICU/CCU experience, the list could go on. The TNS was started by the state of Illinois years ago. Illinois was instrumental in trauma care in the country. From looking at the study notebook that I received and looking at the CEN study guide, I would personally and professionally have to say that the TNS is a much harder and difficult class to take and the same goes for the certification. I say that it's too bad that other states don't recognize the TNS since it would only benefit the care of critically injured, trauma pts. Not only that but it would help nurses learn more about the mechanism of injury and that's what trauma care is all about.

[traumaRUs, MSN, APRN]

Personally, have done both the CEN and TNS and TNS by far is more difficult just simply due to the amt of pathophys that is required.

BTW - central IL has a current TNS class going on. Good luck everyone.

[ImMrBill3, RN]

I anticipate a job offer from the MICU/SICU at the hospital associated with my School of Nursing soon. They don't require any of the certs for ICU's or ED. They will pay the fee for the test the first time. ACLS is offered at the facility and the units are usually willing to pay for it. I agree with the poster who said we as nurses are responsible for maintaining our competency at the highest level (I know I am not even a GN yet, newbie enthusiasm). I intend to take CCRN as soon as I am eligible and TNCC, ATNCC and CEN because I want to work in the ED and I think they will help me be good at it (and get hired into an ED). Most of the hospitals I have been inquiring at have indicated that they have an extensive orientation/training program inhouse for the ED and many only hire internally with experience.

The hospital I expect to work at does not pay any increased salary for the certs. Some I know of have a clinical ladder, more pay and resposibility as you get more certs.

Great topic!

[Connie Elder]

You got that right when you mention pathphysiology. It's just like being in microbiology all over again but only worse. You have to learn things at a much faster pace, but at the end it makes you a better person and trauma nurse. Hat's off to all who can pass the TNS.