RPF,PhD,NP

I had not heard that GNPs were no longer recognized as a valid certification by a state board. In truth, the branches of certifications were getting out of control, we had geriatric and diabetic nurse practitioners. At best, these should have been specializations on top of the primary care NP role rather than a stand alone certification. I would agree, ANCC did create an untenable situation for itself. Unfortunately, this organization has not learned from its past mistakes and moves forward with ill-contrived decisions such as "retiring" the ANP and ACNP credential. I'm never said GNP were always ANPs, I did propose that ANPs (and ACNPs) have always cared for geriatric patients. If the problems lies with the GNP in certain states, that should be addressed. I'm sure someone, somewhere, had a heads up on this issue.

Yes, dianaol1, at the root of this issue is BC/BE - board certification and board eligibility. By retiring the certification, rather than updating it, ANCC is altering board eligibility (BE) with one stroke of a pen. I was speaking to a friend of mine, an NP in academia, who said she had to allow her NP credential to expire due to insufficient clinical hours. Of course, she retook the exam because she was still BE based on her education at the master level. Now ANCC has decided that the content of that master level degree is no longer valid for BE. Of course, the next step will be that a master level education will not be valid either. It seems this could be a "ploy" to mandate the DNP for entry level practice, as suggested by another poster. Whatever one's thought regarding the DNP, at this point in time, having the degree is a luxury and not a necessity. However, changing the rules of BC/BE make this degree a necessity. I have heard from many NPs that the DNP degree lacks in clinically relevant content. But from those who complete the degree, they feel the effort was worth it. I believe this is true with any education, but the value of the degree has yet to be validated to the point where it should be mandatory. I, too, am re-evaluating my support for ANA. I've been a long term member, but I regularly struggle with the feeling that my needs are barely represented. Only recently, APRNs received attention from the ANA. Something to consider. ANCC did stem from ANA, but they are now separate entities. Disclosure: I did apply to and was accepted to a DNP program, but opted for the PhD route. My rationale was that the DNP was an unknown, and given nursing's history of changing the rules midstream, as in this ANCC BC/BE case, I decided to go with the known. I have no regrets.

I have read that the FNP credential is the best suited credential for working in the ED. Most Emergency NPs ultimately provide non-urgent primary care type cases within fast tracks, and having the pediatric scope is a necessary component. Unless one lives in a large urban area where adult and pediatric EDs are mostly separate entities, and in this case the Adult NP is adequate. I do foresee an issue, strictly based on the consensus statement, with FNPs providing Emergency care if the scope of practice extends beyond those primary care components. Over time, once the state boards have adopted scope of practice standards, an FNP may find himself/herself in hot water with the nursing boards. Unless the FNP also has the additional ACNP (or ACAGNP) credential - and many schools are combining these credentials (Vandy/Emory/etc). Congrats on finding your perfect job!

BTW, my protest to these changes were deleted from another website, along with my membership to a certain credentialing body's group. I guess if you don't tote the line, you're eliminated. Oops.

I have some news to report! No, your NP credential is still being moved towards irrelevance. However, I did speak with a high level executive from “big name brand credentialing board” last night. This executive was very pleasant, extremely helpful, answered all my questions, and does his or her job very well. I did appreciate and value the call. The summary highlights are, the train has left the station, the exam is being retired NOT the credential (huh!?), never allow your certification to expire, let’s hold hands. Kumbaya. I believe - in fact - I KNOW in my heart that ANCC and the other Nurse Gods have the best intentions in their actions. NOTE: I mean no disrespect by the term Nurse Gods, but there are so many groups involved in this, that’s the best term I have. However, as you might suspect, I have some concerns. In most states, a NP’s certification is a de facto license. No certification, no practice, no livelihood. Of course, the legislature and state boards of nursing have agreed (so I’ve been assured) to grandfather all retired NP credentials - today. What happens tomorrow, or in five years? Seriously! This is the same legislation that has not agreed upon a national budget in years, and actively writes discriminatory, homophobic, and xenophobic language into state constitutions (some exclusions apply). This is also the same legislation that allows NPs to practice to their full scope and ability (Washington), while others will not allow NPs to freeze a wart (Alabama). So, people can buy wart-freeze OTC, but in the eyes of the state legislature, NPs are not competent enough to provide this treatment. Yes, Ladies and Gentlemen, I feel so much better. Of course, ANCC is not offering any bridge for an NP with a retired credentialed to move into the new and improved credential. No, too many NP programs have not been up to snuff, or at least, it is too difficult or impossible to isolate those slacker programs. The solution is this bright line that must be drawn in the sand, and all those behind it, retired; all those in front of it, magically and angelically competent enough to receive this new credential. Where are these rogue NP programs slinging out disparate degrees? And have our credentialing bodies been asleep at the wheel? A lot of really smart people worked together over a decade, and this was the best solution they could come up with. And these are the same people we are supposed to trust will have our best interest in mind going forward. Now, for all those inadequately prepared NPs currently in practice, clearly public safety is not the issue. Because, if that were the issue, then we – you - us would be required to seek specific continuing education to fill in our perceived knowledge gap. However, if anyone wishes to go to their local graduate program where faculty will happily perform a gap analysis to evaluate your deficiency. Then, the school will allow you to apply to their program, register for appropriate course work, and graciously accept your tuition. This all assumes you have access to a program, that you are accepted, and that there is adequate faculty and mentors to educate you. Now, I’ve read we are facing a dire faculty shortage, yet these new requirement seem to only place additional pressure on resources that are already scarce. I fail to see the logic in that. Especially since this education could be done via alternate methods. Is this about safety, or is this about hand greasing to keep graduate programs flush in cash? Seems we can’t force the BSN as entry to practice, so APNs have become the latest whipping boy. I have nothing against education. That is not the issue. The issue is changing the rules to obtain credentialing without a bridging option. I was told by the Nurse Gods that for those NPs who were required to return to class that they were always appreciative of their learning experience. Of course! I love learning! I gain nuggets of knowledge while reading subjects where I am considered an expert. No one is disparaging education. This is not about education or degree programs. I firmly believe the more educated our profession becomes, the better our profession will be. However, sometimes we (as a profession) need to demand our own bright line in the sand when it comes to graduate education. At some point, this feels like a hamster chasing a carrot on a treadmill. I hope you will unite with me on facebook to protest this move, united. The group is occupy ancc, so no to retiring your NP credential

Rich2008 - you should wait until the PMHNP programs are streamlined. There will be only one PMHNP. Just like I thought, in agreement with Juan, there would be a streamlined Adult NP credential. Never did I imagine ANCC would retire the test - not the credential.

Hello juan de la cruz, and thank you for your comment. I believe you are correct, and most ACNPs would agree that gerontology is a considerable aspect of ACNPs practice. Retiring this credential does not follow any logic.

Kanzi Monkey - AANP has not issued an official statement, but AANP has signed onto the Consensus Model. All of this falls solely on the interpretation and implementation of the Consensus Model. ANCC has chosen a divisive implementation, but AANP has an opportunity to do otherwise. AANP does have a method to credential through Endorsement, if you are certified through another agency, you can obtain your certification without taking the exam. If AANP takes a more inclusive approach and allows currently credentialed NPs to roll into the new credential, rather than cutting everyone off, that could be a game-changer in my mind. I too, would just drop my ANCC certification and no longer support that agency. TraumaRUs - I appreciate your comments, but respectfully disagree. It is never too late to become involved. I have actively participated, and completed multiple questionnaires and provided written statements. My interpretation of the Consensus model was, and still is, that the ANP/ACNP role included geriatric content and gero should be rolled back into the adult health credential. I did apply to a committee, but was not selected. I choose not to allow this to happen and I agree we need to come together under a single umbrella. Tossing out all currently credentialed NPs without a bridge option is NOT the way to do it - this is very divisive and not inclusive. I may fail in this endeavor, in fact, I will fail if everyone adopts a passive attitude to this change. Thank you. Rodney

Thank you elkpark! I found your post. An ANCC representative is a member of my Occupy ANCC, say NO to retiring your NP credential. Please join, and tell them to jump in a lake. We will get nothing accomplished by mumbling and grumbling individually. Just like Bank Of American customers rejected the debit card fees, as a group we can force change through a strong, unified grass root effort. I appreciate your support. Please share with ANYONE and EVERYONE. If you know how to link this post to the other post (as I do not know how), please do so, or let me know how. Thank you! Rodney

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