A recent report by leading nursing workforce analyst Peter Buerhaus and colleagues at Vanderbilt University project there could be as many as 500,000 vacant nursing positions in the U.S. by 2025. The report attributed the shortage to an aging nursing workforce and growing demand for health care services as baby boomers age and enter retirement years.

While closing the gap involves a multi-faceted effort, expanding opportunities for current and future generations of nurses to enhance their skills and earn higher pay can go a long way in not only retaining and attracting top nursing talent, but also improving the quality of care patients receive.

A good model for this argument is a campaign being run by the Veteran's Health Administration Department of Veterans Affairs, Office of Nursing Services. At Veteran's Affairs (VA) hospitals throughout the country the impetus behind the Let's Get Certified! campaign is to enhance professional development options for nurses.

Addressing the Certification Challenge

Certification recognizes clinical knowledge, experience and clinical judgment within a nursing specialty. Benefits of certification include personal growth, recognition, career advancement, financial reward and perceived empowerment. Certification provides a more productive and highly trained workforce for employers, while increasing retention and recruitment, while enhancing professional development and growth.

A general nursing certificate demonstrates competence (i.e. - that nurses have a clinical knowledge base), and passing the nursing board shows that the nurse has met the minimum requirements and qualifications to practice. A specialty certification, on the other hand, serves as the conduit for nurses to achieve higher levels of professional and financial achievement, and raises the bar on the care nursing professionals can deliver to patients in any medical system.

Historically, nurses have been challenged by costs associated with obtaining and maintaining a certification. Inadequate recognition of certifications by health care organizations has also proven to be a disincentive for nurses to keep certifications current – and as a result many are allowed to lapse every year. But with approximately 75 different clinical specialty certification exams available to registered nurses, the upside is so significant that the VA proactively sought to break down some of these barriers and increase certification among the nursing workforce. 

The Let's Get Certified! Campaign – which kicked off May 6, 2008 and runs through May 31, 2009 – encourages nurses to increase their level of knowledge and skill through certification in order to better treat soldiers, veterans and their families. At the end of the campaign period, VA centers with the largest percentage increase in nurses receiving certifications – and that can cite innovative strategies used to achieve success – will be rewarded.

Certification Benefits to Nurses

With approximately 40,000 nurses employed nationally across healthcare centers, the VA is the country's largest employer of nurses. And with a substantial percentage of troops returning from overseas with a need for some level for care, VA nurses play a vital role in ensuring the well being of soldiers and their families. 

While nurses are extremely qualified to care for VA patients, many are increasingly recognizing how vital it is to obtain certifications that would enable them to play a greater role in assisting during surgeries and applying skills to other specialized areas of medicine. Certifications offered by organizations such as the American Nurses Credentialing Center (ANCC) or the Certification and Credentialing Institute (CCI) provide the opportunity for numerous specializations, many of them increasingly in demand, and well regarded, by hospitals across the country.

In addition to the professional development benefits, there is a tangible financial incentive as well. Unlike some community hospitals – where starting nurses are compensated at a uniform "starting" level – VA nurses' starting salaries vary based on level of education, years of experience and certifications held. For this reason, prospective VA nurses have a tremendous incentive to achieve certifications for their skills and experience. The benefits could easily be applied across the board, to nurses practicing in any type of institution. Obtaining specialty certification promotes quality patient care, validates nurse knowledge and expertise, builds confidence and credibility in professional ability and demonstrates dedication to nursing as a profession.

Imagine if every healthcare employer, VA or not, required specialty certifications before promoting? What if nurses who went "above and beyond" were favored in the hiring process, or compensated more than those with a less specialized knowledge base? How would the quality of care given to patients across the country, or around the world, benefit? Certifications are proof of knowledge and skill – and in combination with experience, they are a rock solid base for specialized quality care to patients.

Benefits to VA Centers

One of the reasons VA centers have embraced the campaign's call to action is that the benefits of having a workforce with specialized nursing certifications are wide and deep. Key benefits to the organization include enhanced patient care. Research has shown that certified nurses report more competence, accountability and confidence in their practice than non-certified nurses. (Cary, 2001) In addition, three-fourths of patients indicated they are more likely to select a hospital employing a high percentage of certified nurses. (AACN, 2003)

Another benefit is improved recruitment and retention, as nurses with certification report higher levels of empowerment, which has shown to be associated with satisfaction and intent to remain in a current position. (Piazza et al., 2006)


For any industry facing an impending talent shortage, the impetus is on organizational leaders to identify initiatives and campaigns that effectively recruit, retain and advance professionals. This challenge is painfully acute in healthcare – where organizations face a perfect storm of supply and demand shocks: a shortage of nurses in the pipeline (supply) and aging boomers poised to put increased strain on the system (demand).

The VA's Let's Get Certified! Campaign represents an encouraging model for the nursing profession in that it seeks to move nurses beyond minimum-level knowledge requirements; breaking down historical barriers when it comes to completing specialized certification exams so that nurses can fully leverage the skills and experience they have acquired during their career. The result: a more knowledgeable and satisfied workforce and a higher level of care for patients.

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