Let's get it Right, Who Are We?
1Assistant Professor, Middle Tennessee State University, Practices women's health at New Horizons Center for Women's Health, USA
2Professor, University of Maine at Augusta, Practices midwifery at Maine General Medical Center, USA
*Corresponding author: Barbara Whitman Lancaster, Assistant Professor, Middle Tennessee State University, Practices women's health at New Horizons Center for Women's Health, School of Nursing - Office # 226, USA, Office: 615-898-5843, Mobile: 931-256-0041, E-mail: Barbara.Lancaster@mtsu.edu
Received: August 26, 2017 Accepted: September 19, 2017 Published: September 25, 2017
Citation: Lancaster BW, Evans VS. Let's get it Right, Who Are We? Madridge J Nurs. 2017; 2(2): 69-71. doi: 10.18689/mjn-1000112
Copyright: © 2017 The Author(s). This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Peruse any poster presentation at a nursing conference and you will be in awe of the brilliant scientific minds of nurse researchers. Their works demonstrate the logical steps of research and scholarly works. When reading their credentials some list RN first, others last, PhD first, others last, some list both B.S.N and M.S.N. there is no rhyme or reason. The credentials game aptly described the credential mess as alphabet soup . This is confusing to health care providers, the public, third party payers, and peers . The purpose of this article to shed current light on why it is important to list your credentials uniformly, what that order is and why, the six basics of listing, legal use, multiple credentials, and the importance of uniformity.
The American Nurses Credentialing Center [ANCC] , suggests that having a standard way of listing credentials ensures that nurses, health care providers, consumers, and officials will appreciate the value and significance of the credentials. Listing credentials provides information that the individual possess competence in their specialty . Proper presentations of credentials would eliminate the mystery in trying to figure out someone's role. As the nursing profession continues to define itself and achieve parity through the Doctor of Nursing Practice (DNP) terminal degree, it is vital for the profession to be unified in listing credentials. Uniformity helps to quickly identify authors and credibility. It removes the distraction of puzzling over their credentials and the natural inclination of criticizing how someone has incorrectly listed their credentials.
Here's the one, two, three…six!
1. Educational degree (your highest degree is the one listed. Previous lesser degrees are not listed if they are in the same subject. If in another profession, list in order of degree). This degree comes directly after your name because it is a permanent credential. List your highest degree first.
2. Licensure (RN, LPN). State credentials such as licensure are required for you to practice. This requires the passing of a national licensing exam.
3. State requirements (generally giving authority to practice at a higher level such as advanced practice nurse (APN) or advanced practice registered nurse (APRN) and requires a license from the state).
4. National certification (awarded through a certifying body and demonstrates expertise in a particular area). Ex: Family Nurse Practitioner – Board Certified (FNP-BC). Most states require APNs to have a national certification to practice.
5. Awards and honors (such as fellowships)
6. Other certifications (non-nursing related such as Emergency Medical Technician
(EMT) or may be non-professional.
Examples: Jane Doe, DNP, APN, WHNP-BC, NCMP, Jane Doe II, PhD, MPH, RN, Jane Doe III, DNP, RN, APN, CNM, IBCLC, FAAN.
Legal use of credentials
The only credential that a nurse is required to use on legal documents such as prescription pads and progress notes, are those that the state has authorized the nurse to use while practicing in that state . Typically this will be RN for registered nurse or APN, APRN for advanced practice nurses, or CNM for nurse-midwives. An example would be: Jane Doe, APN or Jane Doe, RN. The licensure credential RN is usually standard and may or not be required in addition to the APN or APRN credential. Contact your state board of nursing for specifics. Professional endeavors such as speeches, scholarly writing, or testimonies, all your relevant credentials should be used . Keep in mind journals may re-arrange your credentials at their discretion.
For those individuals with multiple credentials  Follow your name with the credential that can least be taken away from you, in descending order with awards or fellowships listed last. An example would be: Jane Doe, PhD, RN, NCMP, CPT. PhD degree once deferred has the least chance to be taken away, so it goes first. The license (RN) has the potential to be revoked and the certification (NCMP) if not renewed could be terminated. The non-nursing certificate as a personality trainer (CPT) is listed last. If you have a nursing and non-nursing degree, you would list the highest non-nursing degree first followed by the highest nursing degree. If you have multiple certifications you would list the most recent certification first .
The plot thickens
The DNP degree satisfies a terminal degree for the advanced practice nurse, as it is a clinical practice degree . However, it is possible for a masters prepared, non-advanced practice nurse to earn a DNP, thus creating some confusion in listing credentials. The credentials could be listed as a PhD nurse. The DNP prepared non-advanced nurse would next list licensure as an RN rather than as an APN. To add more confusion, Fitzpatrick and Carpenter (2016) point out, the DNP title in the strictest sense is incorrect for a professional title as it really is a practice title, as the name suggests. However, the authors go on to state that it is used and as a professional title.
As the authors explored this topic and discussed examples, it became clear to us, how unclear and confusing this process could be. We were finding situations that were not clear and easy, but confusing and ambiguous. The ambiguity we found arises from the differences that exist from state to state, and the different regulatory statutes within specialties. For example, Nurse-midwife credentialing in some states is not through nursing, but may be a public health statute, or a midwifery board. It is necessary to understand what licensures are necessary and what needs to be listed in the credentials. Stay tuned for future articles as the authors explore the confusion that can oftentimes surround the DNP.
Let's wrap it up
This alphabet soup will continue . As long as there are life- long learners there will be certifications to take and degrees to earn. Credentials are important as they are a testament to the blood, sweat, and tears of the earned certification and/or degree. It is our responsibility to help others know what are credentials mean and not to confuse them. Display your credentials with pride. There is strength in unity. Let's show everyone that nurses are confident, brilliant, and deserving of respect. Let's get it right!
Wrap it up and review with these four scenarios:
Scenario: J. Parker graduated 5 years ago from the University of Florida with a BSN, and a BA, and last year with a MSN. How would credentials be listed?
a. J. Parker, BSN, MSN
b. J. Parker, BSN
c. J. Parker, MSN
d. J. Parker, MSN, BA
Scenario: J. Parker was licensed as a Registered Nurse 5 years ago in State of Florida. Using the information in the previous scenario, how would credentials be listed?
a. J. Parker, BSN, MSN, RN
b. J. Parker, BSN, MSN, BA, RN
c. J. Parker, MSN, BSN, RN, BA
d. J. Parker, MSN, BA, RN
Scenario: J. Doe graduated 4 months ago with a DNP and has been practicing as an advanced practice nurse in Tennessee. How would credentials be listed?
a. DNP, APN, RN
b. APRN, DNP
c. DNP, APN
d. DNP, RN, APN
Scenario: J. Doe, as mentioned in scenario 3, practices as a Family Nurse Practitioner. How would credentials be listed?
a. DNP, RN, FNP-BC
b. DNP, FNP-BC
c. DNP, APN, FNP-BC
d. DNP, RN, APN, FNP-BC
(Congratulations are due if all scenarios were answered with the last option, letter d).
Conflict of Interest Statement
The authors declare that there is no conflict of interest regarding this manuscript.