1. Section Editor(s): Ryzner, Diane MSN, APRN, ACNS-BC, OCNS-C
  2. President, Orthopaedic Nurses Certification Board

Article Content

I use the word nursing for want of a better. It has been limited to signify little more than the administration of medicines and the application of poultices. It ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet-all at the least expense of vital power to the patient. - -Florence Nightingale (1860)

Diane Ryzner, MSN, A... - Click to enlarge in new window President, Orthopaedic Nurses Certification Board

Nursing has come a very long way since the 1850s. We don't just administer medicines and change dressings anymore. Nursing has advanced and applied science to improve how we think about and deliver patient care. Florence Nightingale was a visionary whose courage and passion improved nursing care and, ultimately, patient outcomes. She used data and statistics to drive changes in patient care. She elevated the profession of nursing and raised respect for nurses as professionals. Florence Nightingale did not settle for the status quo.


What does this have to do with orthopaedic nurse certification? Don't just settle for the status quo. Challenge yourself to become the best orthopaedic nurse you can by becoming certified. I like to think literally sometimes, so what does certification really mean? The etymology of the word certification is derived from the Latin certficare, a stem of the word "certify," or certus (certain) and facere (to make) ("Certification," 2018). I challenge you to make certain you are the best orthopaedic nurse you can be.


Whether you are a certified orthopaedic nurse or not, what words come to your mind when you think about certification? Here's what comes to my mind as a sort of word association exercise when I think about certification: Confidence. Credibility. Knowledge. Expertise. Quality. Satisfaction. Proud. Accomplishment. Goal. Value. Recognition. Excellence. Achievement. Validation. Advancement. Reward. Challenge. Attainment. Dedication. Empowerment. To me, all of these words offer powerful, dynamic images of certification.


Nurses have investigated the relationships between certification and nurse-sensitive indicators, patient outcomes, nurse job satisfaction, to name a few. Researchers are not settling for the status quo. More research is being conducted with priorities that encompass anything from patient outcomes to improved job satisfaction to validation of knowledge in a specialty. The American Board of Nursing Specialties Research Committee published the Nursing Certification Bibliography in 2015. It contains 27 pages of journal references grouped by topic related to certification. Articles included in the bibliography include more than 50 published articles on specialty certification; more than 40 articles on the value of certification; more than 25 articles about role delineation/exam development/exam blueprint; more than 25 articles about advanced practice certification; more than 30 articles about descriptive studies; 16 patient outcome studies; 18 certification preparation studies; 21 competency and continuing competence; and nine more articles categorized as general interest. I think we are at the tip of the iceberg, and I believe research related to certification can change the status quo, impacting nurses, the care they deliver, and patient outcomes.


The Orthopaedic Nurses Certification Board (ONCB) does not settle for the status quo either. The ONCB recognizes that many master's prepared orthopaedic nurses have positions or roles that touch musculoskeletal health, such as case management, offices, service line directors, or manager roles. We are launching a new advanced certification credential, a portfolio certification option for master's prepared orthopaedic nurses who are not nurse practitioners. The ONCB mission is to "improve musculoskeletal health by providing orthopaedic nurses with certifications that promote their professional development and advance the practice of orthopaedic nursing." Our simple tagline states, "Recognizing excellence, improving care." The ONCB recognizes the contributions master's prepared nurses make to improve musculoskeletal health, and this new credential will be a validation to those nurses.


The ONCB continues to offer the Orthopaedic Nurse Certified (ONC) credential maintained by more than 6,800 registered nurses. The Orthopaedic Nurse Practitioner Certified (ONP-C) credential is held by more than 125 nurse practitioners. The examinations are updated regularly using data obtained from the role delineation study. Orthopaedic nursing practice evolves and changes, and the examinations evolve and change on the basis of the role delineation study data. Again, we are not settling for the status quo. A popular incentive program titled Retest for Success provides access to examination preparation questions as well as a free examination retest, if needed. Orthopaedic nurse certification will continue to be a valuable, sought after, and prestigious credential for nurses and employers.


This past May at NAON Congress in Albuquerque, the ONCB held a certification breakfast to recognize the 30th anniversary of the very first ONC examination-the first opportunity for this credential to be earned by orthopaedic nurses. It was an incredible event! Our board members developed a presentation for this event and invited attendees to come to the microphone to share stories about the impact of certification on their careers. Amazing stories were shared by certified orthopaedic nurses from around the country. The stories made me so very proud to maintain my orthopaedic credential. It's now more than 4 months later as I write this editorial, and I smile as I remember hearing from my fellow certificants at the breakfast. I was not always an orthopaedic nurse, but I value certification as a testament to professional growth. I did not settle for the status quo. I became orthopaedic-certified in 2011.


I challenged the orthopaedic nurses on my unit to commit to becoming certified last spring. Many of those who were eligible to test took my challenge, successfully studied together, and passed the certification examination. Their photographs are displayed in the hallway on our unit, and they received special RN Certified tags to attach to their ID badges. They committed to preparing for the examination to validate their knowledge and elevate their orthopaedic nursing practice. I strongly recommended joining NAON so that our nurses could tap into the journal and free member webinars to help prepare for the examination. These nurses did not settle for the status quo. They took my challenge to improve professionally and attain orthopaedic certification. As orthopaedic nurses, we make a difference in the lives and health of our patients. Do not settle for the status quo! Make a difference, certus facere, make certain, and become an orthopaedic-certified nurse.




American Board of Nursing Specialties Research Committee. (2015). Nursing certification bibliography. Retrieved from[Context Link]


Certification. (n.d.). In Online etymology dictionary. Retrieved from


Nightingale F. (1860). Notes on nursing: What it is and what it is not. New York, NY: D. Appleton & Co. [Context Link]