1. Reigle, Juanita P. RN, ACNP

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Last year at a national nursing conference I was struck by the number of nurses who trimmed their name tags with ribbons announcing their certifications and any past or current involvement with the organization. I have witnessed this display before and have collected and attached various ribbons to my own name tag to let others know that I was certified, a speaker, or a former taskforce member. It struck me, however, as I was talking with a colleague whose 10 ribbons trailed from sternum to pelvis, that these elaborate displays are more about individual status than the profession's.


I also realized that the phenomenon isn't restricted to ribbons at professional meetings. We litter our names with letters, such as CCRN, CHPN, CNAA, and MSN, to boast about our certification or education level. But is all this bravado really necessary? Or do we display these credentials because, as the late Rodney Dangerfield said, we "don't get no respect"?


Before every reader takes exception to my comments, I must make it very clear that I support certification. In fact, certification is essential to protecting the public and validating nursing expertise. Specialty certification reflects a commitment to both continuing education and practice. Employers would be well served by requiring specialty certification of nurses in high-risk areas because the need for specialized skills intensifies as the care becomes more complex. It's also true that nurses are hungry for recognition-we are happier in our practice when our contributions are acknowledged and celebrated. Organizations that publicly praise nurses for awards, certifications, advanced degrees, and publication are often rewarded with higher staff satisfaction and retention rates.


My concern is with our need to display on our name tags and professional work every credential earned. Do we perhaps add these initials because we see ourselves as undervalued? The message such display sends is that we are more than just nurses-we are nurses with specialty certification or bachelor's and graduate degrees. But how can we affirm the value of our profession when we publicly work to differentiate ourselves from one another?

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I'm worried that our overzealous display of credentials does more to divide our profession than to unite it. Indeed, the nursing profession is layered and complex, with its multiple educational entry routes and numerous specialty organizations offering an alphabet soup of credentialing options. The overt displays of titles may convey to professional colleagues, patients, and families that every nurse is different and that nurses with many titles after their names are "better" than those without. But it might not be the case. Most nurses gain wisdom in clinical practice, regardless of the letters after their names. In an effort to prove our professional status, we are instituting a caste system in which nurses who lack multiple titles are considered to be inferior.


Nursing began as a nonacademic profession; the first nurses cared for the sick with skill gained by doing. But legitimacy in the current health care arena may be harder to attain. Our profession is mired in a decades-long struggle to proscribe a minimum educational route for entry into practice. A single route would clarify the skills required. If we are unclear on this, how can our colleagues and the public value our contributions?


I believe it's time that we value our professional licensure. Specialty certification and advanced education should be encouraged, praised, and perhaps even required. We should be confident that our contributions are worthy, essential, and significant; it's our inclination to boast that should be reconsidered.