This issue of Rheumatology Nurse Practice (RNP) is the first of several coming out this year that will offer continuing education (CE) credit hours for nurses. Your initial reaction may involve nothing more than an “OK, so what?” shrug of the shoulders. Rest assured, the lengthy journey that has allowed the Rheumatology Nurses Society (RNS) to attach CE credit hours to this education was undertaken with a clear purpose to bring more value and sophistication to our audience of nursing professionals.
From its inception, we have gone to great lengths to bring you the highest caliber enduring education through RNP. The term enduring describes any “non-live” CE activity that endures (sustains content without notable changes) over time. Enduring activities may include online and recorded-live events, courses, e-books, and self-learning web materials, as well as print materials such as RNP, which is offered both in hard copy and online format. Just like the milk carton in your refrigerator, though, enduring activities have an expiration date. Generally, the opportunity to earn CE credit for participating in a specific enduring activity is up to two years following the date of its original release.
State requirements vary regarding the number of credit hours that both RNs and LPN/VNs must earn through participation in and completion of CE-certified activities for renewal of licensure. See NURSE.com (http://ce.nurse.com/RStateReqmnt.aspx) to look up the requirements of each state, the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands. Please note that this site contains advertisements for various sites that can help fulfill CE requirements; we do not endorse any of those sites through our referral here.
Why so many differences from state to state regarding licensure renewal requirements? The story goes back more than 100 years, when state governments first enacted laws designed to protect the public’s health and welfare by overseeing and ensuring the safe practice of nursing. All states and territories have enacted a nurse practice act (NPA), a law enacted by the state’s legislature that establishes a State Board of Nursing with the authority to develop administrative rules or regulations to clarify the law. NPA laws typically include language related to discipline of the profession, scope of practice, and standards for education pre-and post‑licensure.1 Because NPAs are overseen by state-controlled boards and are not tied to national standards, there are significant variations from state to state.
Requirements for initial and continuing nursing licensure are complex. It is easier to think of each state as a separate country rather than a united republic. Some states, such as Connecticut, do not require CE’s for RNs or LPN/VNs for general licensure. Other states, such as Virginia, have a much more complex system (up to eight different options) to satisfy CE requirements. For those states that require CE, the necessary number of required hours varies. Some states require nurses to obtain a certain number of CE credits annually while others require more credits over a 2- or 3-year period.
Washington, for example, is one of the states with the most stringent CE requirements. Every 3 years, both RNs and LPN/VNs are required to complete 531 hours of active nursing practice as well as 45 hours of CE-certified education. Even U.S. territories such as Puerto Rico have systems in place to ensure that nurses appropriately keep up with the profession, requiring 3 hours of infection control education specific to HIV, hepatitis, or tuberculosis. The Puerto Rico nursing board also caps the number of hours that RNs and LPN/VNs can earn through enduring education (20 of the 30 required hours for each licensing period for RNs, 15 of 21 required hours for LPN/VNs). Those of you who are travel nurses, or work in multiple states and carry multiple licenses, understand all too well the trials of meeting various state requirements and paying their associated fees.
In the last decade, nursing has poised itself to accept greater autonomy and responsibility in the care of our patients, impacting patient outcomes, health disparities, and access to care. There are scores of specialty practice nursing entities and numerous levels of advanced practice nursing degrees available, as well as massive specialty organizations offering credentials in specialty practice. Each one of these typically requires nurses to complete periodic CE credit hours, which may include CEs in pharmacology, HIV/AIDS, infection control, pain management, identifying and reporting child abuse, and other topics. The newly available RN-BC rheumatology nursing certification by portfolio offered by the American Nurses Credentialing Center requires a minimum of 10 hours of annual rheumatology/rheumatology nursing CE each year as part of an individual’s requirement to maintain certification.
There are numerous paths nurses may take to obtain useful continuing education; however, not all paths are created equal or contain the required rigor required for acceptance as a CE activity. Hence the need for highly respected organizations to train, oversee, and maintain high standards through accredited providers. Along with American Nurses Credentialing Center (ANCC) CEs, most RNs are able to count the medical profession’s American Medical Association Physician’s Recognition Award Category 1™ (AMA PRA Category 1) credits on equal basis—1 hour of CME credit = 1 hour CE.
There is some cross acceptance of CEs and an increasing push for medical education providers to obtain Joint Accreditation from three bodies in one application—from the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the ANCC.
In late 2016, RNS completed the rigorous process that allows us to provide CE credits for education of appropriate rigor. You are reading our first independently accredited piece right now. To prepare RNS for this milestone, we have in place a Lead Nurse Planner, Nurse Planners, and other support staff within our Provider Unit to ensure that we strictly adhere to the ANCC’s accreditation standards and guidelines when offering credit hours for educational activities.
There are instructions within this issue pointing you to the web portal you will need to visit to acquire CE credits. Within that portal, you will find a post-test that you will need to pass to ensure that you read and absorbed this education, as well as a short activity evaluation. We certainly encourage even those nurses who are not required to complete annual CE hours to go onto the portal to test your knowledge and competence regarding the topics covered within this issue of RNP.
One last topic we will cover here concerns medical assistants. Medical assistants who are certified through the American Association of Medical Assistants (AAMA) are allowed a certain number of CEs to be “outside of” AAMA-provided CEs. There are restrictions, just as with RN and LPN licensure renewals, requiring responsibility for each individual to check with their organizations for these allowances. This particular publication is rated with a higher (more comprehensive) rating of 3.7 on a scale of measurement consisting of the following rubric; Very easy = 1; Somewhat easy = 2; Moderate = 3; Difficult = 4; Very difficult = 5. The difficulty of material is dependent on the target audience.
Nursing careers take widely divergent paths and require differing levels of education, all leading to a special set of skills, knowledge and practice. It is incumbent upon the RNS to provide quality CE activities meeting the gaps identified for the rheumatology nurse to provide safe and competent care to the public. We welcome your ideas and input regarding your personal professional gaps and needs. Lastly, we hope we are able to provide quality resources both for you and other members of your healthcare team. If your organization is able to accept our CEs, rest assured we maintain and are evaluated by the highest standards.
AUTHOR PROFILE:
Sheree C. Carter, PhD, RN, RN-BC, is an Assistant Professor at The University of Alabama Capstone College of Nursing, Tuscaloosa, Alabama, and former President of the Rheumatology Nurses Society.
Reference
1. Russell KA. Nurse practice acts guide and govern nursing practice. Journal of Nursing Regulation. 2012;3(3):36-42.