By Melissa Nosik, Lisa Rosenfield & Mai-Linh King
The December 2023 issue featured an ethics-focused article addressing the role of credentialing organizations in upholding ethical standards and fostering accountability. This month’s follow-up article explores the ethical landscape within the nursing profession, including general expectations for conduct, national and state level resources, and information about reporting alleged violations.
Specialty nursing certifications not only enable nurses to expand their knowledge, skills, and expertise but also open doors to advance career opportunities. These certifications possess distinct characteristics, including additional training requirements, expiration after a specified duration, and renewable status upon meeting specific conditions. The United States boasts a robust and diverse representation of nursing specialty certifications.
The conversation about nursing certification, standards of practice, and accountability begins with an overview of the oversight structure. Regulation practices vary widely, encompassing international, national, state and individual credentialing organizations.
On an international level, the American Board of Nursing Specialties (ABNS) plays a pivotal role in improving patient outcomes and consumer protection by promoting quality nursing certification. With a membership comprising 73 member organizations, ABNS represents almost 930,000 certified registered nurses worldwide (ABNS, 2020).
At the national level, the National Council of State Boards of Nursing (NCSBN) serves as the primary regulatory board for nursing. NCSBN’s mission revolves around ensuring safe and competent nursing care through effective regulation, practice and education. By empowering nursing regulators across the nation, NCSBN strives to protect the public’s health and welfare. Collaborating with Nursing Regulatory Bodies (NRBs), which issue licenses, outline standards, and monitor compliance, NCSBN oversees the safe practice of nursing. Currently, 59 NRBs operate in the United States, all being members of NCSBN. Another important function of not only this regulatory board, but also of specialty certification boards, is a mechanism for verifying credentials (e.g. NURSYS; NCSBN, 2023).
While the NCSBN has a national purview, individual jurisdictions enact Nurse Practice Acts (NPA) enforced by their respective NRBs.1 These laws encompass qualifications for licensure, allowable nursing titles, scope of practice and consequences for non-adherence to the law (NCBSN, 2023). Compliance with these laws and regulations is required for the maintenance of nursing licenses. The Nurse Practice Act Toolkit links users to their State Boards of Nursing (BON), where they can then locate their NPA. BONs embed accountability mechanisms for regulation of practice within their states, and the processes for intake of complaints therefore varies by jurisdiction. Each state BON regulates and oversees nursing practice in their state by enforcing state nursing laws and disciplining nurses who violate these state standards and laws.
In addition to national and state obligations, individual credentialing organizations often establish ethical codes of conduct for their certificants. As an example, the Competency & Credentialing Institute (CCI) maintains a Code of Ethics, which details ethical responsibilities of CCI certificants and addresses regulation of practice, misuse or misrepresentation, and potential sanctions. CCI also provides a mechanism to report an alleged ethics violation of CCI’s ethical policy and procedure requirements through self-reports or reports concerning another nurse.
Some general guidelines for possible reasons to report an alleged ethical violation may include:
- Falsification of information and/or documentation
- Failure to maintain required licensure
- Gross negligence
- Commission of a crime
- Misrepresenting the status of a credential
- Cheating on an exam
- Violating policies or procedures
- Engaging in conduct unbecoming of the profession.
While the specific expectations of licensing boards may differ, the underlying ethical principles of the nursing profession remain steadfast. The American Nurses Association Code of Ethics stipulates the values and ethical responsibilities of the nursing profession in general. These components are vital in sustaining the integrity, reliability, and trustworthiness of the profession, which in turn benefits patients, the public, and other stakeholders alike.
Sources:
- ABNS: https://www.nursingcertification.org/
- NCSBN: https://www.ncsbn.org/boards.page
- CCI Ethics Webpage: https://www.cc-institute.org/ethics-policy/
- ShiftMed: https://www.shiftmed.com/blog/complete-list-of-specialty-nursing-certifications/
- ANA Code of Ethics: https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/
https://www.ncsbn.org/nursing-regulation/about-nursing-regulatory-bodies.page
- Melissa R. Nosik, Ph.D., BCBA-D, ICE-CCP, SHRM-SCP is the chief executive officer of the Competency & Credentialing Institute. Lisa Rosenfield, MA, serves as the accreditation and compliance manager at the Competency & Credentialing Institute. Mai-Linh King, MS, BCBA, CPTM is a consultant for Spark LLC working with the Competency & Credentialing Institute.
