Ask an Expert: Which Additional Certifications Should NPs Pursue?

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Certifications allow nurse practitioners to demonstrate their expertise in a variety of clinical settings. While all nurse practitioners are certified in their population-focus (i.e., medical specialty), some earn additional certifications to expand their knowledge base and increase their job opportunities. This article discusses certifications that nurse practitioners can pursue to augment their population-focus, including orthopedics, emergency medicine, palliative care, oncology, and dermatology.

Orthopedic Nurse Practitioner

Orthopedic nurse practitioners (ONPs) are advanced practice nurses who assess, diagnose, and manage patients with a wide variety of musculoskeletal conditions. Currently, Duke University offers a special orthopedic nurse practitioner program that requires applicants to complete an additional three courses on musculoskeletal conditions.

Because ONPs are highly specialized, they and often earn higher than average salaries. To become an orthopedic nurse practitioner, you must be certified through the Orthopaedic Nurses Certification Board. To be eligible to apply for the certification (ONP-C), you must have been a nurse practitioner for at least three years with a minimum of 2,000 clinical hours training patients with musculoskeletal conditions. Most applicants are either family nurse practitioners, pediatric nurse practitioners, or geriatric nurse practitioners.

Certifying Organization Requirements Renewal Cycle Cost Exam Questions Study Resources Organization’s Guide Content Outline
Orthopedic Nurse Practitioner (ONP) Orthopaedic Nurses Certification Board
  • Three full years of experience practicing a nurse practitioner
  • A master’s degree or doctor of nursing practice degree from an accredited university
  • Have completed a minimum of 2,000 hours as a nurse practitioner treating musculoskeletal conditions; practice hours from orthopedic fellowships or postgraduate residency problems count toward these hours
  • Current unrestricted license as a registered nurse and nurse practitioner
Every five years
  • $340 National Association of Orthopaedic Nurses (NAON) members, online application
  • $365 NAON members, paper application
  • $455 non-members, online application
  • $480 non-members, paper application
150 Orthopedic and Sports Medicine Case Studies for Advanced Practice Nurses by Karen Myrick, DNP, FNP, ANP

30-minute overview video

Musculoskeletal Conditions

  • Degenerative Disorders
  • Orthopaedic Trauma
  • Sports Injuries
  • Inflammatory Disorders
  • Metabolic Bone Disorders
  • Pediatric/Congenital
  • Musculoskeletal Tumors
  • Neuromuscular

Emergency Care Nurse Practitioner

Emergency nurse practitioners specialize in the treatment of acute, life-threatening conditions, and they often find themselves working in emergency rooms or urgent care centers. Vanderbilt University offers a unique emergency nurse practitioner program that prepares graduates as dual family nurse practitioners and geriatric acute care nurse practitioners. This program includes an additional four courses focused on treating children, adults, and seniors with critical illnesses, injuries, or acute trauma.

You can become certified as an emergency nurse practitioner through either the American Nurses Credentialing Center (ANCC) or the American Academy of Nurse Practitioners Certification Board (AANPCB), the details of which are both listed below. For certification through the ANCC, you must complete a portfolio review, whereas for certification through the AANPCB, you must complete an exam.

Certifying Organization Requirements Renewal Cycle Cost Exam Organization’s Guide Portfolio Content Outline
Emergency Nurse Practitioner (ANCC) American Nurses Credentialing Center
  • Master’s or doctor of nursing practice degree in nursing
  • Current nurse practitioner state licensure
  • National certification as a nurse practitioner
  • Completed a minimum of 2,000 hours of advanced practice in the specialty area of emergency care in the past three years; up to to 50 percent of these practice hours may be from an emergency care fellowship or residency program
  • Completed 30 hours of continuing education in advanced emergency care in the past three years
Every five years
  • $525 for non-members of the ANCC
  • $150 for ANCC members
  • $470 for members of the American Academy of Emergency Nurse Practitioners
  • $470 for members of the Emergency Nurses Association
No exam required; rather, applicants undergo a portfolio review which requires a peer-evaluation and self-evaluation, as well as the submission of a professional development record, resume, and academic transcript More information can be found in the Certification Through Portfolio Application Requirements Handbook and the Portfolio Preparation Tips
  • Professional development
  • Professional and ethical nursing practice
  • Teamwork and collaboration
  • Patient safety and quality
  • Supervisor evaluation
  • Self-evaluation
Certifying Organization Requirements Renewal Cycle Cost Exam Sample Questions Organization’s Guide Content Outline
Emergency Nurse Practitioner (AANPCB) American Academy of Nurse Practitioners National Certification Board
  • Master’s or doctor of nursing practice degree in nursing
  • Current nurse practitioner state licensure
  • National certification as a nurse practitioner
  • One of the following:
    • 100 continuing education credits; 2,000 emergency practice hours
    • Graduate or postgraduate degree in emergency medicine
    • Fellowship or residency program in emergency care
Every five years
  • $315 for non-members of AANP
  • $240 for AANP members
150 Emergency Nurse Practitioner Candidate Handbook (pg. 27) Emergency Nurse Practitioner Candidate Handbook
  • Conditions
    • Thoracic and respiratory disorders
    • Cardiovascular disorders
    • Dermatologic soft tissue disorders
    • Abdominal & gastrointestinal disorders
    • Musculoskeletal disorders
    • Renal and genitourinary disorders
    • Nervous system disorders
    • Head, ear, eye, nose, throat disorders
    • Traumatic disorders
    • Psychobehavioral & other disorders
  • Medical screening
  • Medical decision making and differential diagnosis
  • Patient management
  • Patient disposition
  • Professional legal, and ethical practice

More detailed information can be found in the Emergency Nurse Practitioner Candidate Handbook (pg. 23)

Hospice and Palliative Care Nurse Practitioner

Palliative care nurse practitioners specialize in the treatment of those with serious illness. Care is usually focused on providing relief from the symptoms and stress of the illness. Ultimately, the goal of this treatment is to improve the quality of life for both the patient and his or her family.

Drexel University’s College of Nursing and Health Professions offers a certificate in advanced study in holistic hospice and palliative care. This includes 12 credit hours of coursework that focuses on end-of-life care, evidence-based complementary and integrative therapy approaches, and medical treatments aimed at alleviating pain and suffering.

The Hospice and Palliative Credentialing Center offers the ACHPN certification for nurse practitioners. This requires the completion of a 175-question exam and at least 500 hours in the past year (or 1,000 hours in the past two years) of working as a palliative care nurse practitioner.

Certifying Organization Requirements Renewal Cycle Cost Exam Questions Sample Questions Study Resources Organization’s Guide Content Outline
Hospice and Palliative Care Nurse Practitioner Hospice and Palliative Credentialing Center
  • Current, active registered nurse license
  • Master’s or doctor of nursing practice degree from an accredited nurse practitioner school
  • At least 500 hours in the past year or 1,000 hours in the past two years of working as a hospice or palliative care nurse practitioner
  • Official academic transcript that includes completion of courses in advanced physical assessment, advanced pathophysiology, and advanced pharmacology
Every four years
  • $345 for members of the Hospice and Palliative Nurses Association (HPNA)
  • $465 for non-members of the HPNA
175 Advanced Certified Hospice and Palliative Nurse Candidate Handbook (pg. 14) Clinical Pocket Guide to Advanced Practice Palliative Nursing by Constance Dahlin,‎ Patrick Coyne, and‎ Betty Ferrell Advanced Certified Hospice and Palliative Nurse Candidate Handbook
  • Nursing process for caring for adult patients and families
    • Assessment
    • Diagnosis and planning
    • Intervention and evaluation
  • Scientific knowledge
    • Disease process
    • Diagnostic tests and procedures
    • Prognosis
    • Responses to illness, loss, grief, and bereavement
  • Education and communication
  • Professionalism
    • Ethics
    • Scope, standard, and guidelines
    • Self-care and collegial support
    • Leadership and self-development
  • Systems issues
    • Resource access, utilization, and continuum of care
    • Quality improvement

A detailed content outline can be found starting on page 11 of the Advanced Certified Hospice and Palliative Nurse Candidate Handbook.

Oncology

Oncology nurse practitioners focus on patients with cancer, including screening, prevention, early detection, and genetic risk as well as diagnosis, staging, and treatment planning. These nurse practitioners typically work in large hospital systems or at a cancer treatment center. The Columbia University School of Nursing offers an oncology nurse practitioner subspecialty that includes specialized coursework and oncology clinical placement. Students in this program must choose between an adult or pediatric oncology track.

The Oncology Nursing Certification Corporation offers an oncology nurse practitioner certification. Graduates of oncology programs are eligible for this certification as well as those without a formal oncology background but who have fulfilled specific clinical experience and continuing education requirements.

Certifying Organization Requirements Renewal Cycle Cost Exam Questions Sample Questions Study Resources Organization’s Guide Content Outline
Oncology Nurse Practitioner Oncology Nursing Certification Corporation

Pathway 1

  • Graduate degree from accredited nurse practitioner program with concentration in oncology
  • Current license as a registered nurse and nurse practitioner
  • 500 hours supervised clinical practice as an adult oncology nurse practitioner within the past five years
  • One graduate level oncology course or 30 hours oncology continuing education within the past five years

Pathway 2

  • Graduate degree from accredited nurse practitioner program
  • Current license as a registered nurse and nurse practitioner
  • 1,000 hours practice as an adult oncology nurse practitioner obtained within and/or following the graduate program within the past five years
  • One graduate level oncology course or 30 hours oncology continuing education within the past five years
Every four years
  • $296 for a member of the Oncology Nursing Society or the Association of Pediatric Hematology Oncology Nurses
  • $225 for a member of these organizations who is above the age of 65
  • $416 for a non-member of the organizations
  • $315 for a non-member who is above the age of 65
165 A practice test can be completed on the website Advanced Oncology Nursing Certification Review and Resource Manual by B.H. Gobel, S. Triest-Robertson, and W.H. Vogel Oncology Nursing Certification Test Candidate Handbook
  • Screening, prevention, early detection, and genetic risk
  • Diagnosis, staging, and treatment planning
  • Cancer treatment
  • Side effects and symptom management
  • Oncologic emergencies
  • Survivorship
  • End-of-life care
  • Psychosocial issues
  • Coordination of care
  • Professional practice
  • Roles of the advanced practice nurse

More detailed information can be found in the Test Content Outline

Dermatology

Dermatology nurse practitioners (DCNPs) focus on the assessment, diagnosis, and management of skin diseases and disorders. They typically work at hospitals and clinics treating a variety of conditions from acne to skin cancer alongside other nursing and physician specialists. The Dermatology Nurses Association certifies dermatology nurse practitioners. To be eligible, you must complete a minimum of 3,000 clinical hours of dermatology practice, some of which can come from a dermatology graduate program.

Some dermatology nurse practitioners further specialize in aesthetics. These providers specialize in cosmetic procedures such as botox, dermal fillers, sclerotherapy, chemical peels, microdermabrasion, mesotherapy, and laser hair removal. Aesthetics nurse practitioners often work in a dermatology office or in a medical spa.

Certifying Organization Requirements Renewal Cycle Cost Exam Questions Study Resources Organization’s Guide Content Outline
Dermatology Nurse Practitioner Dermatology Nurses Association
  • Master’s or doctor of nursing practice degree in nursing
  • Current nurse practitioner state licensure
  • National certification as a nurse practitioner
  • Minimum of 3,000 hours of recent NP practice with current practice in dermatology; this can include hours obtained from a formal dermatology nurse practitioner program, post-graduate fellowship, or residency program
Every three years
  • $300 for a member of any nurse practitioner organization
  • $300 for those who have already obtained their dermatology nurse certification
  • $400 for non-members
175 questions Dermatology: Illustrated Study Guide and Comprehensive Board Review by Sima Jain Dermatology Nurse Practitioner Certification Brochure

The exam measures a DCNP’s ability to:

  • Assess and diagnose acute and chronic conditions that occur across the life span in dermatology
  • Prescribe interventions, including evidence-based treatment, therapies, and procedures
  • Teach patients, significant others, community, and colleagues about prevention and management of dermatological conditions.
  • Consult for and with peers and other health care professionals regarding specific cases
  • Analyze research data in order to implement effective evidence-based data
Dr. Melissa DeCapua, DNP, PMHNP-BC

Dr. Melissa DeCapua, DNP, PMHNP-BC

Author

Melissa DeCapua is a board-certified psychiatric nurse practitioner who graduated from Vanderbilt University. She has a background in child and adolescent psychiatry as well as psychosomatic medicine. Uniquely, she also possesses a bachelor’s degree in studio arts, which she uses to enhance patient care, promote the nursing profession, and solve complex problems. Melissa currently works as the Healthcare Strategist at a Seattle-based health information technology company where she guides product development by combining her clinical background and creative thinking. She is a strong advocate for empowering nurses, and she fiercely believes that nurses should play a pivotal role in shaping modern health care. For more about Melissa, check out her blog www.melissadecapua.com and follow her on Twitter @melissadecapua.

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