CNA Certification

The history of CANNT dates back to 1968, when the Canadian Society of Extracorporeal Technicians (CANSECT) was formed. CANSECT’s members came from the fields of heart-lung perfusion and dialysis – two different disciplines linked by the shared concept of extracorporeal circulation. By 1975, the differences between these two groups came to outweigh the commonalties that had brought them together. The groups separated, with the dialysis membership forming the Canadian Society of Perfusionists. In 1977 this organization was renamed the Canadian Society of Dialysis Perfusionists.

In 1984 the group again changed its name to the Canadian Association of Nephrology Nurses and Technicians (CANNT). This was amended in 1996 to the current title, the Canadian Association of Nephrology Nurses and Technologists.

Among other things, these name changes reflect the ongoing growth and expansion in the specialty. Initially, the group’s interests were directed toward the new field of extracorporeal circulation; today, the emphasis is on holistic patient care. “We see hemodialysis as one modality of care – one part of the whole – and recognize the importance of different modalities in the total plan of care,” adds Amos. “Overall, the changes in our association’s name reflect our evolving identity and serve to remind us that we must not build barriers to the creative ideas that fuel our continued growth.”

CANNT’s membership is composed of nurses and technologists involved in the specialized care of nephrology patients. Members care for patients throughout the entire continuum of end stage renal failure, during conservative management, during all modalities of dialytic intervention, during transplantation, during life, and up until death.

CANNT is a voluntary not-for-profit organization dedicated to serving the needs of its members. Its primary purpose, as set out in the association’s bylaws, is to promote the dissemination of knowledge among those involved in caring for patients with renal disease. The organization aims to improve the care of renal patients by offering formal and informal educational projects for members in the sub-specialties, both adult and pediatric: technology, hemodialysis, peritoneal dialysis, transplantation, and progressive renal insufficiency (pre-dialysis).

The executive of CANNT is made up of four officers: the President-elect, the President, the Past-president, and the Secretary/Treasurer. In addition to the executive, four Vice-Presidents are elected to represent the Western, Ontario, Quebec, and Atlantic regions of Canada. CANNT also elects a Technical Member-at-large, who represents the technology sub-specialty within the association.

The Membership Committee, with the President-elect as its chairperson, is responsible for developing membership information and services packages. The committee also markets the association, with the goal of increasing membership.

The CANNT Journal, published four times a year, is intended to share nephrology information with members. The journal has seen some positive changes recently, becoming peer-reviewed and adding regular columns and continuing education articles.

Nephrology nurses and technologists must ensure that the equipment and methods used in nephrology-related treatments are safe, effective, and in accordance with accepted protocol. To this end, CANNT has established standards of practice to determine the quality of care the patient receives and to judge the competence of the nephrology nurse and technologist. These standards provide direction to nurses and technologists and promote quality care and excellence in practice. CANNT also encourages members to remain up-to-date and competent by regularly evaluating performance against these standards of practice.

CANNT’s national symposium has become one of the most highly regarded meetings of its kind in Canada. Held annually at selected major sites, the national symposium is the occasion for the annual business meeting and features presentations for and by nephrology nurses and technologists.

Before 1985, CANNT offered a voluntary certification exam to its eligible members. Around that time, CNA began looking at developing certification exams for various nursing specialties. In 1990 CANNT chose to join the CNA Certification Program in an effort to meet general standards of reliable and valid testing. Since then, the exam for the CNeph(C) designation has been written annually through CNA, with recertification required every five years. Well over half of CANNT’s nursing members are now certified, demonstrating their commitment to the nephrology profession and to quality patient care. Currently, CANNT is working to establish a certification process for CANNT’s technical members.

CANNT formed the idea of establishing special interest groups in 1998, primarily to encourage members’ involvement in the association and to provide professional activity hours for recertification. The list of special interest groups includes education, research, advanced practice, administration/ leadership, government relations, marketing, clinical practice, which in turn includes progressive renal insufficiency (pre-dialysis), pediatrics, transplantation, hemodialysis, peritoneal dialysis, and technology.

CANNT acknowledges and supports members in a variety of ways. Each year the association grants three bursaries of up to $1,000 to qualified nephrology practitioners who want to further their professional education:

• the CANNT Technical Bursary for technical members
• the Frances Boutilier Bursary for nurses continuing their education at the baccalaureate level
• the CANNT Bursary for nurses studying at the graduate level.

CANNT also has an annual awards program open to all CANNT members. Corporate Excellence Awards are presented each year as well with the support of corporate members. Awards are granted to the authors of the four best manuscripts submitted for presentation at the national symposium. And, the Journal Award is reserved for the author of the best article published in the CANNT Journal during the year.

For years, she and other nephrology nurses at the Atlantic Health Sciences Corporation did their own fundraising for things such as nephrology conventions and certification exam fees. “We felt there weren’t a lot of avenues for funds to support certification,” says King.

Of even more importance to King, she sensed there was an underlying feeling that there was little recognition for certification. She decided the best course of action was to try to tap into other sources of funds. The hospital corporation was identified as the best target.

Much of the credit for the breakthrough goes to Barb McGill, then Vice-President, Patient Programs and Chief Nursing Officer. King says McGill was instrumental in persuading the hospital to realize the important contribution certified nurses make to the hospital and to their clients. McGill truly believed in the concept of certification.

Believing in certification is something King will gladly spend time telling others about. “I believe it’s a personal achievement. An achievement that is not only professional, but personal as well,” says King. “You are proving to yourself and to others that you are committed to this specialty and to giving the greatest quality of care possible.”

In addition to maintaining a national standard of care, King and other certified nephrology nurses at the Atlantic Health Sciences Corporation now enjoy an educational increment on their biweekly cheques. King would like to see nurses certified in other specialties also enjoy this benefit and urges them to campaign the hospital. And the word is also spreading to other Atlantic nursing employers that certification is something worth paying for.

Another contributing factor that opened the hospital’s eyes to the value of certification was a letter written by the Manager of CNA’s Certification Program, Hélène Sabourin. In the letter, she points out that there is a significant cost to the nurse in writing the certification exam, and a significant amount of time invested in studying.

Sabourin also points out that although CNA is not considered a bona fide post-secondary educational institution, CNA Certification is part of a new era in national care standards, one that demonstrates commitment to the principles of continued competence encouraged by provincial Quality Assurance Programs. Certification is a clear example of self-learning and life-long learning.

In addition, by confirming that a registered nurse has demonstrated competence in a nursing specialty by having met predetermined national standards of that specialty, the program benefits the nurses, the public and the employer. Though voluntary, the Certification Program offers nurses the chance to prove how committed they are to high quality care.

King, who became certified in 1997, takes pride in passing on what she has learned through her certification training to other nurses and clients. Teaching them about their disease, treatment and drugs, she improves their quality of life and their ability to make informed decisions concerning their condition.

If anyone else has information to share regarding educational allowances or other certification issues that have been overcome, please contact the Certification Program and your successes can be passed on to inspire others.

We would also like to encourage readers to send us names of potential certified nurses we can profile in Certification News.

The Certification Program has kicked off a new promotional campaign this year to boast about the merits of becoming certified. With almost 10,000 nurses certified, the program continues to grow in number and reputation.

Under the banner, Certification Preferred, the new brochure and poster outlines the benefits, the reasons and the eligibility requirements of the program. What is also new for 2000 is a prep guide for every specialty exam. A superb resource for preparing for the exam of choice, each guide is developed by the same nurse specialists who create the certification exam itself. The prep guides are the most accurate and relevant prep text available.

All eligible candidates for the year 2001 examinations will automatically receive a copy of the new prep guide for their nursing specialty. The cost of taking the certification exams have been increased this year to help offset the cost of producing the prep guides.

Applications to write exams in all specialties must be post-marked on or before Friday, 3 November 2000. Exams for all specialties take place Saturday, 31 March 2001. For more information, get the 2001 Application Guide, which will be available in June 2000.

CNF Awards

Critical Care
Mary C. Nisbet, RN, CNCC(C), Ontario
(R) Martha H. Mackay, RN CNCC(C), British Columbia

Emergency
(R) Elaine B. Zeleny, RN ENC(C), Ontario
(R) Oksana Antonyk, RN ENC(C), Alberta

Gerontological
Melodie A. Powell, RN GNC(C), Manitoba
Twyla N. Jaworski, RN GNC(C), Manitoba

Nephrology
Kim A.L. Stringer, RN CNeph(C), Ontario
Julie Ann L. Lawrence-Murphy, RN CNeph(C), Ontario

Neuroscience
Karen L. Whitmore, RN CNN(C), British Columbia
Fiorella M. Paua, RN CNN(C), Ontario

Occupational Health
(R) Paula J. Harnum-Brown, RN COHN(C), Ontario
Jane M. Tooze, RN COHN(C), Ontario

Oncology
Lynn P. Sheppard, RN CON(C), Ontario
Elaine Chu, RN CON(C), British Columbia

Perioperative
Lorna M. Hendren, RN CPN(C), Manitoba
Cheryl L. Carleton, RN CPN(C), Ontario

Perinatal
Martha D. Nutbrown, RN PNC(C), Nova Scotia
Paula D. Morrison, RN PNC(C), Ontario

Psychiatric/Mental Health  
Darlene M. Newell, RN CPMHN(C) Newfoundland
(R) Bernice M. Defreyne, RN CPMHN(C), Ontario

(R) = recertified

The results from this survey will be compiled with the results of a current survey underway of those nurses who choose to recertify. With the results of both surveys at hand, staff will be in a position to make improvements to the Certification Program – both in terms of initial certification and recertification.

With regard to the survey of nurses who chose not to recertify, the results have been analyzed and noted. Incidentally, the response rate for this survey was 256 nurses or 17 per cent.

The most common complaint, 48 per cent of the responses, was that the recertification fees were too high. We acknowledge that this concern is one that affects many nurses, especially when continuing education courses must also be paid for in many instances. 

Program staff have tried to deal with this issue in the past, and since 1996 recertification fees have been decreased twice. A recent recommendation from the CNA Board of Directors indicates that the Certification Program should be in a cost-recovery situation by 2003. This board decision will influence financial decisions made by the Certification Program, but this issue will be reviewed in the near future.

While looking at the responses it was noted that 27 per cent checked that they were retiring or had retired from the nursing profession. The high number of nurses reaching the retirement age contributes to the current nursing shortage. CNA continues to lobby and influence the government to work toward finding health human resource solutions for the future of our health care system.

Approximately nine per cent of survey respondents commented that they did not feel certification was appropriately recognized. The Certification Program has done much recently to increase the profile of certification. Upon the request of successful candidates, staff send out two letters to people of the recently certified or recertified nurse’s choice. The letter outlines the nurse’s achievement and the benefits for certification. 

The Employer Recognition Award was also established last year, to recognize employers and individual champions of the CNA Certification Program through support and recognition of CNA certified nurses. As well, CNA continues to work with universities and unions to establish credit and salary recognition for certification.

In response to other concerns mentioned in the surveys, certification staff are exploring ways to make it easier for nurses to earn continuing education hours. To ease the restrictive nature of the previous requirements of earning 75 formal hours and 25 professional hours, the Certification Program has revised the requirements. Now called continuous learning (CL), to be eligible for recertification candidates must accumulate 100 hours of CL activities related to their specialty. Using this streamlined criteria, nurses should find it easier to organize and earn CL activities.

Staff are also looking into the application process to make it less tedious and ensure all specialties have the same yearly term. This may, however, for budgetary reasons take a couple of years before being implemented