Specialties and Certifications for Nurses

Nursing is a diverse field offering a wide range of advancement opportunities, particularly for those who pursue specialization and certification. A Bachelor of Science in Nursing is often a prerequisite for those interested in attaining these professional distinctions and the associated benefits. Specialized and certified nurses frequently report higher salaries, improved career prospects and greater recognition among employers and peers.

How Are Specialties and Certifications Related?

Specialties represent areas of nursing practice that usually require specific or advanced skill sets, education and experience. With more than 100 nursing specialties — from ambulatory care nursing to wound, ostomy and continence nursing — numerous options align with virtually any interest.

Certifications typically are required for those practicing in nursing specialties and demonstrate that relevant key competencies have been mastered. The American Board of Nursing Specialties (ABNS) defines certifications as "the formal recognition of the specialized knowledge, skills and experience demonstrated by the achievement of standards identified by a nursing specialty to promote optimal health outcomes."

Certifications are granted by an outside independent credentialing organization and are a voluntary step beyond nursing licensure, with the latter issued by state boards of nursing and mandatory to practice professionally in any capacity.

Is a BSN Required for Certain Specialties and Certifications?

Although some pathways remain open to nurses with associate degrees, several require or strongly favor applicants with a baccalaureate background. This shift may be prompted, in part, by the 2010 Future of Nursing report by the Institute of Medicine (IOM), now called the National Academy of Medicine (NAM). The report established the goal of 80% of nurses obtaining their BSN by 2020 in order to meet the challenges of caring for an older population with complex health needs.

Three certifications requiring a minimum of a baccalaureate degree in nursing are:

Informatics Nurse. Informatics nurses combine their clinical expertise and knowledge of information systems technology to improve workflows like electronic health record (EHR) charting. The American Nurses Credentialing Center (ANCC) offers credentialing for informatics nursing and awards the credentials Registered Nurse-Board Certified (RN-BC) upon completion.

Registered Nurse First Assistant. A registered nurse first assistant (RNFA) is a perioperative nurse who works directly with surgeons in the operating room. Nurses obtain RNFA certification (CRNFA) through the National Assistant at Surgery Certification (NASC).

Wound, Ostomy and Continence Nurse. These nurses deliver care and education to patients with acute and chronic wounds such as bedsores and diabetic ulcers as well as those with ostomies and loss of bowel and bladder control. CWOCN certification is offered through the Wound, Ostomy and Continence Nursing Certification Board (WOCNCB).

Why Pursue a Specialty or Certification?

Certifications demonstrate a commitment to the specialty along with achievement of a greater depth of relevant knowledge, expertise and professional competence. Nurses who obtain certification are more likely to benefit from increased job marketability and recognition by employers and peers. Since certifications are acknowledged nationwide, specialized nurses have significant career portability and access to a wider range of jobs.

Specialization also usually leads to higher salaries. PayScale (July 2019) reports that the RN average salary is $62,850 while a board-certified RN (RN-BC) earns $82,000 and a certified wound, ostomy and continence nurse $79,000. According to the Healthcare Information and Management Systems Society 2017 Nursing Informatics Workforce Survey, 55% of certified informatics nurses earn more than $100,000 per year while only 37% of their non-certified counterparts reach that figure.

Raising the Bar

With dozens of specialty and certification options, BSN-prepared nurses have several pathways to fulfill their professional interests. Although a BSN is not mandatory for all certifications, many credentialing bodies now require or strongly prefer candidates who have completed baccalaureate-level degree programs. Specialization often leads to higher salaries, expanded job opportunities and marketability as well as employer and peer recognition.

Learn more about UNM's online RN to BSN program.


American Board of Nursing Specialties: Research

American Nurses Credentialing Center: Informatics Nursing Certification (RN-BC)

Healthcare Information and Management Systems Society: Nursing Informatics

Institute of Medicine of the National Academies: The Future of Nursing – Focus on Education

Johnson & Johnson Nursing: Find a Specialty

National Assistant at Surgery Certification: CRNFA Application

Nursing Management: Specialty Certification – Nurses' Perceived Value and Barriers

PayScale: Board Certified Registered Nurse (RN-BC)

PayScale: Certified Wound Ostomy Continence Nurse (CWOCN)

PayScale: Registered Nurse (RN)

Wound, Ostomy and Continence Nursing Certification Board: Eligibility

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