December 7, 1998

The other day I saw a magazine article about a nursing leader, and over her large color photo was her name, followed by a long, long string of credentials. There was the RN-C, the BS, then the MN, then the PhD, then the NP, then the FAAN. Lately I’m even seeing credential initials that I can’t translate because I’ve never seen or heard of them before.

It’s not that I’m against recognizing any of these achievements or the credentialing process offered by specialty organizations. But I think the insistence on using every one of these credentials after our names suggests fundamental problems within nursing. After all, our name tags aren’t supposed to be our résumés.

A long list of initials after our names—whether on a name tag, with a signature on a letter, or in a magazine—is making nursing look highly unusual compared with the other professions. We give the impression that our core credential—being a registered nurse—is somehow not quite enough. It’s almost as if we have come to believe that the nurse with the longest list wins.

But if nursing were well-understood and revered, if we were truly considered a profession by the public at large, would we feel the need to list so many letters after our names? Think of your CPA, your attorney, your priest or rabbi, or your physician. Some may use two sets of credentials … but three? Or four?

So, big deal. What does it cost us, you might ask. We work hard for each of these educational accomplishments and certifications, and our colleagues should know what we’ve attained, some might say.

But if the credentials are not understood by our patients—or even by some of our co-workers—then they’re doing nothing but confusing people. The average patient who sees "RN-C, MN, FNP, CS" after a name doesn’t have a clue what any of that means in terms of the nurse’s ability. To most people, these credentials look like a new form of Morse code. Even the respiratory therapist, social worker, or physician who sees the long string of initials probably has no idea what each one stands for. And who could? Every year we create new ones, each with a process and a meaning all its own.

It has never been more important for our patients to know what they’re getting when they work with us. But if we somehow, even subconsciously, rely on our growing list of credentials to reassure our patients—and perhaps ourselves—that we are indeed respectable, accomplished professionals, then aren’t we missing the boat? Shouldn’t our core credentials and our actual nursing practice speak for themselves?

What do you think?

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