President's Note: Rising Above: New
Questions, New Opportunities
Embrace the Art of Possibility
By Dorrie Fontaine, RN, DNSc, FAAN
While relaxing with my 12-year-old son
Sumner at the pool during the NTI in San Antonio, I found myself chatting with
other NTI participants-some experienced clinicians, others less experienced. As
our conversation naturally turned to critical care, I was again struck by how we
face similar problems and joys, regardless of where we work.
Although it was only "NTI Monday,"I thought
ahead to Thursday afternoon when I would announce "Rising Above: New Questions,
New Opportunities"as my theme for the year and the logical next step to our bold
voice commitment. Why not start now?
"Are there many CCRNs in your unit?"I
asked. One nurse, I'll call her Julia, responded that, though she had been a
critical care nurse for more than 20 years, she had just never made time to take
Wanting to encourage Julia, I probed
further. "You've worked with complex patients for 20 years now. Surely you have
the knowledge and skills to become a CCRN. What's the worst that could
happen?"She didn't hesitate. "I would fail in front of all my friends,"she
Interesting, I thought, because nurses in a
recent AACN survey reported expense, lack of employer support and not enough
study time as the major barriers to becoming certified. Only 7% of the
respondents cited fear of failure as a barrier. So, why do so many nurses also
speak of this fear?
Fear of Failure
The fact is that I know there are many
Julias. I was one.
Twenty years ago, when I worked in an ICU
and taught trauma and critical care in the University of Maryland's
trauma/critical care master's program, I decided to seek CCRN certification.
There was just one hitch. Some of my students would be taking the then
paper-and-pencil exam at the same time. What if they passed, and I failed? I
passed, but first I had to overcome my fear of failing in front of my students
I am currently reading the Art of
Possibility, a wonderful book by Rosamund Stone Zander and Benjamin Zander. They
have opened my eyes to new ways of being, thinking and acting.
The Zanders ask readers to think about what
is possible with some fascinating results. They claim that, by simply shifting
to a perspective of openness and possibility-by rising above, so to speak-we can
transform with hope some of the thorniest challenges we face.
Often, fear blocks us from taking chances
on truly important matters. Becoming certified may be one of those times. By
rising above and embracing the art of possibility, new questions are likely to
reveal new opportunities. Consider these:
� Why doesn't every nurse who attends a
CCRN review course follow through to take the exam?
� How do I quiet an inner voice that says,
"I'm worried that I am not smart enough to pass the CCRN exam"to one that says,
"More than 40,000 nurses are CCRN-certified. Of course, I can. I should be one
� How would I create the possibility of
time to study, take and pass the CCRN exam?
� The exam is computer-based and scheduled
individually, so why does anyone else need to know I'm taking the exam?
I realize that I overcame my fear when I
rose above and recognized the value of being a competent nurse with CCRN after
my name instead of focusing on my anxiety about the test. Because my path in
academic administration-the last year as associate dean at the University of
California, San Francisco, School of Nursing-limits my daily contact with
patients and families, I now keep the credential alive
in my heart and on my r�sum� as a CCRN
alumnus. (Visit www.certcorp.org to find out more about alumnus status.)
Are You Afraid?
What are you afraid of that keeps you from
accomplishing what you desire? Becoming certified may be that accomplishment.
Would your colleagues ridicule you for failing to obtain a credential that we
know benefits patients, families, hospitals and, of course, nurses, instead of
admiring you for trying?
If you are already certified, become a
certification buddy and coach someone else toward achieving his or her
credential. You can find support in AACN's white paper on certification,
published in the December 2002 issue of the American Journal of Critical Care
and available online at
Certification > Benefits of Certification > Safeguarding the Patient and the
Profession: the Value of Critical Care Nurse Certification.
About Julia. She later sought me out and
said, "What you said inspired me, and I'm going to take the CCRN exam.�
"Let me know the day, and I promise to send
you positive energy and good thoughts,"I told her.
To all the Julias out there: E-mail me your
exam date at email@example.com. I promise to think of you and send each
of you good thoughts as well. It's the least I can do to help you create the
possibility of CCRN for yourself.
Nurses Truly Are Heroes
After reading the recent "President's
Note"column (AACN News, May 2003) and participating in a Nurses Week conference
at the facility in which I work, I felt compelled to write. Both touched on
As a nurse for 32 years, I truly believe
all nurses must be heroes. It isn't the extraordinary nurse who does heroic
things. More often than not it is the everyday nurse doing everyday things that
impact many people-the patient, certainly, but also the family.
Consider the tremendous amount of teaching
done every day. New staff, family members and patients all require masses of
information. Add to that the medical students, new interns, residents and
just-arriving staff MD. The list goes on.
Last week a group of four medical students
left our unit. On the last day of medical school, the last day on our unit, they
brought bagels for the staff. I like to think they will remember us not just as
the nurses and nice people we are, but also as the ones who helped guide them on
the next step of their journey. Will they remember how the attending CCM worked
with us? Asked for our input in patient care?
Remember what they learned from the nurses
as well as the MD? I'd like to think so.
Nurses today have a "MacGyver"spirit. They
must have it to survive. If you are too young to remember that television show,
MacGyver was the guy who could fix anything, get out of any scrape with nothing
more than a paper clip, duct tape or string. You will see this spirit in action
in any unit, in any institution where a nurse works. The hemostats holding
things (like the BP cuff) together. What nurse doesn't know how to screw things
together with scissors, or for that matter, have a set of tools stashed
Although I have some bad memories, I have
many good memories. Successes and failures both go hand in hand with nursing.
For example, I recently was thrilled when a patient made a fist at me as I
leaned over her bed. Why? This post-transplant patient with a 5-year-old son had
a head bleed and was not expected to regain neurological function. A good
memory, this one.
Jolan Dallatore, RN, BSN, CCRN
West Alexander, Pa.