From left to right: Deb Siela, Barbara Washington-Knight and Bobbi Leeper each earned a CCRN in the 1970s and were honored at NTI 2025
After AACN introduced CCRN certification in 1976, Debra “Deb” Siela and Barbara Washington-Knight became certified in 1977, and Barbara “Bobbi” Leeper in 1978. We interviewed these longtime CCRNs for their thoughts on how critical care nursing has evolved over the past 50 years and how CCRN certification continues to keep pace with these changes.
Bobbi Leeper, MN, RN, CNS, CCRN since 1978
Bobbi, a semiretired cardiovascular critical care CNS, has practiced for 30 years at Baylor University Medical Center in Dallas. She is AACN’s liaison to the American Heart Association’s Emergency Cardiac Care Committee and author or co-author of many articles, abstracts and book chapters.
After CCRN was introduced, Bobbi eventually gave into peer pressure to take the exam. “A couple of dear friends in Kansas City [who had helped develop the credential] were all over me, like, ‘you gotta do this,’” she says.
“I’m like, ‘No, I don’t. I don’t have to do anything.’ But finally, I just decided, you know, to heck with it, I’ll give it a try. What’s the worst that can happen? They can’t take my birthday away from me.”
Bobbi passed the exam in 1978 and quickly realized that she could drive culture change. A cardiologist had told her that nurses don’t need to know anything about EKGs, only how to operate a defibrillator. His statement motivated her to get heavily involved with her local AACN chapter and to start teaching 12-lead EKG classes to nurses in her facility and the wider community. She remains close with AACN members from those early days. “We’re all still really great friends, and we’ll meet every few months to just get caught up.”
Bobbi understands the anxiety that many nurses feel when preparing for the CCRN exam. “I just took a deep breath,” she says. “Remind yourself: What’s the worst that can happen? If you have to sit for it two or three times, that’s fine. It’s completely within your reach.” She advises nurses to “get together with friends, over coffee or a glass of wine, and just review.”
Once a nurse has earned a CCRN, Bobbi believes it’s especially important to maintain the certification: “[Certification renewal] contributes to keeping [nurses] up-to-date and then, of course, I think they gain a lot of self-satisfaction out of that. And then, as a result, the staff who maintain their certification, who pursue that continuing education, hopefully provide better, more comprehensive care.”
Barbara Washington-Knight, BS, RN, CCRN since 1977
After graduating with a nursing diploma, Barbara joined the Air Force in 1972. She knew she wanted to work in critical care, but the military “puts you where they need you,” she says. She sat for the CCRN to validate her critical care knowledge. “It was terrible!” she says with a laugh. “At that time, we had to sit for two days. I was in Northern California, and the test was given in Berkeley. So we had to drive up there and take that test, and oh, it just seemed like the most difficult test ever.” After receiving her results in the mail several weeks later, she was elated that she passed.
After achieving CCRN certification, Barbara asked her supervisor for permission to attend NTI in Hawaii. She was denied. But Barbara made her case, asking for reconsideration because NTI would help with certification renewal. Ultimately, she was approved to attend. “It was a great learning experience,” she says. “I think every nurse should get a chance to go.” Barbara has attended many NTIs over her career, likening the experience to a family reunion. “We all look for each other now,” she says. “I love it.”
Barbara spent 20 years in the Air Force, serving in Texas, Alabama, California and Turkey. After retiring from the military, she worked at Valley Health System and Kaiser Permanente. In 1998, Barbara helped organize AACN’s Inland Empire Chapter, and she’s still actively involved. “We’ve had many nurses become certified. And that has been a great moment in my life, becoming a certified nurse and starting this critical care group. I see what can happen when nurses come together, how nurses can really grow.”
Deb Siela, PhD, RN, CCRN since 1977, CNE, RRT
Deb began her nursing career in a Fort Wayne, Indiana ICU after earning a BSN from Indiana University in 1974. “My nurse mentor and I were aware of AACN,” she says. “When we found out that AACN was going to offer certification in critical care nursing, we were on board because certification would validate our knowledge. In addition, we had a plan to move to California, where this certification would be valued for employment.”
Deb went on to work for nursing registries that supplied critical care nursing units across Los Angeles. After earning a master’s degree in nursing from UCLA in 1980, she worked for 10 years as a pulmonary CNS while continuing as a bedside nurse in critical care and emergency nursing.
In 1990, Deb moved back to Indiana to begin an academic career at Ball State University, where she now serves as an associate professor of nursing and graduate curriculum development director. She is also an editorial board member of Critical Care Nurse.
Deb continually renews her CCRN certification, because “it demonstrates my updated critical care nursing knowledge for my nursing undergraduate and graduate students. It also gives me a sense of pride.”
The CCRN exam, like all of AACN’s other credential exams, is updated every five years. Considering her 49 years of continual renewal, Deb lists some of the biggest changes she has seen in nursing: “use of computers, use of the internet, use of evidence-based practice (EBP), EBP care guidelines, EHRs, smart mechanical ventilation, airway management, cardiopulmonary monitoring, neuromonitoring, electronic patient beds, noninvasive monitoring and treatments, clinical nurses carrying phones, critical care nursing research, sedation of critically ill patients, recognition of delirium, recognition and care of septic shock, fluid management, wound care, 12-hour shifts, use of hospitalists, robotics and AI, and many more.”
To nurses considering CCRN certification, Deb advises, “Expect a big time commitment. You should obtain review books and attend a CCRN review course, either live or online. Take CCRN practice exams. Consult with CCRN nurses. Once certified, you will feel in part that you are a super critical care nurse. Attend NTI, and you will feel the synergy of all the CCRNs who are there. It is awesome.”