The 5 no-nos of alphabet soup

When I was in nursing school, one of my professors made it very clear that, no matter what areas of nursing we decided to go into, we would all be nurses. She also made it clear that, regardless of how many nursing positions we accepted away from the bedside, we would still be nurses. For this reason, she said we should always list RN behind our names before any other credentials—to show that we are nurses before anything else and to reduce workplace incivility among colleagues—ADNs vs. BSNs vs. MSNs, etc.

Because of that professor’s instruction, I wrote my name and credentials that way for years, until that fateful day when a well-respected colleague told me I was doing it wrong. I let him know why I listed my credentials in the order I did, but he didn’t let up. Because I completely respected him and his viewpoint, I decided to do a little research and found he was right.

Even before I realized I was incorrectly listing the pomp-and-circumstance letters behind my name, I had a real issue with the massive dissension those letters create among nurses. Rather than become too irritated by the squabble, I decided to joke about it and refer to the collection of initialisms that follow nurses’ names as “alphabet soup.”

The more letters the better, right? Not necessarily.

Look at websites that list names and credentials of more than a handful of nurses, and you will often find the letters behind names listed in various orders. The nursing profession does not mandate the “proper” way to list credentials. As with many of other areas of nursing, there is no consensus. Observing the inconsistencies this has caused in the alphabet soup that follows some nurses’ names has given me many a hardy laugh. I have literally seen it all. Below are my nominations for the five biggest no-nos when listing nursing credentials.

No-no #1: Listing your RN license first

While the rationale for why RN should be listed first made complete sense to me, most “how to” guides will tell you that the alphabet soup has a certain order—and for good reason. List your highest degree first, followed by your license and, lastly, a credential identifying a specialty you have, if any, in nursing. The rationale is simple: List your honors in the order they are most secure. In other words, you list your degree first, because it is the least likely credential to be revoked or taken away.

The credential that identifies certification in a specialized area is listed last, because it has to be renewed regularly, and you may either lose the certification, decide to let it go, or become certified in another area. The certification credential is more fluid than the others; one year you may have it, the next year you may not. With regard to your license to practice nursing—your RN credential—that’s listed second, because it’s more stable than a certification, but not as stable as an academic degree.

No-no #2: Listing every degree you ever earned

It's completely unnecessary to list within a string of credentials every degree hanging on your wall. I have seen some nurses list an associate degree followed by a nonnursing bachelor degree, followed by a bachelor of science in nursing degree. Here’s the thing: Your highest degree is the only one that truly matters. While it’s nice to write your life story in alphabet soup, that’s what résumés and curricula vitae are for. Some people rationalize that if they had a nonnursing degree prior to obtaining a nursing degree, it should be noted. Well, my thought on that is simple: If you are working as a nurse, unless that other degree is higher than your nursing degree, it is not essential to list it behind your name. If people want to see your nonnursing degrees, they can look at your résumé.

No-no #3: Listing more than one nursing license

This is probably the no-no that bugs me most. If you are an advanced practice nurse (APRN), we know you are a registered nurse, so there is no need to list both your RN license and your APRN specialty. It is also not a good idea to list APRN as your license, because there is no APRN license in nursing; the license is based on your specialty. When looking at your credentials, people don’t want to know that you are an APRN; they want to know what type of APRN you are. APRN is an overarching category that encompasses various types of nursing licenses—certified nurse midwives (CNMs), certified nurse anesthetists (CRNAs), nurse practitioners (NPs), and clinical nurse specialists (CNSs). Also, listing both APRN and your specific APRN license—as in “Your Name, APRN, CNM”—is not only redundant, it’s unnecessary for the aforementioned reasons.

No-no #4: Listing more than one specialty certification

You may want to list all your certifications in the form of alphabet soup, but why not leave something for people to learn about later? Really, you only need to list one certification. Which certification you choose to list is completely up to you. I tend to think that nurses should list their most honored certification, the one that requires the most work to maintain, or the one that is most prestigious to other nurses.

For instance, if I were a fellow of the American Academy of Nursing (FAAN), I would list that and not my inpatient obstetrics certification (RNC-OB) from The National Certification Corporation (NCC). Also, it is important to remember that some certifications can be combined with your license, while others cannot. For example, women’s health nurse practitioners who have been certified can list WHNP-BC, in place of WHNP, and still include another certification in their alphabet soup. However, nurses who are certified as advanced forensic nurses need to list both their licenses and AFN-BC.

Nurses should be careful to list only those certifications that are nationally or internationally accepted. For example, although most labor and delivery nurses are required to maintain fetal-monitoring certificates issued by the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN), this certification should not be included in our credentials. To help distinguish between certifications that are credentials and those that are not, answer the following questions. If you answer yes to each one, you have a certification that can be listed as a credential.

• Did you have to pay extra money to obtain the certification (not to take a class, but to submit an application and take the test)?
• Did you have to take a test similar to the NCLEX-RN to obtain this distinction?
• Do you have to earn more CEUs than other RNs to maintain the certification?
• Do you have to show proof of CEUs or retake the certification examination to maintain the certification?
• Does the certification come from a national or international credentialing organization?

If you are still unsure, look for the proper way to list the certification on the certifying organization’s website. If no instruction is provided for listing the certification with your other credentials, it’s probably not the type of certification that should be included in your alphabet soup.

No-no #5: Listing non-specialty certifications

Unfortunately, I have seen nurses who list advanced cardiac life support or other required patient-care certifications among their credentials. What’s worse, I have even seen BLS—yes, as in basic life support—listed as a credential. Clearly, nurses who do this do not understand that a credential is a degree or certification that’s above and beyond anything required to work with their patients.

If you aren’t sure whether or not you’re certified, you probably aren’t. Certifications require an application process that is completely separate from each state’s nursing-license application process, and there is a test that must be passed. Such certification tests are similar to the NCLEX-RN, but they are each given for very specialized areas. A number of certifications can be found on the American Nurses Credentialing Center, while other certifications developed specifically for women’s health nurses, pediatric nurses, and nurse educators are found at The National Certification Corporation and the National League for Nursing, respectively.

As nurses, we have fought long and hard to receive certain distinctions based on our education. I agree with nurses who believe it is important to let others know of our commitment to our profession and our commitment to meet and maintain the highest level of distinction in our areas of expertise. However, to do so, we don’t need a list of letters behind our names that is long as the alphabet itself. I’ll use myself as an example. here:I list my credentials as “MSN, RNC-OB, C-EFM.” This lets others know that I have a Master of Science in Nursing degree. I am a registered nurse, certified in inpatient obstetrics by the NCC and with additional certification in electronic fetal monitoring, also from the NCC (this in addition to my AWHONN advanced fetal monitoring certificate, which is not listed among my credentials).

I encourage RNs to give a great deal of thought to their alphabet soups and list only: 1) their highest earned academic degree (in other words, it shouldn’t be an honorary degree), 2) one nursing license (with certification, if appropriate), and 3) one nationally or internationally recognized specialty certification. Not only is this the proper way to cite your nursing credentials, it also keeps members of our profession from looking like egotistical credential fanatics who only maintain certifications so we can list them behind our names.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

How I ended up at UCLA

I’m often asked how I chose UCLA (University of California, Los Angeles) as the school I would attend to obtain my PhD. To be honest, I don’t feel as though I chose it, but that it chose me.

Before I was halfway through my MSN program, I began looking at nursing PhD programs. I also considered EdD programs, because my MSN is in nursing education, and I have a passion for teaching. Enrolled at the time in an online program, I was not keen on pursuing another online program, but I knew this meant I would have to move. I looked around the UCLA School of Nursing website, but did not see how the PhD program would be a good fit for me, because my research interest was nursing education and the PhD program at UCLA does not focus heavily on research related to that interest. In fact, until a chance meeting with the nursing school’s director of recruitment, outreach and admissions, my mind was made up that UCLA was not the place for me.

During a break at the 2010 Leadership Summit in Honolulu, Hawaii, USA, sponsored by the Honor Society of Nursing, Sigma Theta Tau International, I approached UCLA School of Nursing’s exhibit table. To be honest, I was alone and, because the woman behind the table was also alone, thought I’d stir up a little conversation. I told Rhonda Flenoy-Younger—director of recruitment—that I had looked at UCLA, but didn’t think the program was for me.

She encouraged me to look at the information on a flash drive she handed me, and she took down my email address. She also introduced me to the dean of the School of Nursing. In speaking with him about my research interest, he encouraged me to apply to UCLA but not with the same research interest. When I returned home, I began receiving emails from Flenoy-Younger, inviting me to meetings of the Pan-African Nursing Students and Alumni Association (PANSAA) at UCLA. I ignored the first two meeting invitations, but responded to the third.

At the PANSAA meeting, I immediately felt a level of comfort among the students that I hadn’t felt at my undergraduate school or in the online MSN program from which I had recently graduated. Very interesting to me was that there were alumni in attendance, some who had graduated in the 1970s and ‘80s. Even the dean was there. I left that meeting feeling that, maybe, UCLA had something to offer after all. 

The next day, after attending a PhD information session presented by the UCLA School of Nursing (UCLA SON), I was sold! The support I felt from the faculty, their obvious love of research and UCLA, the personal stories of those on the student panel, and the commitment of the School of Nursing to provide tuition for all graduate teachers’ assistants was all I needed to make my decision. I left the session with my mind made up—I would apply to UCLA and would continue to apply until I was accepted.

A few days later, while attending the 2010 Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) convention in Las Vegas, Nevada, I met a nurse educator-researcher who encouraged me to contact a faculty member at UCLA SON who was her personal friend. After contacting the professor, I set up a meeting with her.

First, though, I met with another faculty member, who encouraged me to choose a research interest about which I was truly passionate, not one that simply coincided with my MSN degree. At that point, my interest changed from nursing education to teen-pregnancy prevention. A week or two later, I met the friend of the nurse I had met at the AWHONN conference. Unbeknownst to me, the area of nursing about which I was now most passionate was the research area of this faculty member. I was sitting face-to-face with a world-renowned expert in teen pregnancy, and I had no idea! The encouragement I received from these two faculty members only strengthened my resolve to obtain my PhD from the UCLA School of Nursing.

Watch for my next post on choosing a doctoral program.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.