How to master the CRNI exam
Tips from those who know firsthand
As a home infusion nurse, there's no higher credential than CRNI (certified registered nurse of infusion therapy). But with the horror stories you've heard about the exam, maybe you've been putting off taking the plunge. First, some horror stories are true, to which the 62% pass rate attests. (For more statistics on the exam, see p. 68.)
The test is not impossible, though. Just extremely difficult. But with proper preparation and hard work, you too can become a CRNI.
Why CRNI?
If you're in it for the money, you're in the wrong field. But if you truly care about patients and want to provide the best care possible as well as add a personal level of expertise and credibility, then you should consider becoming a CRNI.
"Once you achieve the certification, you are viewed as an expert, and the exam certainly has to be at a level that it tests your levels of knowledge and expertise that would reflect the fact that you are an expert," says Darnell Roth, CRNI, CEO of DR Intravenous Therapy Consulting, a St. Louis, MO-based company offering continuing education in vascular access and infusion therapy.
"Credibility was really important for me because I teach it," says Fran Powers, MED, CRNI, the IV Nurse Educator for the Warwick, RI, branch of PharMerica, a pharmaceutical company specializing in long-term care facilities and nursing homes. "Also, if you are doing a lot of infusion, I would certainly suggest it. It doesn't give you an increase in pay most of the time, but it does increase your credibility."
"Becoming a CRNI sets the nurse apart as an expert in the field," notes Marilyn Booker, RN, MS, CRNI, an infusion therapy consultant in Hughesville, MD. "It indicates the nurse's commitment to the profession and to patients."
In addition to the increased credibility, Powers says taking the test forces you to learn more about IV therapy, as well as staying current with the latest information as you maintain your certification.
In the end, though, it comes down to making a personal commitment to your clinical specialty.
"It is a decision to take a step through that doorway to a higher level of responsibility and a commitment to excellence in practice," says Kay Coulter, CRNI, of Coulter Consulting in Clearwater, FL. Follow these tips to prepare:
1. Find a personal approach.
Each of the CRNIs who spoke with Home Infusion Therapy Management emphasized finding out how you study and learn best and how to stick to that approach. What works for one nurse may not work for another.
"You must identify and be familiar with your individual learning style," says Coulter. "We learn through either visual, auditory, or tactile. If someone is tactile, and they need to write something down or feel it and they listen to tapes, it won't be as effective. I stress that people must find out what works for them."
You also need to find out where your own strengths and weaknesses regarding infusion therapy are.
"Before you even begin studying, you should do a very thorough self-assessment to determine what in the content area is your weakest point," says Roth. "Not that you'll skip any sections, but you'll know where to concentrate."
2. Choose your weapons.
There are numerous study guides and resources available to help you prepare for the exam. Again, the key is once you've established how you learn best, choose the tools that fit your strengths.
There are numerous reference tools, but some come highly recommended, several of which are "essential." First, get a copy of the Intravenous Nurses Society standards.
[Editor's note: You can contact the INS for information on its standards and study guides at (617) 441-3008.]
"This is a must," says Roth. "Test questions will never reflect regional or geographic practice, but they will reflect the INS standards of practice." You should also use the textbook Intravenous Therapy: Clinical Principles and Practice, published by INS.
The Intravenous Nurses Certification Corporation, which administers the CRNI exam, also offers audio and video tapes as well as a study guide. "The audio tapes are a great tool for a home care nurse who travels a lot either to work or from patient to patient," says Roth.
Powers used the INS video tapes and took notes from those. "I would say that 90% of the questions came right from the videos," she says.
Booker also found the videos helpful. "I prepared for the exam by watching videotapes purchased from the INS," she says. "I also read everything I could get my hands on. The Journal of Intravenous Nursing and the INS Standards of Practice were very helpful."
Ann Williams, CRNI, an infusion nurse at Deaconess Home Medical Equipment and Infusion in Evansville, IN, an IV nurse consultant, began with Coulter's CRNI review class in June for the test in September.
Coulter says the most frequently quoted benefits of attending a review are:
· provides direction for focused study;
· helps identify areas of strength and weakness;
· increases awareness of the depth of the knowledge required to pass the exam;
· increases confidence when taking the exam.
"I didn't know where to start, and her class gave me direction," says Williams, who took the class' study guide and made flash cards.
"They went with me wherever I went, so if I had free time, I could study," says Williams. "I had a separate group of cards for pediatrics and another group for chemotherapy."
Other options are to take a CRNI review program or start a study group of other nurses planning on taking the exam. "I can't think of any preparation that I would recommend against," says Booker. "Any method that provides you with current and accurate information and complies with the INS standards of practice is worthwhile."
3. Start early.
Leave plenty of time to prepare, to the tune of several months, if you want to do your best.
"Regardless of your background, leave ample time to study for the exam," says Roth. "I took the exam in April and began studying in January."
Powers started studying three months before the exam, and Coulter four months.
"Three to four months is a reasonable time frame because of the mass of information that has to be assimilated," says Coulter. "If one tries to do this in four weeks, they could feel so overwhelmed that the task may seem unachievable. That's not to say it can't be done, but for the majority of people, three to four months is best."
Once you've given yourself a time frame to work in, you need to set aside a certain time each week during which you'll study. Otherwise, with personal and job commitments, you may not find the time to study. Coulter says this is critical. "Most people have difficulty maintaining a dedicated schedule committed to study," she says. "'Life' tends to intrude and distract us, so one must be extremely disciplined."
"I scheduled a certain amount of time each evening to study," says Williams. "But you could set aside two hours every Monday night. You have to pick what works for you and treat it like a meeting you have to be at."
Roth suggests setting aside 10 hours worth of time to study each weekend, and letting others around you know that the time is for study.
"You need to set up ample time without distractions: You can't do this in the living room with the television on," she says.
"On Monday nights for four hours, my family knew they had better not talk to me," jokes Coulter. "If you have to, go to the library."
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