In December 2002, the American Association of Critical-Care Nurses (AACN) and the AACN Certification Corporation jointly issued a white paper titled “Safeguarding the Patient and the Profession.”1 Distributed as a call to action for all those who might influence or benefit from the contribution to patient care that nurses certified in critical care afford, the paper presents a cogent yet multi-faceted argument regarding the requirements demanded for nursing practice in this specialty. Attestations and confirmations that acute and critically ill patients admitted to hospitals today manifest greater complexity, comorbidity, illness severity, and age than those of past generations are offered in support of these positions, with considerable underscoring of one particular point—that is, that competent practice as a critical care nurse requires knowledge, skills, and experience that far surpass those required for entry level nurses to gain licensure as a registered nurse. If states enact laws regulating the initial...

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