The Ultimate Guide to Understanding Continuing Education for Nurses

Continuing ed? Say what? I just completed my degree! Most of the time, we think of a college education as a one-and-done proposition. You get your degree, go out and start your career, and never darken the door of a classroom again – at least, maybe, until you retire and take a sculpture class for fun at the local community college. But many professional careers aren’t like that. In certain professions – like law, accounting, social work, or health care – regulations, techniques, and technology change quickly, sometimes from day to day. That’s real life – the things you learned in nursing school when you earned your BSN may not still be the way things are done a year from now, or even a month from now.

The pace of modern healthcare means that you’re never done learning your craft, and that you can always learn something new that makes you a better nurse. To be a responsible, effective nurse, you have to keep learning. Sometimes, though, people can’t be trusted to keep their expertise, knowledge, and skills current on their own time – or on their own dime. That’s why, in just about every state, registered nurses have to take continuing education courses to keep their credentials. That’s where CEUs come in.

What is a CEU?

If you’ve gone through the process of getting your BSN and taking the NCLEX exam for your RN license, you have probably already heard about Continuing Education Units (CEUs) from your teachers or fellow nurses. Before you entered the world of healthcare, it may never have occurred to you that the nurses who draw your blood, check your vitals, and give you a sticker at the end, had to keep educating themselves from year to year. Many prospective caregivers start their nursing education not realizing that nursing education is never actually over.

In most states, keeping your RN license means earning a certain number of CEUs every year. A CEU is simply a measure of how many “contact hours” of continuing education you have – that is, how many hours you sat in a classroom (or at a computer) learning new things that increase your skills or knowledge. That number can be very different from state to state. In the state of North Carolina, for instance, RNs need 30 CEU hours every two years, or 15 if they are credited as an investigator or author on a research project. In New York, on the other hand, only 3 hours every 4 years is required (or every three years for nurses who have DEA clearance to work with pain medication), but they have to be in specific areas: child abuse reporting and infection control.

To earn the CEUs you need to renew your RN license, you may need to take courses in things like:

  • Changes in regulations
  • New techniques or treatments
  • Emerging technology
  • Diverse communities
  • New public health dangers
  • Cutting-edge research

In some cases, these are things a nurse will learn on the job; if there’s a previously unknown strain of flu ripping through the public schools, nurses will be the first to notice it. But in other cases, nurses may need more incentive to catch up on trends and developments in the field; it’s the rare nurse who gets home from a 14 hour shift in the ER and wants to curl up by the fire with a scholarly journal on medical research.

So, like it or not, to keep your RN license, CEUs are a fact of life.

Where Do I Earn CEUs?

The good news, as far as convenience goes, is that nurses can earn their CEUs in all kinds of different ways and places. The essential thing is to make sure the the CE courses you are taking are accredited by a legitimate, nationally-recognized accrediting body. In almost all cases, that should be the American Nurses Credentialing Center (ANCC), which is a part of the American Nurses Association (ANA). If the course you’re taking is not ANCC-accredited, your state board is probably not going to accept it.

Throughout the time period you have before reapplying for your license – which varies between states, but is generally somewhere between 2 and 4 years – you will need to look into finding courses that will earn your required CEUs. Those courses may come from:

Community College/College/University: The absolute most secure way to earn CE credits is from an accredited community college, college, university, or private nursing school. Since they’re already regionally and nationally accredited, almost any nursing continuing ed course from a college will be approved by the nursing board. The courses need to be nursing-related, though; save that sculpture class for retirement.

Hospitals: Many larger regional or research hospitals will provide CE courses for their employees and other nurses in the area. Since offering courses can often be expensive, these tend to come from the more well-funded hospitals; smaller institutions may just not have the means to do it, but that doesn’t mean you can’t make the trip to the larger hospitals that do.

Professional Associations: Who better to offer continuing education activities for nurses than other nurses, through a professional association or organization? Professional groups like the American Nurses Association exist for the purpose of uniting nurses, bringing professionals together to do things for themselves, and that includes continuing education. Once you join a network, pay attention to their communications – you should see opportunities announced in their emails or newsletters.

Online Providers: Many colleges and universities offer plenty of CE nursing courses online, but these days, there is an abundance of companies that provide CE courses fully online. These companies may be for-profit, or they may be nonprofit. The important thing is whether they are accredited or not. If they’re not recognized by the ANCC, they’re not going to be recognized by your state board.

Workshops/Seminars: CEUs don’t necessarily have to come from classes. Since the need for continuing nursing education is very well known, there are many events like workshops, seminars, and research activities that are approved or accredited to count toward CEUs. Groups like the ANA or similar agencies are a good source for information on where and when to find these. In fact, earning CE credit is the #1 reason many nurses attend conferences and conventions – #2, if there’s free coffee.

It’s important to note that, in most cases, your day-to-day work cannot be counted toward CE units. CEUs have to come from formal classes, workshops, seminars, or similar experiences. Depending on how open your state board is, you may be able to make an argument that a class or activity that is not explicitly a “nursing class” still pertains to your profession, but be careful. This is not an “ask forgiveness, not permission” situation – if the board doesn’t accept your credits, you’re out of luck.

Do I Have to Pay for CE Classes?

Maybe, maybe not. In some cases, it will be totally on you to pay for your own continuing ed courses. After all, it’s the cost of doing business. But there are more than a few ways to get your CE paid for, so you can keep your license, and your job, at no cost to you.

You may be able to get your CE requirements for free depending on:

Employer: It’s very common for employers to pay for part or all of their nurses’ continuing education expenses. After all, it’s pretty important for hospitals and clinics to make sure their licensed RNs stay licensed. In fact, many larger, well-funded hospitals will hold their own accredited continuing education classes and events, keeping the whole process conveniently in-house.

Union or Professional Association: Unionized nurses have access to many more perks and benefits than non-unionized nurses, and often one of those perks is paying for, or holding, continuing education courses. The New York State Nurses Association, for example, offers free online CE courses for their members, holds workshops throughout the state, and partners with providers to offers discounts on educational opportunities.

Free Online Courses: It’s the 21st century. Real life is online. And just as more and more nursing students are turning to online RN to BSN completion programs, working RNs who need to complete their CEUs are turning to online CEUs. Many of these courses are free, or very cheap. That, of course, is totally acceptable – as long as those online courses are accredited and approved by your state nursing board. That is something you’ll have to take up with the board in your state, however.

Unfortunately, these sources are not available to everyone. Very few nurses are part of a nursing union; only around half a million nurses are represented by a union, but there are well over 4 million RN and LPN nurses in the US. And most nurses do not work for a large hospital or well-funded clinic; the majority of nurses work for doctor’s offices, small clinics, and local or regional hospitals that may not be able to afford to pay for continuing education, or offer their own CE classes.

There is some good news, though; if you qualify to itemize your income taxes, oftentimes CE fees are tax deductible, so you get some financial benefit from improving your credentials (besides keeping your job).

Get Credit, Keep Working

The process is different in every state, but there are some very broad similarities and guidelines that are roughly the same everywhere. For one, you have to have a valid RN license to practice as a nurse in any state. Every state requires that those licenses be renewed periodically. And to renew your license, pretty much every state requests some kind of continuing education to prove you are still competent and capable of doing your job.

That’s when you have to get credit for your CEUs. Now, what that process looks like is going to depend on your state, but you can count on one thing in every state – there’s going to be a lot of paperwork.

Take North Carolina, for example. It’s a big state for healthcare, and its requirements for nursing licensure are very strict. RNs have to renew their license every two years (on the last day of their birth month, so they can’t forget), and in order to renew, nurses have to complete a significant number of CEUs. These Continuing Competence Requirements (as they’re officially called) have to be done before renewals take effect, and there are no grace periods or exceptions.

Now, for full-time working nurses, the requirement is 15 CE hours and 640 hours of practice; nurse researchers can fulfill the requirements with 15 CE hours and credit as an author, co-author, or investigator on a research project. Nurses without any of those have to complete 30 CE hours to renew their license.

It’s a Matter of Fact

Then come the forms: self-assessment worksheets; learning plans; documentation of employment; evidence submission. They’re not going to take your word for it; everything has to be proven.

Of course, working nurses fill out reports all day, every day; they’re not afraid of a little paperwork. This is just to say, there is a process, and that process is critical to keeping your RN licensure. Every state isn’t going to look exactly like North Carolina; some will be more involved, some will be simpler. But actually taking the course, attending the workshops, or sitting in on the seminars is only part of the job.

Most of the time, if you’ve earned your CEUs from an accredited provider, your state board is going to trust it; the official forms you fill out will be enough. But just in case your renewal raises any red flags and gets you audited, be smart. Keep records of any courses or events you attend for at least a few years, and know where they are. If the board of nursing ever questions your credentials, you will be able to prove that you did what you say you did, learned what you say you learned, and are qualified to work as a registered nurse.

Don’t Sweat It

There are probably a lot of newly-graduated RNs and BSN nurses out there who think about CEUs and shudder. You just got out of school, and you’re not in a hurry to go back. Most people who go into nursing like the hands-on, face-to-face work of caring for patients; the classroom is not for them.But don’t worry. Even if you don’t care for school, CE courses can be a lot of fun, as well as opportunities to network with other nurses.

Look at your continuing education like exercise for your mind. If you choose an exercise you don’t enjoy, your body won’t like you, but if you find a physical activity you actually have fun doing, exercise won’t seem like work. The same goes for your CEUs. Try different formats, different topics, and different settings, and you may turn earning your CE credits from a chore into a welcome break from the daily grind.