One way for hospice and palliative care professionals to recognize our expertise is through certification. This involves a process that validates and evaluates expertise in a specialty area. While licensure assures minimal competency to practice in a field, certification indicates mastery of a defined body of knowledge. 

Even during this time of opportunity and increased exposure, the demands upon hospice and palliative care are increasing and often influence our commitment to our specialty. We all know the stresses of our daily work: the sometimes overwhelming demands of working with the terminally ill, the sense of duty we feel to our team, and the personal stamina it takes to confront life and death issues daily. Too often, the financial rewards are not great, and our compensation is not likely to increase significantly in a climate of decreasing reimbursement for healthcare whether we are certified or not.

So why, after a difficult day that often includes overtime, would we want to consider giving more of our own time to prepare for a certification test? Why, when perhaps our employer offers no incentive or financial reward, would or should we be willing to invest time and money in the certification process?

The certification process can have intrinsic rewards for the professional who commits to preparation and testing. These include:

  • a comprehensive review of the current body of knowledge for which the hospice and palliative professional is accountable,
  • participation with and learning from other colleagues in review courses or study groups,
  • sharpening of skills and knowledge in areas not utilized daily,
  • recommitment to excellence and expertise in the area of practice,
  • increased competence and confidence in practice,
  • recognition by peers and others in the field through credentialing and ongoing use of the title, and
  • future employment possibilities as certification become the expectation of employers of hospice and palliative care professionals.


We can and must be personally accountable for our practice. Our patients and families deserve the very best from each of us.

Several directors of large hospice programs have found certification to be of such benefit among their staff that they are sponsoring review courses and providing funds to offset the costs of certification for the staff. Others are giving certified staff increased wages. The National Hospice and Palliative Care Organization has a Quality Partners program that defines the components necessary for achieving excellence. Certified staff would be one quality indicator.

Individual practitioners have confirmed the value of certification. One nurse said, “I didn’t know how much I didn’t know until I started studying for the exam.” Another claimed, “Preparing for certification helped me to define the body of knowledge for which I’m accountable in my practice. It gave me new confidence in approaching physicians and advocating for my patients.” (Home Healthcare Nurse Vol.18 no.3 March 2000).