Hyperbaric nursing had its origins in the 1950’s, in Europe. Nurses were called upon to support multiplace chambers as the practice of hyperbaric medicine evolved from the treatment of divers (undersea medicine) to those illnesses and diseases suffered by more traditional patient populations. Initially, nurses learnt their roles via on-the-job training. By the 1960’s, formal training became available and was soon an essential prerequisite. This period coincided with the introduction of monoplace hyperbaric chambers.
Many such hyperbaric nurses were experienced in critical care, emergency room, and medical-surgical areas, which reflected the nature of the early referable indications. They were cross-trained in hyperbaric oxygen therapy. Nurses eventually became involved and published in clinical research. In 1978, the first US hyperbaric conference included workshops specifically for nurses. It was sponsored by the Baromedical Department at Memorial Medical Center in Long Beach, CA. In 2002, the first Hyperbaric Nursing Textbook was published.
In 1985, the specialty of hyperbaric nursing became formally recognized with the founding of the Baromedical Nurses Association. The BNA, now an international organization, develops and maintains standards of practice in baromedical nursing. The BNA defines baromedical nursing as “the diagnosis and treatment of human response to actual or potential health problems in the altered environment of the hyperbaric chamber”. The role of the hyperbaric nurse is multifunctional and includes the clinician, educator, research and manager. The goal of hyperbaric nursing is to provide safe, cost-effective, quality patient care, according to established standards.
In the early 1990’s, a BNA committee chaired by Diane Norkool wrote the first set of nursing certification questions with the goal to provide an added competency to hyperbaric nursing. Dick Clarke, President of the NBDHMT, invited the BNA to be a part of the NBDHMT certification process. This occurred and established according to nursing regulatory guidelines in that 40% of the examination would directly relate to nursing activities, the balance of the exam being technical, safety and operational. The Baromedical Nurses Association Certification Board (BNACB) was established in 1995. The first nursing certification was given in 1995 and was taken by the Board members of the BNA. There are currently over 900 hyperbaric certified nurses. The nurse may achieve the level of CHRN (Certified Hyperbaric Registered Nurse), ACHRN (Advanced Certified Hyperbaric Registered Nurse) or CHRNC (Certified Hyperbaric Registered Nurse Clinician).
Training programs for nurses are provided and approved as NBDHMT accredited Introductory Hyperbaric Medicine Courses. Certified hyperbaric nurses are required to maintain continuing education credits to be eligible for recertification.
A BNACB process is in place for validating the requirements for each applicant taking the CHRN certification exam and for their subsequent recertification. Nursing questions are updated by the nursing committee of the NBDHMT. The NBDHMT maintains the confidentiality of the question bank and administers and grades the tests. Certificates are issued by the BNACB; reminder letters are sent by the NBDHMT three months before recertifications are due. Nurses are responsible for notifying the NBDHMT of any updated contact information.
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Updated December 31, 2018