Differences of Scope of Nursing Between States

rkitty198, BSN, RN · Mar 19, 2011

I have worked in Texas and Washington. The difference in Texas is that we have a peer review process, which I believe is the only state that does it. We did Peer Review for Safe Harbor (if our patient care assignment would endanger the patient) and Incident Based Peer Review. http://www.texasnurses.org/displaycommon.cfm?an=1&subarticlenbr=256

I am not trying to tell you how to do your paper, but an idea would be to take two states side by side, do some comparisons (to simplify) and then show the differences. I really think Texas would be a good state to review in your study because the BON functions a little differently than other states (in regards to its decision making models, delegation and so forth).

I think comparing what one state lets one RN do from another is interesting, but I think looking at the conceptual framework of how each one operates is even more interesting- which would be very time consuming, thus the two states side by side would then unfold differences that would be easier to measure.

Side note:

When I did Peer Review, I was told that Texas might have to do away with it because no other state participates in that type of process and it is one of the oldest forms of the process of its kind.

Again my opinion:

Interesting topic, I wonder how it would work out at the national level, because each state is responsible for it's own jurisdiction and the Boards of nursing protect at that level.

The state itself covers over the criminal and civil jurisdiction of the state. I think each state would have to agree on a national scope of practice and regulate it within its states borders. That could take forever! I actually think it is a really great idea. If you want to practice in another state, I think the transition might be easier because we as RN's already know what is expected. Then again each states nursing practice act is a lot like the other in terms of wording in the broadest sense, which is to follow the institutional policy in which one is employed.

I am interested in this topic :)

BrookeeLou_RN · Mar 20, 2011

I have worked in Texas and Washington. The difference in Texas is that we have a peer review process, which I believe is the only state that does it. We did Peer Review for Safe Harbor (if our patient care assignment would endanger the patient) and Incident Based Peer Review. http://www.texasnurses.org/displaycommon.cfm?an=1&subarticlenbr=256
I am not trying to tell you how to do your paper, but an idea would be to take two states side by side, do some comparisons (to simplify) and then show the differences. I really think Texas would be a good state to review in your study because the BON functions a little differently than other states (in regards to its decision making models, delegation and so forth).
I think comparing what one state lets one RN do from another is interesting, but I think looking at the conceptual framework of how each one operates is even more interesting- which would be very time consuming, thus the two states side by side would then unfold differences that would be easier to measure.
Side note:
When I did Peer Review, I was told that Texas might have to do away with it because no other state participates in that type of process and it is one of the oldest forms of the process of its kind.
Again my opinion:
Interesting topic, I wonder how it would work out at the national level, because each state is responsible for it's own jurisdiction and the Boards of nursing protect at that level.
The state itself covers over the criminal and civil jurisdiction of the state. I think each state would have to agree on a national scope of practice and regulate it within its states borders. That could take forever! I actually think it is a really great idea. If you want to practice in another state, I think the transition might be easier because we as RN's already know what is expected. Then again each states nursing practice act is a lot like the other in terms of wording in the broadest sense, which is to follow the institutional policy in which one is employed.
I am interested in this topic :)

Great idea! Florida seems to be one of the broadest nurse practice acts I have seen (no exert mind you) you might use them vs Texas. I personally believe there should be a National license and national BON. States would not be willing as they would lose the almighty$$ but I think it would be a way to stabilize nursing, the min education levels and all the other things that go back and forth over the years. Maybe appease each state by a portion of National fee goes to state you work in for that yr or something like that.

chuckster, ADN, BSN, RN, EMT-B · Mar 20, 2011

. . . I personally believe there should be a National license and national BON.

Not trying to be flippant, but isn't that what the National Council Licensure EXamination (NCLEX) is? And while there is no national BON, the test is developed by the National Council of State Boards of Nursing (NCSBN) which does have representatives from the BONs of all of the states.

widi96 · Mar 20, 2011

I'm not sure of many differences regarding those in the RN role, I know between KS and MO there are major differences in what APN's can do. They have much more freedom in their practice in KS. That's kind of what I'm looking for, but more so the differences of what RN's can do in certain states and can't do in others. It can be for APN's too, I'm just more interested in the RN role.

The reason is - Recommendation #2 from the IOM is in regards to nursing practicing to the fullest extent of their education and, as in the case of the APN in KS and MO, KS seems to feel they are more capable than MO does.

BrookeeLou_RN · Mar 20, 2011

Not trying to be flippant, but isn't that what the National Council Licensure EXamination (NCLEX) is? And while there is no national BON, the test is developed by the National Council of State Boards of Nursing (NCSBN) which does have representatives from the BONs of all of the states.

I was trying to say.. no need to get licensed by each state..a national RN license. I know NCLEX tests the same throughout all states but then each state requires a nurse to obtain a license to practice in that state. That is ridiculous in my opinion. If you passed NCLEX then you should be awarded a license to practice in the United States.

I feel this would regulate nursing in a all states are equal format not what we have now with each BON making their own rules. Wouldn't be helpful to nursing not to have to re-apply or apply for reprocity each time they wanted to work in another state?

elkpark · Mar 20, 2011

I was trying to say.. no need to get licensed by each state..a national RN license. I know NCLEX tests the same throughout all states but then each state requires a nurse to obtain a license to practice in that state. That is ridiculous in my opinion. If you passed NCLEX then you should be awarded a license to practice in the United States.
I feel this would regulate nursing in a all states are equal format not what we have now with each BON making their own rules. Wouldn't be helpful to nursing not to have to re-apply or apply for reprocity each time they wanted to work in another state?

(There are some other threads here discussing this issue, if you're interested in what others have posted on the topic. I'm one (of many) who is strongly opposed to the idea.)

atokarz · Jan 16, 2012

Hi,

I am actually researching the same exact topic for a work related project. If you could email me where you have found most of your information that would be extremely helpful. Thanks!

My email address is [email protected]

Thanks,

Andrew