?? A "National Nursing License" (RN) - page 2

Just out of curiosity...........what do all of you think about the feasibility of there being a National Nursing License, for RN's? What would some of the "pros" and "cons" be? I live... Read More

  1. by   RNforLongTime
    I was originally licensed in PA back in 1997 as an RN. Then it cost me 35 bucks for an original license. When I renewed for the first time in 1999 it cost 21$--no CEU's required in PA. Now that I am licensed in OH--it costs like 40 bucks every two years PLUS I am required to earn 24 CEU's -one hour of which HAS to be related to Nursing Laws in Ohio. I just received my new PA license-good till 2003--they RAISED the cost to 45 bucks--still no CEU's. i am currently practicing in OH--but you never know when I may decide to go back to work in PA.

  2. by   frustratedRN
    PA raised their fees too but i cant remember how much they went to.
    a national nursing license is a great idea but what is to stop those from malpractice just moving to another state on the same license?
  3. by   Jenny P
    Bonnie, you are wrong about Minnesota being part of the Nurse Licensure Compact- to practise in So. Dakota, Iowa, Minnesota, Wisconsin, and No. Dakota, you need a license for each of those states; PLUS, if you wish to work as an RN in No. Dakota, you MUST have a 4 year Bachelors' degree in nursing.
    There are many reasons why states want to be part of the compact; and there are also many reasons why states don't want to be part of it. Pro reasons: simplification of regulations to track nurses; easier to exchange information on nurses; decrease paperwork. Cons: decreased revenues for boards of nursing; Nurse Practice Acts would have to change and become more similar to each other; less control of who is working in each state. The other reason that many states are against it is that, yes, each state has its own Nurse Practice Act, but many of the rules concerning nursing practice in a state are not in the Nurse Practice Act but a regulatory: I think it is New York that has a mandatory rule about reporting any suspicions of child abuse to authorities (I think I remember that I was told a few years ago that this was like a 10 page rule booklet or something), but that isn't in its Nurse Practice Act.
    You used to be able to get information from the National Council of State Boards of Nursing's web site, but now it looks like the nurse Licensure Compact part of that website is locked and only for NCSBN members only. (www.ncsbn.org)
    I think that the last time I checked, there were about 7 states that were members of the Nurse Licensure Compact. I can't see North Dakota becoming part of it (because of the BSN/BAN requirement); and I don't think Minnesota would be part of it either. Minnesota has a good program for working with impaired nurses (and other impaired health care professionals), and also its continuing ed requirements. Plus our state nursing association has reservations about becoming part of the compact. And I'm sure the Mn. State Board of Nurses would miss the $$$$$$$.
  4. by   WriteStuff

    Thanks so much for your information Jenny. I had heard about the compact when I first moved here three years ago. But I couldn't remember with accuracy a lot of the details.....I appreciate your "filling me in."

    Do you know if in North Dakota, where the minimum level for practise is a B.S., are the Diploma Grads "grandfathered" in? There are probably a lot of Nurses still practising who graduated from the three-year hospital diploma programs, way back then "in the cave days." :0)

    Just curious.

    Thanks again.....

    Bonnie C.
  5. by   CEN35
    the states all want their share of the money. Pay out $25 -50 and let ALL the states share in it? NEVER happen.

  6. by   Jenny P
    Bonnie, North Dakota went for the Bachelor degree in a big way. I graduated from a 3 year diploma school in North Dakota MANY years ago, and yes there are still many of us around. But what N. D. did was to set up a tele-learning system so that all of those ADNs and Diploma nurses could earn their BSNs at their local hospitals. (Please help me here, you North Dakota nurses; it's been a few years since I studied this and I may have it wrong). So I don't think they were grandfathered in; but rather given a specific time frame in which to earn their bachelor degrees; then after that time, they either had earned their degrees or didn't work as RNs anymore.

    The interesting thing is that North Dakota is one of the few states in the US that does NOT have a nursing shortage! Go figure!
  7. by   myst
    I know this sounds simple, but a national licensure would ensure a national standard of practice, holding all accountable to the same levels of excellence. No matter where you went, there would be the same expectations present. I also think this would be a fantastic idea for M.D.'s and Lawyers...... at least it'd be one way to ensure some level playing field as far as knowledge level goes.

    I'm all for it!
  8. by   WriteStuff
    Thanks for answering my question Jenny P.
    I often wondered what would happen to the rest of us who aren't "B.S.'d" yet. I know that many years ago, when the Diploma Programs were all phased out and they instituted the A.D. Programs, the "talk" then was of "grand-fathering" everyone in if the B.S.Degree became the minimum entry level standard by the states.

    I think the idea of "grand-fathering" was a throw-back idea from WWII when a lot of women went off to the war front to care for injured soldiers, and returned stateside more experienced and knowledgeable than licensed nurses in the hospitals in those days........so they were "grand-fathered" in as Licensed Nurses just because of their experience.

    Although I have a "mixture" of both programs, the Diploma Program always made "more sense" to me because of its greater emphasis on the clinical experience for students. The 4yr. programs (B.S.) are so heavy on theory, and light on clinical, when students graduate and enter the work force they're short of "terrified" in the clinical setting. That's just my extremely humble opinion based on my own observations of new grads coming into the hospitals over the years.......it doesn't make it necessarily the truth. And that subject (differences in "readiness" from each program i.e. , A.D. , B.S.N., could be another whole thread).

    Bonnie C., RN
  9. by   Jenny P
    Myst, there is a problem here with your thinking (according to some state regulatory boards, anyway). It appears that here in Minnesota, the State Board of Nursing sees its function as protecting the public from poor nursing practice, while the State board of Medicine sees its duty as protecting the physicians from the public! (I have no clue who protects whom in the case of lawyers!).

    Also, each state board of nursing sees its duty different from other states. Some states feel that only by doing X number of CEUs can ensure that a nurse can remain licensed, while other states don't think CEUs are a big deal. In some ways, the Nursing Licensure Compact could be compared to drivers licenses: you can use it in every state; but you have to follow that particular states' rules while practicing (or driving) there.
    Several years ago, Montana had its freeway speed limit posted as being "reasonable and prudent." Now that meant (according to my brother-in-law) that IF you had a decent vehicle and the weather was good, you could go 80-100 MPH on the Interstate. If you had an old gas-guzzling, oil-burning, rusted-out beater with a cracked windshield, though, you might get a ticket doing 40 MPH! But if someone with a valid Montana drivers license tried driving at those speeds (either too fast OR too slow) on the freeway in another state (say, Minnesota); they would be ticketed for breaking the law here.

    The same thing can happen with the Compact. Each state has its own Nurse Practice Act which meets the state regulatory laws for that particular state. Those laws are passed by that states legislative body, and that is where each state gets its Nurse Practice Act- by that particular states' unique laws.
  10. by   rjlrn95
    Maybe we should have to retake the nclex every so often, PLEASE no hate mail, but it would keep us on our toes. It is theory and not practical--maybe they would have to rewrite some of the questions--ha.

    I agree with the differences in clinical readiness. I see that right here in my area and the ADN programs. One school is heavy in clinical hours and another in theory. Unfortunatly for me I came out of the one heavy into theory and I was terrified for the first 1.5 yrs of practice. Also allowed me to be intimidated by other more "experienced" nurses on the floor. There are still days I question myself, even when I know I'm correct.
  11. by   BrandyBSN
    I guess I never really understood the arguement that BSN programs were light in clinicals. True, we are heavy in theory, but as juniors, we log 14 hours in clinicals a week, and as seniors, we log a minimum of 12 a week. When we graduate, we will officially have completed a minimum of 1100 hours of clinicals. (1100 is the minimum for graduation). the two ADN programs here only does 8 hours a week, just on wednesdays. Granted, each program is different, and state requirements are different, but i definatley dont think that just because we are heavy in theory doesnt mean that we dont put in the time in the field too
  12. by   WriteStuff

    your comments are well-taken brandy and i understand what you are saying.
    those of us who either graduated from, or at least "remember" the days of the diploma programs recall that it was a period in time for nursing when the "mindset" was for preparing nursing students to come out of school and be able to function (with a minimum of fear and intimidation) in the hospital environment almost immediately.
    we're talking 30 and 40 years ago and such a "mindset" was realistic given the "stage" of development we were in where medicine, science, research and technology are concerned.
    with the explosion of advancing technology, along with our knowledge in science and medicine, came the need for our profession to keep up. that's why our preparation moved into the college and university arenas. and rightfully so.
    i know for myself, having had the benefit of the college program, that my knowledge base has served me well in terms of making judgement calls in my work setting when it has been demanded of me. this is where the real "difference" lies when we start comparing "programs" of preparation. i'm not one to "bash" anybody's program (a.d. vs b.s.n.), because regardless of our program of preparation, it is the actual experience we gain when we start working that is the "tell all."
    and we must not overlook the fact that "personalities", temperment, and motivation of each of us plays a vital part in the kind of nurse we end up becoming.

    some of us view nursing as "just a job to do, get the pay check" and "i'm outta here!" nurse's in the profession who fit that description stick out like the proverbial "sore thumb."

    bonnie c., rn
  13. by   rjlrn95
    Brandy, I didn't in any way mean that any of us were underprepared, just that some programs emphasize diff areas and for some it will make a diff in their experience. Every student has a diff level of learning and comfort and ability==I guess my point is that it is a shame we don't know these things going into the programs.