Federalize Nursing Licenses! Who's with me? - page 3

Okay, I've had it. Over the past few months I've spent several hundred dollars on nursing licenses for three states. Between fingerprint fees, license fees,transcript fees, notary fees and worst of... Read More

  1. by   rollingstone
    Quote from SmilingBluEyes
    I am curious. NOT disagreeing with you outright, but can you please expound on this by explaining WHY you prefer to pay for several licenses by state?
    Just opposed to the bureaucracy and what's to say a federal license wouldn't end up costing more. Would just prefer the states to work it out as some are already doing with compacts.
  2. by   Sheri257
    I wouldn't want it. There are certain standards that my state has adopted that other states haven't that I think are important for the profession. I'm happy with the BORN in my state wouldn't want any other regulatory authority handling these matters.

    I also don't think a driver's license is the same as nursing. As we all know, the skill level and regulatory issues are much more complicated than driving a car.

    Last edit by Sheri257 on Apr 30, '04
  3. by   bellehill
    The compact state idea is great but keep in mind that you must live in one of the states in order to use the compact. For example: I hold a NC license from when I lived in NC, when I started traveling I gave up the NC address and thus gave up my ability to use the compact. When I was trying to be licensed in AZ (which is a compact state) I had to apply and pay all applicable fees because I did not live in a compact state. Make sense?

    I love the idea of a federalized license, even if it costs a little more. Lets get all the states using the same scope of practice and get everyone requiring the same amount of CE credits.
  4. by   mobileLPN
    while I wrote federalize in my OP, I actually think that the same goal could be accomplished by simply mandating that EVERY state grant reciprocity through a framework like the Interstate Nurse Licensure Compact. If federalization were to occur though....... The argument about nursing being more complex than driving doesn't quite work when you consider the Airframe and Powerplant license post. A&P is a highly specialized skill requiring extensive education, critical thinking and often has hundreds of lives depending on it being done well. If these licenses are federal, why not nursing? Someone mentioned that the cost and beauracracy would be greater. There is no way that it could cost any more in money, or in paperwork than what I've paid for just 3 states. As far as tracking problem nurses... a total non-issue. As I mentioned in my OP, I can go to most Boards websites, type in a name and 5 seconds later have the status of that individuals license, its expiration date, etc, etc... Good discussion!
  5. by   cenote
    Simple Reciprocity mandated by the Feds would be enough. Each state would be required to recognize that an RN can practice in any state on passing the NCLEX and with the credentials granted by her state. An extra fee to grant practice priviledges could be required (so the states wouldn't balk too much and can get their greedy hands on our money). But the license acceptance would be automatic with forwarding of a copy of records by each state mandatory (they would be so happy since our state could charge us a fee for each copy sent).

    Elimination of fingerprinting and background checks could be controlled by a central clearing agency. Simply put. Every employer would be required to send in a simple form with our name and license number so that a record could be kept of every place we practice. Any problems with the nurse could also be reported to the same agency. Any state that wanted to check on a nurse could do so.

    I'm sure there are many ways to accomplish this without too much trouble. Regardless , its WAY OVERDUE.

    Our national organizations are lax in helping with this. We may just need to rise up and demand this action. Ready for revolution?:hatparty:
  6. by   Hellllllo Nurse
    I think scope of practice should be the same in all states, too.
  7. by   HealinghandsRN
    Quote from Shezam!

    That's one of the best ideas I've heard in AGES!!!

    Definitely needed in today's world of travel nursing!

    [font=Comic Sans MS]I had to write to tell u, I absolutely love the quote u have....Perfect words for that feeling.....
  8. by   SunnyRn2B
    DITTO THAT! I,m not an RN yet, but I want to travel after I get some time in.
    I think this is a GREAT idea. Someone has their thinking cap on. I will be keeping up withthis idea and see if I can join others that would like to see a change in licensing. It would be nice to see nurses going where they are needed without having to go thru red tape everytime they go to another state. Time for a change!
  9. by   ParrotHeadRN
    I know I will sound completely ignorant here :imbar , but can someone please explain to me what a compact state is?
  10. by   mobileLPN

    simply put, if you live, and hold a license in one of these states, you can use that license to practice in any of the other states listed.

    "civil disobedience becomes a sacred duty when the state becomes lawless and corrupt" - Mahatma Gandhi
  11. by   oramar
    Quote from mobileLPN
    Good link to know about. I looked around it to see if it contained info about Pennsylvania, didn't not see any. It could be there, I may not have found it. I would like to know about Pa. and compacts. I have never heard if Pa. has any compact states.
  12. by   NRSKarenRN
    from listing to the sbon presenting at the psna conventions, here is what i can recall is pasbon concerns. maybe pattyjo can remember more..

    state sovereignty
    interstate compacts are formal, binding contracts, entered into voluntarily by two or more states, that require consent from congress under the compact clause of the u. s. constitution. because each state surrenders some measure of sovereignty when it enters into a compact, the compact provisions likely would supersede conflicting state statue.

    pa state legislature is well known for being conservative and protecting "state sovereignty". the pa sbon has had concerns regarding pa regulations on who can become a nurse and practice issues being stricter than some other states. these regulations are seen as a measure of "public protection". therefore, if pa became part of the compact they would lose some of the public protection measures.

    discipline of pa licensed nurses
    the sbon already spends 75% of its time on disciplinary hearings at meeting. how they handle practice issues and dicpline pa nurses may be different from a compact state. compact states have not fully discussed this issue.

    [color=#aa5522]from ojin 1999 article:
    [color=#aa5522]the regulatory dilemma surrounding interstate practice
    by terri gaffney, mpa, rn

    [color=#aa5522]issues related to interstate practice

    this article will address four specific issues related to interstate practice, namely, state sovereignty, discipline, information sharing and regulation of advanced practice registered nurses.

    state sovereignty
    the onset of nursing regulation in the u.s. dates back to the early 1900's. nurses advocated for a registration process as a means to establish recognition for nurses and to protect public health and welfare. the first state to enact a registration law was north carolina in 1903. new york, new jersey and virginia soon followed.

    although regulating health care providers is within the powers of state governments, the state's authority is limited. the u.s. constitution establishes that
    1. the regulatory scheme must be a "rational relationship" to a valid purpose and
    2. the regulatory scheme must provide a person who is denied the right to practice the profession certain procedural rights.
    a "rational relationship" is established when the following conditions are met (deloughery, 1991). first, the regulatory law must be intended to protect the public from licensees that are incompetent or unfit to practice. and second, regulation must be deemed to be a "reasonable means" of accomplishing the goal of public protection.

    the nurse licensure compact offers a convenient way for nurses to practice in a party state (a state participating in the compact) without obtaining another nursing license. however, it remains unclear whether the model adequately protects the public, particularly when the state (as well as the public) has no means of determining in which of the 50 states a nurse is practicing at any point in time.

    one public protection concern arises when nurses practicing remotely in another state are not held to the same licensure standards as those who are licensed in that state. states currently establish qualifications for licensure which may include residency restriction, education criteria or continuing education requirements. nurses licensed in a party state (a state participating in the compact) but practicing, either physically or electronically, in a remote state would be exempt from qualifications established by the remote state. additionally, in some instances a party state could take action to limit the nurse's ability to practice in a remote state, but if the home state failed to take action against the nurse's license, the nurse would be free to practice in any other party state. each of these factors infringe on the ability of the state to establish a regulatory means to protect the public, thus impacting state sovereignty.

    the constitution guarantees that certain procedural rights be provided to persons denied the right to practice their profession. generally the compact allows any party state (a state participating in the compact) to take action against the multistate licensure privileges of any nurse practicing in that state, meaning that a state can withdraw this privilege to practice in that state. however, only the home state many take action against the license itself (i.e., revocation or suspension). hence a nurse may experience two disciplinary processes, one related to the multistate licensure privileges and a second related to privileges in the home state. it is important to ensure due process and to avoid unfair burdens on nurses attempting to defend their ability to practice safely. the right of the individual nurse to a fair hearing of any disciplinary action must be preserved without the nurse incurring unreasonable or unfair burdens, such as financial costs, in pursuing this right.

    information sharing
    another component of the nurse licensure compact is the establishment of a coordinated licensure information system (clis) to be operated by a nonprofit organization comprised of state boards of nursing. this data bank would contain personal information, licensure information and disciplinary information.

    currently, the ncsbn maintains a disciplinary data base. although states may choose whether or not to report adverse actions taken against nurses, a number of states do contribute disciplinary information to the data bank. the benefit of such a mechanism is the sharing of information between state boards of nursing. thus nurses who are disciplined in one state cannot easily relocate to another state to practice.

    [color=#aa5522]while the disciplinary data base has great merit, concerns related to the privacy and confidentiality of information held by a new data system remain.

    while the disciplinary data base has great merit, concerns related to the privacy and confidentiality of information held by a new data system remain. since there is a trend to make licensure information more publicly accessible, nurses should be interested in the data elements contained in the clis and what entities, other than state boards of nursing, would be entitled to access clis data. as with all information date bases, nurses deserve some assurances regarding the range of information that will be available through the clis, and to whom it will be available, particularly since personal information such as home address and telephone number will be contained within the data base. an ana house of delegates backgrounder report (1998b) noted that the rapid explosion of communication technologies has already posed a significant challenge to a number of governmental and non-governmental bodies regarding public access to information.

    regulation of advanced practice registered nurses

    finally, many questions remain as to the effect of the compact on advanced practice nursing. currently, the compact provides multistate recognition for the practice of rns and lpns only, not advanced practice registered nurses (aprns), who are educated and certified at a more advanced level than are rns and lpns. although aprns are not included in the compact at this time, the ncsbn is currently developing a separate compact to address aprn practice.

    perhaps, however, a better approach to resolving the diverse education and certification requirements for apns are uniform licensure requirements. as minarik (1999) states, "rather than adopting the complex approach of interstate compacts for the regulation of advanced practice, nursing should seize the opportunity to promote a uniform acts model of licensure for apns" (p. 93). uniform acts are not contractual agreements between states, but rather guides for states that wish to enact individual legislation. such an approach maintains state sovereignty while addressing the education, certification and scope of practice issues that currently vary from state to state for aprns.

    Last edit by NRSKarenRN on May 2, '04
  13. by   mobileLPN
    thanks for posting those NRSkaren. I think those points are much stronger arguments for a national standard of entrance and practice, than against reciprocity. After all, in America, are we not all equal? Why should our government allow a person living in Topeka to recieve a lower, or higher standard of nursing care, than a person in Phoenix?

    Also, a national database ( just add the info to the currently existing NCIC criminal and warrant databse) can access CURRENT information on any person in about 20 seconds using the social security or DL numbers. This is how the cop who pulls you over in Pittsburgh can arrest you for the speeding ticket you forgot to pay last year in Fresno.

    "You must be the change you wish to see in the world" -Mahatma Gandhi