Why do nurses get licensed by a state board instead of a federal board?

nurse2033, MSN, RN · Oct 21, 2010

Politics. It sure would be easier for us, but the laws are not for our convenience. It makes sense as each state has its own needs, and sets the requirements for a plethora of job.

kesr · Oct 22, 2010

Interesting question - it applies to doctors, lawyers, cosmetologists, barbers, real estate, drivers' licenses and more I can't think of. I guess we need to remember the US is a republic of states each with their own states' rights. Canadian nurses - is your licensing provincial or federal?

BabyLady, BSN, RN · Oct 22, 2010

Forgive my ignorance, but I've always wondered, why do nurses have to get licensed on a state-by-state basis?
Wouldn't it be easier for nurses to change jobs if there was a singular federal license board?
How does the actual practice of nursing vary from state to state?

It has to do with the US Constitution, believe it or not.

The Federal Government has no authority on matters specifically reserved for the states.

babyNP., APRN · Oct 22, 2010

Interesting question - it applies to doctors, lawyers, cosmetologists, barbers, real estate, drivers' licenses and more I can't think of. I guess we need to remember the US is a republic of states each with their own states' rights. Canadian nurses - is your licensing provincial or federal?

Actually, lawyers can only practice law in the states that they have passed the bar. Someone who took the NY bar cannot practice in PA unless he/she passes that bar.

DoGoodThenGo · Oct 22, 2010

Article I, Section VIII of the US Constitution pretty much spells out the powers of the federal government. No where will you find mention of creating any sort of licensing or so froth for trades/professions. If the government even tried, such a law would be shot down by the courts.

Unlike other countries, many of them former monarchies, the states of the "United States of America", created a national government via the Constitution. This document enumerates the powers and reach of the federal government, and what is not laid out there, belongs to the states.

In essence the states are sovereign within their own borders for legislative purposes, as is the federal government when it involves national or intersate issues. When there is a dispute over who is stepping on whose toes, the matter ends up in the courts and usually the SCOTUS has to make the call.

For much of history, especially in the old world of monarchs in the UK and Europe, a guild or trade applied to the king or whomever was head of state to petition for charter to practice, protection and so forth. When the United States was "created" the idea was *not* to have all powers rest with a central government, telling the states what to do.

Whom is allowed to practice any sort of trade or profession, their education, requirements for licensure (if any) and governance , are strictly a local (state) issue. States set up "boards" to oversee various professions and to amoung other thing ensure safety of those within it's own borders. There is no equal in the federal government for this.

Pigs will learn to apply lipstick and fly before states cede their powers to control nursing and or any other profession. As it tis many are having second thoughts about joining the national board exam (NCLEX) system, thus giving up individual state licensing exams.

himilayaneyes · Oct 22, 2010

Personally, I believe it's about money and not about convenience for nurses. Every time you go to another state they get to charge you some money. The states aren't about to give that up. Plus, a federal license for nurses would require that there be a federal licensing board and federal nursing practice act which I don't see happening any time soon.

laynaER · Oct 22, 2010

In addition to what others have mentioned, the laws that govern nursing vary from state to state.

SaraO'Hara · Oct 22, 2010

Because our country is backwards.

manusko · Oct 22, 2010

Forgive my ignorance, but I've always wondered, why do nurses have to get licensed on a state-by-state basis?
Wouldn't it be easier for nurses to change jobs if there was a singular federal license board?
How does the actual practice of nursing vary from state to state?

Even if it was a national liscense and not a federal liscense that would make more sense since you take the same test regardless of your state. I took my boards for Texas and tested in Oklahoma. But the question is " How would a state get their money from me if we had a national liscense? "

Guest27531 · Oct 22, 2010

I think we will see Nurse Practitioners licensed at the Federal level within our lifetime. Those who have some power in Wash DC are starting to talk about that now...I'm not so sure about other levels of nursing as it's such a political game and the states will not want to give up everything. They may give in on NPs just because of the shortage of Primary Caregivers and the economics of health care.

DoGoodThenGo · Oct 22, 2010

In addition to what others have mentioned, the laws that govern nursing vary from state to state.

Anyone advocating the United States federal government take over the licensing of nurses, should think *very* long and hard on the matter.

Do you really want the controlled by special interests and money body that calls itself the US Senate and Congress making decisions on how nursing is practiced in this here country? Anyone who thinks that this would be good for the profession, am here to tell you think again. Nurses make up the largest group employed in healthcare, and yet their voices are rarely heard. Who does have power? Oh there is the AMA for a start. Then countless groups/persons representing drug makers, attorneys, medical device makers, hospitals, nursing homes and so on, and so on. Instead of waging individual wars against various aspects of nursing practice some find objectionable such persons will concentrate their efforts in Washington DC. Winning there will spread the victory across the county, and those affected will have to bear it as best they can.

What changes could be wrought upon the nursing profession? Oh I don't know, how about for a start lowering the bar as just what functions require a legally licensed RN. Mandated staffing ratios? Forget it, unless you can get the Feds to go along (and thems with the money will put thekabosh on that). Oh there could be no end of treats in store. The nursing profession could advance, or it could be driven so far into the past y'all will be back in starched whites and caps.

The recent history of this country has shown power concentrated in Washington DC bodes no good. Decisions are made by those too far from those it affects, and the only thing that seems to matter is money, money, money.