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Nursing licensure: Practicing across state lines

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Practicing as a nurse is a privilege that we all have to earn. We not only have to apply ourselves to a higher standard to achieve the title, but we have to maintain that standard and strive to exceed it. This “standard” I am speaking of is your licensure as a nurse.

The journey we make to become a nurse is based on a universal process, but can traverse a different path depending on your geographical location. This can be the source of confusion and frustration for those who cross a state line (or international border) to practice as a nurse.

The following information is taken from the National Council of State Boards of Nursing (https://www.ncsbn.org/index.htm).

As nurses, we all have sat for a national certification exam–ever heard of the NCLEX? This exam is the basic building block and requirement to practice as a nurse in any given state. Each state grants licensure to anyone who completes certain requirements that include (but are not limited to) the certification exam. Once we are licensed by the state, we can work as nurses.

Here’s the catch: Each state has its own set of requirements. There is no universal or national state standard. While this can be annoying, it does not limit you and your ability to practice in any state. In laymen’s terms, you may have to jump through a couple additional hoops and even pay more fees, but as long as you have met the national requirements to practice as a nurse, it’s only a matter of paperwork and due process before you can begin practice in another state.

I speak from experience. I have crossed state lines to work as a travel nurse as well as where I live. It can be arduous and time-consuming, but nothing should prohibit your choice to practice in another state.

There is a relatively new movement by certain states to try and alleviate this challenge. As we know, there is a nursing shortage, and time and money is of the essence when job seeking. The “Nurse Licensure Compact” (https://www.ncsbn.org/nlc.htm) is enabling multistate licensure for nurses through a streamlined process that allows a nurse to cross state lines to work without the additional paperwork and fees.

Why is there such a discrepancy between states and their licensure requirements? I’m not sure. I’m guessing it has to do with liability and cost. I do know that a nurse’s scope of practice definitely differs by state.

While the difference is minute in some cases, it also has a lot to do with responsibility and level of education. I know that in some states an LVN/LPN cannot administer certain IV medications, while in others they can. I also know that an LVN/LPN can seek additional certification to address this limit in their practice.

Ultimately, as a nurse you need to be informed of what licensure laws apply to you and your current working scenario. We are regulated by state and national standards for a reason. It is just another step to maintain our patient’s safety.

Disclaimer: These are simply the views of a fellow nurse, for further more definitive information, please contact your state’s licensing board (https://www.ncsbn.org/contactbon.htm).

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