Compact Licensure Disciplinary Risks
The Nurse Licensure Compact (NLC) enables nurses to practice in other states besides the one in which they reside. There are currently 24 states included in the NLC, which includes Tennessee and neighboring Missouri, Arkansas, and Mississippi. Eligibility for a multistate license requires that a nurse legally reside in a compact state (National Council of State Boards of Nursing, 2014). There are no additional applications required to apply for a compact license. Only one multistate license can be active at a time. Therefore when issued a compact license, any previously active compact licenses are made inactive. Also it is important to note that nurses are required to practice according to the nurse practice act of the state for which they are actually practicing in rather than their primary state of residence. Therefore a nurse could be subject to disciplinary action in the states of practice. The nurse’s home state license is recognized in all compact states unless the nurse is under disciplinary action or restriction. With the compact licensure in place, the question is then raised to whether there is an increased risk for disciplinary actions in compact states opposed to non-compact states.
Article One
The article Troubled Nurses Skip from State to State Under Compact exposed nurses under disciplinary actions in one compact state were being able to continue practicing in another compact state. The article discusses the case of one particular nurse, Craig Peske, who was fired from a Wisconsin hospital in 2007. Peske was suspected of stealing Dilaudid, “when in a three-month period he signed out 245 syringes full of the drug – nine times the average of his fellow nurses” (Webe...
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...nd disciplinary information of all licensed RNs and LPN/VNs” (Weber & Ornstein, 2010). Therefore, if all states used this database the disciplinary issues would be reduced.
Works Cited
National Council of State Boards of Nursing. (2014). Nurse licensure compact. Retrieved February 9, 2014, from National council of state boards of nursing: https://www.ncsbn.org/nlc.htm
Ornstein, C., & Weber, T. (2009, July 10). When caregivers harm: Problem nurses stay on the job as patients suffer. Retrieved February 9, 2014, from ProPublica: http://www.propublica.org/article/california-eyes-discipline-for-2000-nurses-sanctioned-by-other-states
Weber, T., & Ornstein, C. (2010, July 14). Troubled nurses skip from state to state under compact. Retrieved February 9, 2014, from ProPublica: http://www.propublica.org/article/troubled-nurses-skip-from-state-to-state-under-compact
Often time, nurses has been viewed by patients, their family members and the medical team as basic emotional care givers, pill crushers or cart pullers and not as healthcare professionals who are more interesting in health promotion, disease prevention and better patient outcomes. They also often forget the emotional, physical, mental, and caring part that is involved with the profession. And to make matters worse, nurses are continued to be viewed as a threat by doctors more than ever before especially with the opening of Nurse Practitioners programs.
Noone, J. G., Cleary, B. L., Moulton, P., Wiebusch, P. L., Murray, J. L.,Yore, M., & Brunell, M. L. (2010). Toward standardization (Part 1): assessment of state and national nursing workforce data sources. Policy, Politics, & nursing Practice11(3), 173-183. Doi10.1177/1527154410390521
Both Nurse Practitioners and Nurse Practitioner-students work closely with patients to monitor their health and provide care for acute and chronic illnesses. However, in the academic-clinical setting, the NP-student may only perform this function at the discretion of the supervising NP. Although work environments and responsibilities bestowed upon these distinctive nurses can be quite different, Nurse Practitioners, Registered Nurses and students is bound to the same laws and regulations governed by all states and territories that have enacted a nurse practice act (NPA). The NPA itself is insufficient to provide the necessary guidance for the nursing profession, therefore each NPA establishes a state board of nursing (BON) that has the authority to develop administrative rules or regulations to clarify or make the governing practice law(s) more specific (NCSBN
It is clear that statewide mandated nurse-to patient ratios result in drastic financial changes for every hospital impacted. Hospitals often have to compensate for hiring more nurses by laying off support staff. Mandated ratios also result in an increase in holding time in emergency rooms . (Douglas,
The Texas Board of Nursing,(2009). Nursing practice act. Nursing peer review, nurse licensure compact, & advanced practice registered nurse compact. Austin, TX
The shortage of registered nurses (RNs) in the United States has been a cyclical topic dating back to the 1960s. Only recently have employers in certain regions of the nation stated a decline in the demand for RNs. Consequently, according to the American Association of Colleges of Nursing’s (American Association of Colleges of Nursing [AACN], 2014) report on 2012-2013 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, American nursing schools denied admission to 79,659 qualified applicants from baccalaureate and graduate nursing programs in 2012. The reported decrease in job availability and rejected admissions has left many individuals to question if the nursing shortage still exists. On the other hand, some experts project that the United States will be short more than one million RNs by 2020 (Dolan, 2011). Although some parts of the country are in less of a demand than others, it is undeniable that there is a national shortage of RNs.
Many nurses face the issue of understaffing and having too much of a workload during one shift. When a unit is understaffed not only do the nurses get burnt out, but the patients also don’t receive the care they deserve. The nurse-patient ratio is an aspect that gets overlooked in many facilities that could lead to possible devastating errors. Nurse- patient ratio issues have been a widely studied topic and recently new changes have been made to improve the problem.
“REGISTERED NURSES AND NURSE PRACTITIONERS.” Labor Market Information. 2002. Employment Development Department. 12 Feb 2008 http://www.calmis.cahwnet.gov./file/occguide/NURSEREG. HTM.
"State Legislative Initiatives to Address the Nursing Shortage." American Association of Colleges of Nursing. Oct. 2006. 11 Dec. 2012 .
My plans after obtaining my advanced degree is to acquire licensure to practice as AGNP in the state of Texas. The Texas BON acknowledges that APN education, experiences, and competency levels vary, hence, holds individual APN accountable for knowing and practicing within their own scope of practice and competency always. The APN’s education is the grounds to their scope of practice: however, the APN can expand the scope of practice within the role and population-focus, as long as it remains within limits of the law. The Texas BON restricts the scope of practice for the APNs. The Nurse Practitioner Supervision Laws require¬¬¬¬¬ APN to work under physician supervision within seventy five mile perimeter. In addition, there is the Texas ' Nurse Practitioner Prescribing Laws which require APNs to prescribe medications under physician supervision and APNs are not allowed to prescribe schedule two drugs. All prescriptions written by the NPs must include the supervising physician 's name, address, Drug Enforcement Administration (DEA) number and phone number (Texas BON,
National Council for the State Boards of Nursing, APRN background, (2012). Report of the nursing policy and legislative efforts. Retrieved from https://www.ncsbn.org/428.htm#Nurse_Practitioner_Certification
Association, A. N. (2010). Nursing Scope and Standards of Practice. (2nd ed.) Maryland: American Nurses Association. Retrieved January 20, 2014 from http://media.wix.com/ugd/8c99f2_4fde86431966e34f2e03bbb137edfee3.pdf
American Nurses Association (2010). Nursing: Scope and standards of practice (2nd ed.). Silver Spring, Md: American Nurses Association.
Nursing originally derived from the medieval era when nuns exercised their assistance to medical practitioners for injured Christian Warriors. The basics of nursing education were outlined by Florence Nightingale during the arrival of the Crimean War. In great detail she wrote a book entitled “Notes on Nursing” that explained the duties and subjections of a nurse. Nursing was then considered for the first time a professional job because particular training and education was needed to fulfill the duties. Many physicians recognized the significance of nursing and instructed a course for people who aspired to be potential nurse. During the Civil War the demand for nurses became a great need for the massive number of injured veterans. Nurse Registration Acts was passed and in 1903 North Carolina was the first state to grasp the Nursing Licensure Act. Nursing has expanded tremendously into its own individual categories such as Registered Nurses (RNs), Nurse Practitioners (NPs), and Licensed Practical Nurses (LPNs), etc. Nursing continues to evolve over...
.... Professional nursing: Concepts and challenges (6th ed.). Philadelphia, PA: Elsevier Science Health Science div.