Nursing Licensure
In general terms, all nurses must receive training, be granted a diploma, and pass certification exams. Then they must be licensed in the state where they want to practice. There is much uniformity in nursing licensure, but there are some state-to-state differences.
To begin with, you have to go to nursing school. You could take classes at a career college and graduate with an LPN diploma. You could go to a nursing school for four years, and get a BSN. The beginning of the licensing process begins at nursing school.
After you finish your training, you must apply to the nursing board in your state for licensure. You must meet the requirements of your state. Once you do that, you can then register to take the NCLEX-RN or NCLEX-PN examination.
The National Council of State Boards of Nursing (NCSBN) is responsible for the examination process leading to a nursing license. The NCSBN is comprised of the nursing boards for all 50 states, plus the District of Columbia, and four U.S. territories – American Samoa, the Virgin Islands, Guam, and the Northern Mariana Islands. There are 60 member boards, because 4 states have 2 nursing boards – one for LPNs and one for RNs, and one state has a separate board for advanced practice nurses.
The NCSBN develops the NCLEX tests to ensure that a candidate has enough knowledge and skills to be able to work in an entry-level position as either an RN or an LPN.
Your test scores will go to your state nursing board. It is the state board that grants you a nursing license.
To give an example, take the state of California. If you want to become a registered nurse, you must first graduate with a nursing degree. It can be an ADN (associate degree in nursing), a BSN (bachelor of science in nursing), or a master's entry-level program in nursing. These requirements are quite standard. California allows two other groups to apply for licenses. California permits military corpsmen who completed RN level education and clinical experience in the military to take the national RN exam. California also recognizes the LVN 30 unit option. LVNs are what California calls LPNs. A licensed LVN in California can take a 30 unit course which has been created as a career ladder to becoming an RN, and then take the RN exam.
You must apply to the California State Board of Registered Nursing, the BRN. You fill out their application well before graduation. You must have your school send transcripts to the BRN. You must be fingerprinted, so that a fingerprint background check can be done. You can then take the NCLEX-RN exam. If you pass, the BRN will issue you a registered nurse license.
In California, if you want to become a practical (vocational) nurse, you will be allowed to take the NCLEX-PN if you graduate from an accredited program, or "equivalent education and experience." This means 54 hours of pharmacology, 51 months of paid bedside nursing, and verification of skill proficiency. You can also qualify to sit for the practical nurse examination after similar work in the military.
Nurses from other states have to go through a licensing process because California has not implemented the Nurse Licensure Compact. About half the states have implemented this compact, which in essence means they can practice in another state with their state's license as long as they follow the laws of the state.
Licensure specifics are similar for most states. Essentially all involve appropriate training which has been verified, fingerprinting for a background check, and passing the NCLEX. If you then want to practice in another state and both your original licensing state and the state you want to move to implemented the NLC, you have very little paperwork to complete to practice in the other state. If they don’t follow the NLC, you will have to do most of what you did to get your first license, but you do not have to retake the NCLEX.
California licenses registered nurses for two years. The first license is for two birthdays; subsequent licenses are for two calendar years. Nurses must participate in 30 hours of continuing medical education during that two year period. Again, this is similar to what most other states require.
In some states there are specific other requirements, and states differ in what they allow for military service. Requirements are different for nurses who trained in another country.
If you want to be a licensed nurse in the same state as where you trained and graduated, you should have little difficulty in meeting all the requirements of the licensing board of that state. The NCLEX exam is the biggest hurdle you have to cross. Everything else is really just paperwork.
Published: 2009-10-14
