Issues related to licensure and credentials
Candice Clarkson, Laura Cummings, Madison Moorehead & Courtney Musselwhite
Presentation Topic
Discuss issues related to licensure and credentials. Give examples and discuss the role of continuing education, certification, and what is advanced practice?
The Nursing License: What We All Desire
According to the Mississippi Nurse Practice Law (2010), “a license means an authorization to practice nursing as a registered nurse or a licensed practical nurse designated herein” (p. 4).
Many medical-related professions, including nursing, are regulated by state practice law, and these sets of legislation establish standards of professional practice and licensing.
The concept of licensing is so important to our profession of nursing since the overall goal and purpose of licensing is to protect the health, wellbeing, and safety of the public.
The Nursing License: What We All Desire
As we all know, the steps to reach the point where one can apply and obtain a nursing license are strenuous, difficult, and at times maddening.
Therefore, as future nurses with that desired RN license, we want to do everything we can in order to remain in good standing with the professional standards of our state board of nursing and the Nurse Practice Act.
Related to licensure, the Mississippi Board of Nursing defines what certain requirements are needed to obtain a license and also establishes various limits and guidelines of the license.
The Nursing License: Licensure Laws
There are two types of licensure laws: mandatory or permissive.
Mandatory law “requires any person who practices the profession or occupation to be licensed (Chitty & Black, 2011, p. 80).
Permissive law “protects the use of the title granted in the law but does not prohibit persons from practicing the profession or occupation if they do not use the title” (Chitty & Black, 2011, p. 80).
Today, every state has a mandatory licensure law for the profession of nursing in order to protect the general public seeking nursing care.
Criteria for Nursing Licensure
What are the applicant qualification for a nursing license in the state of Mississippi?
In addition to criteria for nursing licensure, each state board of nursing also has the power to establish criteria and guidelines for nursing education programs.
Currently, in order to be granted a nursing license, only state approval or accreditation of the nursing education program is needed.
This is beginning to create an issue within the profession of nursing since some states are seeking to require that nursing programs have national accreditation as well in order for their graduates to meet state approval for licensure.
Mobility of Nurses: What does this mean for our licenses?
Licensure by Endorsement: Allows RNs to practice and work in other states without requiring nurses to take an additional licensure exam
Nurse Licensure Compact: Established to promote the mobility of nurses while also protecting and promoting the wellbeing, health, and safety of the general public
Professional Licensure vs. Institutional
LicensureAccording to Marquis and Huston (2012), “professional licensure is a privilege and not a right” (p. 110).
Some professionals are now advocating the concept of institutional licensure, which would allow the healthcare institution or agency to determine the professional competency of the nurse and grant licensure.
Supporters of this form of licensure believe that it would support better efficiency and usefulness of nurses and greater flexibility.
However, most professional nursing organizations completely reject this idea.
Alternative to Institutional Licensure:
Certification Certification is a form of credentialing of nurses that “goes beyond licensure by validating a high level of knowledge and proficiency in a particular practice area” (Chitty & Black, 2011, p. 162).
Completely voluntary
Promotes further professionalism and prestige of the nurse
A certifying organization or body awards a certificate to the nurse who successfully passes the certification exam and submits documentation of experience and letters of reference.
Today, there are 48 different professional certifying bodies that offer certification in different areas of expertise.
Certification
Examples of Certifying Bodies: American Association of Diabetes Education, Pediatric Nursing Certification Board, National Association of Neonatal Nurses, American Nurses Credentialing Center (ANCC)
ANCC is the largest of the certification organizations and offers 40 various certification programs for associate degree or baccalaureate RNS and advanced practice nurses.
Certification usually lasts for three to five years; then the nurse must apply for recertification through retesting or providing documentation of continuing education credits and continued clinical practice.
Benefits of Certification
Greater salary
Larger scope of practice
Greater job and professional opportunities
Confirmation of knowledge, skills, and ability to provide competent nursing care
Recognition and respect from healthcare institution and coworkers
Challenges with Certification
A lack of uniformity among the many established certification bodies leads to confusion and concern related to consistency, standardization, testing, and practice prerequisites.
Many nurses believe that nursing certification would benefit from a national certifying board rather than continuing to use the multiple standards of certification currently in place.
It’s all about the license....• Board of Nursing: Their purpose is to carry out the laws
outlined in the Nurse Practice act of their state, and provide safety for the general public. The board is put together by the governor of the state, having 13 members from various areas of nursing practice and various locations over the state.
• Requirements for licensure: Submit an official transcript from an accredited nursing school, complete a criminal background check and finger printings, submit a notarized application and pay fee, as well as register for the NCLEX and pay the testing fee. (Complete within one years time, any falsification of information will result in withholding ones license and up to a $5000 fee)
Nursing Applicant Rejects - #1
Nursing Applicant Rejects - #2
Nursing Applicant Rejects - #3
Board of Nursing: Disciplinary Action
Denial, Revocation, & suspension of license: “The board shall have power to deny, revoke, suspend, or refuse to renew any license or permit to practice nursing issued by the board or applied for in accordance with the provision of this act, including the power to fine said individual, upon proof that such person has violated the provisions of Miss. Code Ann. Chapter 15 as more specifically defined in Section 73-15-29.”
*All unprofessional conduct is defined within the Mississippi Nurse Practice Act, we will specifically address 10 examples.
HOW
LICENSE
TO LOSE
YOURIN 10WAYS
#1. Practicing under
the influence
of alcohol.
#2. Misappropriation of drugs,
supplies & equipment
#3. False Representa
tion of licensure
#4. Inappropriate Delegation
The Nurse…..
….The UAP doing the nurses’ job.
I have no idea
what I’m doing!!!
Oh yeahhh,
I’m getting paid for
this
Laura was the BEST PATIENT EVER!!
#6.Violating Professio
nal Boundari
es
#7. Willfully altering medicati
ons
HELP!! I’ve fallen and I can’t get up!!!!
#9. Convictio
n of a felony in the past 5 years.
Continuing EducationDefined as “non-degree seeking ways in which nurses maintain expertise during their professional careers” (Chitty & Black, 2011, p. 163)
Promotes continuous and life-long learning
The ANCC is in charge of setting standards for CE, accrediting programs that provide CE, and transferring CE credits form state-to-state.
In 33 states, CE is required and must be documented in order to renew one’s license.
With mandatory continuing education in the field of nursing, the government guarantees that nurses are staying current and educated about what is going on the profession of nursing.
4 Areas of Advanced Practice
1. Nurse Practitioner
2. Certified Nurse Midwife
3. Certified Registered Nurse Anesthetist
4. Clinical Nurse Specialist
Nurse PractitionerRequirements:
Completed a BSN program
Complete a NP master’s/doctorate program
Pass the national NP exam to become certified
From here, the majority of NP choose a specialty area (such as: Family practice, adult or pediatric health care)
Scope of practice:NP can perform physical examinations, take medical histories, diagnose and treat illnesses and injuries, order lab tests, and prescribe medications with some physician supervision.
Some NPs are independent and can be directly reimbursed by agencies, while other NPs work very closely with physicians.
Certified Nurse Midwife
Requirements:
Registered Nurse
Complete a formal midwife course over, which expands over a minimum of 9 months.
Scope of Practice:
CNMs provide woman care and aid in childbirth in a variety of healthcare settings.
Births aided by nurse-midwives are among the safest.
CNMs have the widest prescriptive rights of all advanced practice nurses.
Certified Registered
Nurse Anesthetist
Requirements:Completion of a BSN program & have RN license
Must complete 2 to 3 years of specialized education in a master’s program
must also meet national certification and recertification requirements
Scope of Practice:CRNAs administer anesthetics while collaborating with physician anesthetists or working independently
They practice in a variety of healthcare settings
The safety of care delivered by CRNAs is well established and considered safe.
Clinical Nurse SpecialistRequirements:
Completed a BSN program
Complete a advanced nursing degree – master’s or doctoral
Scope of practice:Qualified to handle a variety of medical and mental health problems
Considered experts in a particular field
Qualified to perform health assessments, develop and make diagnoses, and deliver treatment.
ANCHORWOMEN MOOREHEAD & MUSSELWHITE
Breaking News: ISSUES R/T LICENSURE
Chitty, K.K., & Black B.P. (2011). Professional nursing: concepts & challenges. (6th ed.) St. Louis, MO: Saunders Elsevier.
Healthcare integrity and protection data bank (HIPDB) and national practitioner data bank (NPDB). (2013). Retrieved from https://www.ncsbn.org/418.htm
Healthcare quality improvement act law and legal definition. (2013). Retrieved from http://definitions.uslegal.com/h/healthcare-quality-improvement-act/
Marquis, B. L., & Huston, C.J. (2012). Leadership roles and management functions in nursing. (7th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins
Mississippi Nursing Practice Law. (2010). Retrieved from http://www.msbn.state.ms.us/
Sorrel, A. L. (2010, March 4). National practitioner database expanded. Retrieved from http://www.ama-assn.org/amednews/2010/03/01/prsf0304.htm
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