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Nursing License

Today there is an increase in demand for licensed nurses, which makes it a captivating opportunity to enter the nursing workforce. It is impossible to get a job in a health care system without holding a proper and valid nursing license. In addition, states in the US have established certain rules and regulations, which administer the process of licensing new nurses.

As a result, an applicant may come across some difficulties on the way to getting licensed, as it can be rather complex and long. In this guide, we will cover all of the details you need to know about licensing as a nurse in the United States.

Licensing Requirements and Application Process

In order to obtain a nursing license, an applicant must abide by the state rules and requirements. Even though there may be some differences in fees and testing, all the states have adopted the same procedure of licensing. Below you can find the licensing process details, which are common for all states.

Education and Nursing Programs

When it comes to nursing programs, getting good and reliable education is the key. After graduating from high school and completing professional subjects there, it is time to enroll in a state-approved nursing program.

The program must be accredited by the state Board of Nursing so that you do not face problems in the future. For example, you may not be eligible for the NCLEX or receive a certificate.

There are many accredited and qualified programs, which are offered at both the associate and baccalaureate levels. To clarify, you can choose to pursue an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN).

Earning a Master’s degree (MSN) in the future may also be possible in case you need it for career growth. As a rule, Registered Nurses pursue an MSN, as it offers a variety of job opportunities.

Applying for the Nursing License

Some programs allow students to apply for the license while they are in the last semester of their studies. You should apply to your state’s Board of Nursing and complete the application form. Whether you will need to apply online or by paper depends on your state rules.

You may also apply for a temporary permit, which will let you practice as a nurse until you take the exam.

NCLEX and Registering For the Exam

The National Council Licensure Examination is administered by the National Council of State Boards of Nursing (NCSBN) to assess the knowledge of applicants. The exam covers four categories, which include safe and effective care, health promotion and maintenance, psychosocial and physiological integrity.

You will need to register for the exam in advance and pay the examination fee of $200. If you fail, you must pay the fee again and gain the chance to retake the exam.

Background Check and Fingerprinting

Every future nurse must undergo a criminal background check by having her fingerprints taken. This applies to both resident and non-resident applicants.

Your application will not be complete unless you submit the required materials and prove to have a clean background report.

Nursing Programs and License Types

Before enrolling in an approved program, it is wise of students to take into account what type of work they intend to complete in the future. There are a lot of nursing programs, as well as license types, which have various requirements.

Registered Nurse (RN)

A Registered Nurse is an individual, who has completed an ADN or a BSN degree program and provides care in medical and community settings. The scope of work includes providing care and comfort, maintaining health, and controlling safety.

An ADN program typically takes two years to complete, whereas a BSN program takes about four years. Both programs are good enough to prepare students for entrance exams, but there are a few differences.

To clarify, a BSN degree offers a wider range of job opportunities, starting from health care systems to leadership roles and staff positions. The other program, on the other hand, is relatively shorter and a little easier to complete.

Licensed Practical Nurse (LPN)

A Licensed Practical Nurse is an individual, who has completed an LPN or LVN program and carries out basic nursing responsibilities. The scope of work includes providing comfort for patients, gathering samples, taking vital signs, and managing medication.

LPN or LVN programs are quick enough to complete, as they take approximately a year. They provide students with basic nursing knowledge, as well as allow practicing at hospitals and community colleges.

To summarize, we can say that LPNs share almost the same responsibilities as CNAs. Nevertheless, LPNs tend to earn more money annually than CNAs and their degree is higher.

Certified Nursing Assistant (CNA)

A Certified Nursing Assistant is an individual, who has completed a state-approved certificate program and helps patients with daily concerns. CNAs practice under the surveillance of a licensed Registered Nurse or Licensed Practical Nurse, following their instructions and advice.

The scope of work includes helping patients daily (eating, dressing, exercises), taking vital signs, monitoring care, and responding to their needs.

A CNA certificate program provides basic knowledge about taking entry-level care of patients. It usually does not take long to complete and there are even some programs, which last for four weeks. Before graduating from the program there is a certification exam to pass.

In case a CNA wants to make progress in her career, she may decide to attend a CNA to LPN program.

Advanced Practice Registered Nurse (APRN)

An Advanced Practice Registered Nurse is a nursing professional, who has completed a master’s or doctoral degree and provides primary care. The scope of work includes managing chronic disease, giving advice on public health issues, diagnosing illnesses, and so on.

Under the term Advanced Practice Registered Nurse we can imagine different types of nurses, for example, nurse practitioners, anesthetists, and specialists.

A Master of Science in Nursing (MSN) program is to supply the nurse with skills and credentials to develop existing “talent”. It takes about two years to complete and is suitable for Registered Nurses (RN).

A Doctor of Nursing Practice (DNP) program academically prepares the student for higher positions and career options. It typically takes from one to two years to complete.

Cross-State Licensing for Nurses

Now that some states are experiencing a shortage of licensed practical and registered nurses, cross-state licensing has become even more important. It is to promote health care systems, by providing a lot of licensed nurses with work.

The Nursing Licensure Compact (NLC) has been created for that exact purpose and it allows nurses to hold one license in multiple states. As of 2021, 34 states take part in the NLC and accept its legislation.

To make it clearer, if a state, for example, Maine or Texas, is a member of the NLC, its resident can practice as a licensed nurse in another member state. The best part of it all is that the nurse will not need to meet special licensing requirements and obtain a new license.

Benefits of Cross-State Licensing

COVID-19 has affected our lives in a number of ways and increased the need for licensed nurses. There were cases when a state or hospital needed more health care professionals, starting from licensed practical to registered nurses. For this reason, having a multistate license is very useful, as it will grant better job opportunities.

What is more, cross-state licenses contribute to forming better health care systems, as well as promote career growth and health quality. That is why states should consider changing their laws concerning nursing licensure.

Expired Nursing License

If you failed to renew your license before the expiration date and it expired, you can no longer use it or practice as a licensed nurse. As a result, your license can be suspended, or you will receive fines.

To renew the license, contact the state Board of Nursing, ask for the renewal requirements, and file your request. You may also see the requirements on the official websites of the Board.

Some states require completing a re-entry program and refreshing memory of the nursing job. They also require taking continuing education courses and obtaining a certain amount of credit hours. As a rule, the number of continuing education hours depends on the rules of your state.

You will also need to pay a renewal fee, as well as a reinstatement fee. The fee varies from state to state, and there is no fixed fee for all states.

How to Renew

  • Request license activation and complete the application form
  • Provide necessary documents, including your expired license
  • Pay the fees (as well as penalties if there are any)

Difference between an Inactive and Expired License

Sometimes people confuse expired licenses with inactive licenses and do not see the difference between them. In reality, the difference is huge, as every case is diverse and has completely other solutions.

A nursing license is inactive when a nurse decides to temporarily give up the job and put the license on hold. There is no reinstatement fee for reactivating an inactive license. An expired license, on the other hand, has much to do with your inability to renew it and there is a reinstatement fee.

Working as a Foreign Nurse

If you are a nursing professional in a foreign state and want to find a job in the United States, follow the instructions below.

Move to the United States

To start with, a nurse must have an Immigrant Visa (Green Card) or a work visa to move to the United States. In addition, you will need to complete some paperwork for a work visa and correspond with some standards. You may also consider applying for permanent residence, but it can take rather long. Receiving a job offer from a health care center, or finding a sponsor will definitely facilitate the process.

Note that not all nursing positions qualify, as the state authorizes nursing licenses to only registered Nurses (RNs).

Have Your Credentials Evaluated

The Commission on Graduates of Foreign Nursing Schools (CGFNS) sees to it that applicants comply with basic requirements. To clarify, the Commission decides whether a nursing applicant is eligible to take the NCLEX or further education is needed.

Examinations

Once the Commission finds you eligible for the NCLEX-RN, you can register for the exam and pay the exam fee of $200.

If English is not your first language, you will also need to take a language proficiency exam.

Look for a Job

If you have not received any job offer from a medical institution, you should look for a job with the help of a nursing recruiter.

Nursing License Costs

The same way as other licenses, a nursing license is also related to some costs and fees. Those fees are not the same for each state, and the same goes for nursing programs.

Education Fees

For the most part, students have to pay for obtaining education and earning a degree. The programs cost somewhere between $40.000 and $100.000. It usually depends on a number of factors, such as teaching methods, the place of a nursing school, and so on.

There are also other costs associated with buying textbooks, studying materials, uniforms, and medical equipment.
Some students, who are less privileged, may be eligible for various programs and scholarships. There are also student loans, which are very suitable for getting a degree with no initial financial resources.

Licensure Fees

Paying for your education is not the end, as you will also need to pay for licensure. To clarify, a license application will cost you about $100-$150. What comes to a temporary permit, it will cost about $75-$150.

The NCLEX has a fixed fee for taking the exam and you must pay $200 per attempt. After you register for the exam, you may choose to change exam type (RN/PN) or the nursing regulatory body. However, there will be an additional fee of $50.

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