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Among the many challenges facing the healthcare industry in 2022, one issue is uppermost in the minds of healthcare executives: staffing shortages, and especially the critical — and increasing — shortage of registered nurses (RNs).

 

  • Statista estimates that 83% of hospitals and healthcare providers experienced a shortage of nursing staff in 2021.
  • The U.S. Bureau of Labor Statistics (BLS) forecasts that about 194,500 RN jobs will need to be filled each year over the coming decade to meet new demand and replace experienced RNs who are retiring

 

Since the beginning of the COVID-19 pandemic, RNs have proved to be “medical superheroes,” in the words of Incredible Health. They worked extra shifts, consistently put in overtime, and time and again went the extra mile for their patients and coworkers. The critical role played by RNs is evident in the decision by many states to remove certain barriers in the nursing licensure process to help increase access to care in response to the COVID-19 pandemic. In addition, the Nurse Licensure Compact (NLC) allows nurses licensed by one state to practice in dozens of others.

 

For those wanting to take on one of the most vital and challenging professions, the outlook for nursing careers has never been brighter. Programs such as an RN to BSN online (RN-BSN) degree help prepare tomorrow’s nursing leaders for a range of positions in clinical settings, research, and management. Knowing how to get a nursing license is a key step on the road to a rewarding nursing career.

Steps Required to Qualify for a Nursing License

Once you’ve decided to pursue a career as an RN, you’ll be ready to start the process of gaining the required skills and experience to qualify for a nursing position. The soft skills that nurses need include a commitment to serving others, being perceptive of people’s feelings, being well organized, and having the ability to think critically.

 

While the process for gaining a nursing license varies by state, the path to becoming a licensed RN entails four steps:

 

  1. Earning a degree in nursing from an accredited institution
  2. Completing supervised clinical training requirements
  3. Passing the National Council Licensure Examination (NCLEX-RN)
  4. Applying for a nursing license from the board of nursing in your state

 

For people interested in becoming a licensed vocational nurse or licensed practical nurse (LVN/LPN), the process of getting a nursing license similarly involves passing the NCLEX-PN exam for practical nurses. Some states require that candidates for the NCLEX-PN have a high school diploma or GED certificate, as well as a diploma from an LVN/LPN program from a community college. These programs typically entail one year of study.

Complete a Nursing Degree Program from an Accredited College or University

The three most common nursing degrees for becoming an RN are a four-year Bachelor of Science in Nursing (BSN), an Associate of Science in Nursing (ASN) that typically takes two years to complete, and a diploma from an approved nursing program of a hospital or medical center, which requires two to three years to complete.

 

The degree must be from a nursing school accredited by the state in which you will apply for a license. In addition to state accreditation, nursing programs at colleges, universities, and other institutions are accredited by two national organizations:

 

  • The Accreditation Commission for Education in Nursing (ACEN) is recognized by the U.S. Department of Education, which is a requirement for accreditation in many states. It is also recognized by the Council for Higher Education Accreditation (CHEA). The ACEN accredits all levels of nursing programs, including bachelor’s degrees, master’s degrees, and post-doctorate certificates.
  • The Commission on Collegiate Nursing Education (CCNE) is affiliated with the American Association of Colleges of Nursing (AACN). It is recognized by the Department of Education as a national agency that accredits bachelor’s degree and master’s degree programs in nursing, as well as Doctor of Nursing Practice (DNP) and post-graduate advanced practice nursing certificate programs.

 

Nursing degree programs include a requirement to complete a certain number of hours of supervised clinical training. Supervised training of nursing students in clinical settings prepares them for the complex technical and nontechnical tasks they will be expected to complete as RNs.

 

  • Interacting directly with patients in clinical settings teaches students to recognize each patient as a unique individual.
  • Students need real-world practice to develop competence in a range of procedures, from bed making and patient hygiene to accurately recording a patient’s vital signs.
  • Nursing students need to be exposed to patients presenting with diverse symptoms and conditions so they can develop a range of practical clinical skills.
  • Students working in clinical settings learn how to take direction from supervisors and when to take the initiative in many different learning situations.

Register for the NCLEX-RN

The first step in the registration process for the NCLEX-RN is to register with your state nursing regulatory body (typically the Board of Nursing Register) to confirm that you meet the state’s exam eligibility requirements. The next step is to register with Pearson VUE, whether online via the Pearson VUE site or by telephone. To register you must create a Pearson VUE account, provide an email address, and submit a payment of $200 (or a voucher from a third-party payer such as a nursing school, agency, or employer).

 

Registration requires use of a program code that can be downloaded from the NCLEX site. After registering with Pearson VUE, you’ll receive an email confirmation within two days. Registrations remain in effect for one year, and the validity dates are listed in the Authorization to Test email. You can have only one NCLEX-RN registration open at any time.

Pass the NCLEX-RN

Once you have completed the registration process and scheduled a test date, you’re ready to prepare to take the exam. Start by reading the NCSBN’s Candidate Bulletin for the NCLEX, which explains the candidate rules, test security procedures, the check-in process, the testing environment, and what happens after the test.

 

Next, you should become familiar with NCLEX test plans, which contain detailed information about the material covered on the exam and provide tips that help you categorize exam items. Test plans include the following items:

 

  • Definitions of all Client Needs categories
  • Distribution of the topics covered by Client Needs category (Safety and Infection Control, Health Promotion and Maintenance, etc.)
  • Detailed breakdown of the topics covered in each Client Needs category
  • Sample items in each category from previous exams
  • Explanation of the passing standard and scoring
  • Item-writing exercises

How to Get a Nursing License in Another State

The most straightforward way for RNs to obtain a license to practice in a state other than the one they applied to initially is by getting a multistate license via the Nurse Licensure Compact (NLC), now being called the Enhanced Nurse Licensure Compact (eNLC). As of December 2021, 39 states have approved full or partial NLC legislation or have NLC approval pending. (Note that the NLC also applies to LVNs and LPNs.)

 

Multistate licenses are available only to nurses who declare a compact state as their primary state of residence. According to the NCSBN, RNs who are residents of a non-compact state may apply for a license by endorsement in a compact state, but their eligibility is limited to a license that allows them to practice only in the state they applied to. However, residents of non-compact states can apply for as many licenses as they desire.

 

  • When nurses move from a non-compact state to a compact state, they can apply for licensure by endorsement in their new state before or after the move. They may also be issued a multistate license if they meet eligibility requirements.
  • Nurses who move from a compact state to a non-compact state must apply for licensure by endorsement in the new state before or after the move. Their multistate license from the NLC state becomes a single-state license allowing them to practice only in their new state of residence. They must contact the board of nursing in their previous state of residence to update their address.
  • Nurses moving from one compact state to another compact state must apply for a license by endorsement in their new state of residence as soon as possible after they move, as no grace periods are allowed. This applies regardless of the expiration date of their current license. They may practice on their former state license only until the new multistate license is issued by their new state of residence.

 

A primary benefit for nurses who hold a multistate license is the ability to practice in any NLC state without having to obtain single state licenses for each. RNs who received their license in an NLC state automatically have a multistate license as long as they remain in good standing. A compact license allows nurses to practice in another compact state for as long as they maintain their primary residence in the state that issued their license.

 

The increase in demand for nurses in COVID-19 hot spots motivated state boards of nursing to issue emergency licensure rules intended to ensure sufficient nursing staff during periods of peak demand. For example, California’s emergency order allows any out-of-state medical personnel to practice within the state to assist in the response to COVID-19 to the extent that their current license allows. Similarly, New York’s order permits RNs, licensed practical nurses (LPNs), and nurse practitioners licensed in other states, Canada, or other countries to practice in the state during the pandemic.

 

RNs can apply individually for a nursing license in one of the states and U.S. territories that don’t currently participate in the NLC program. At present, these include Alaska, Connecticut, Hawaii, Minnesota, Nevada, New York, Oregon, and Washington, as well as Washington, D.C. NLC legislation is enacted but awaiting implementation in Ohio, Pennsylvania, and Vermont; similar legislation is pending in California, Illinois, Massachusetts, and Michigan.

How to Check Nursing License Status

The NCSBN’s Nursys site allows nurses to check the status of their nursing license and determine whether their license applies to multiple states or only to their state of residence. The database maintained by the service tracks active nursing licenses and disciplinary actions collected from state boards of nursing; it is designated by the boards as a primary source equivalent database. Entries in the database include the date that the information was updated from the relevant state board of nursing.

 

Nurses are permitted to access the Nursys database to verify their license and disciplinary history solely for licensure, endorsement, or employment. They may not reproduce, reuse, sell, or apply the data for commercial or any derivative use, including use by any third party. In addition, the data may not be accessed using any data mining, gathering, or extraction tools.

 

RNs may challenge the accuracy or completeness of entries in the database by sending an email to Nursys. The service then forwards the challenge to the relevant state board of nursing, which will notify the challenger when the discrepancy is resolved.

 

Nursys provides three separate online license verification services:

 

  • Nursys E-Notify is a free service that sends nurses automatic updates about the status of their license, including expiration reminders, via email or text message. Institutions may enroll their complete nurse list with the service to receive updates on their license status.
  • QuickConfirm License Verification allows nurses to view and verify their licensure information by entering their name, license type, and state, or by entering a specific license number. The free service allows nurses to download or print a report showing their complete licensure and disciplinary record.
  • Nurse License Verification for Endorsement lets nurses request secure electronic verification of their licensure for multiple state licensing boards. Nurses enter the state and license type, and the service automatically sends that state’s board of nursing all verifications received from participating states.

 

Nursing license verification services are also provided by various state boards of nursing. The NCSBN’s National Nursing Database tracks all active licenses and provides an interactive map that lists contact information for all 50 states and U.S. territories. The information includes the location’s mailing address, links to its website, the name and title of a contact, telephone and fax numbers, and whether the state is an NLC member.

How to Renew a Nursing License

Renewing a nursing license typically requires paying a fee to renew an active or inactive nursing license or advanced practice nursing license, and to reinstate an expired nursing license. The journal Nursing 2022 maintains a database of RN renewal requirements by state that includes a link to each state’s website, its telephone number and email address, and the state’s requirements for license renewal.

 

Most states mandate a set amount of continuing education credits, a set number of hours of professional activities, and/or a number of hours employed as an RN. For example, renewing an RN license in Florida entails completing 25 contact hours of board-approved continuing education (CE) every two years except for the first renewal after being licensed by exam. (A contact hour is a 50-minute session.)

 

The state also stipulates one hour of study on HIV/AIDS, two hours on preventing medical errors, two hours on human trafficking, two hours on recognizing impairment in the workplace, and two hours on domestic violence. (Note that courses on end-of-life care or palliative health care may substitute for other CE requirements.)

 

These are among the other RN license renewal requirements in various states:

 

  • Arizona: In the past five years, either completing 960 hours of practice as a licensed RN, completing a board-approved refresher course, or earning an advanced degree (RN to BSN, MSN, doctorate, or advanced-practice certificate)
  • District of Columbia: Completing 24 contact hours of practice-related CE in the past two years, with exceptions for speaking at a CE session or having worked on published medical research
  • Louisiana: For full-time nurses, completing five contact hours in approved educational activities (10 hours for part-time nurses and 15 hours for inactive nurses)
  • New York: Completing three contact hours of CE in infection control and two contact hours in child abuse identification and reporting (one-time requirement)
  • Texas: Completing 20 contact hours of CE in their area of practice in the past two years or a board-approved nursing certification in their area of practice

 

States that have no requirements for renewing an RN license are Connecticut, Georgia, Hawaii, Idaho, Illinois, Indiana, Maine, Mississippi, Missouri, Montana, New Jersey, North Carolina, Oklahoma, Pennsylvania, Virginia, Washington, and Wisconsin.

Joining the Ranks of Licensed RNs

Knowing in advance the licensing and renewal requirements for RNs in the state or states where you intend to practice allows you to pursue a nursing education that will prepare you to get your nursing career off on the right foot. Programs such as Maryville University’s RN to BSN online are designed to help graduates become leaders in their chosen nursing field. Find out more about how the program helps RNs qualify for a range of management and high-level roles in acute care, mental health, and other nursing specialties.

The RN to BSN, MSN, Post-Master’s Nurse Practitioner Certificate, and DNP programs at Maryville University are accredited by the Commission on Collegiate Nursing Education, 655 K Street, NW, Suite 750, Washington, DC 20001, 202-887-6791.


Sources

Accreditation Commission for Education in Nursing, Search ACEN Accredited Nursing Programs

 

American Association of Colleges of Nursing, Commission on Collegiate Nursing Education

 

American Association of Nurse Practitioners, Emergency State Licensure COVID-19 Response

 

American Nurses Association, Workforce

 

The Balance Careers, “How to Become a Nurse: Education, Licenses, and Other Qualifications”

 

BMC Nursing, “Supervising Students in a Complex Nursing Practice — A Focus Group Study in Norway”

 

Florida Board of Nursing, Registered Nurse (RN)

 

HealthLeaders, “The Staffing Crisis Will Dominate 2022 Finance Trends. Here’s What to Do About It”

 

Incredible Health, “Job Outlook for Nurses 2022”

 

Incredible Health, “The Ultimate Guide to Nursing Compact States 2021”

 

Indeed, Registered Nurse Job Description: Top Duties and Qualifications

 

National Council Licensure Examination, How to Register to Take the NCLEX

 

National Council of State Boards of Nursing, Candidate Bulletin & Information

 

National Council of State Boards of Nursing, The National Nursing Database

 

National Council of State Boards of Nursing, NCLEX & Other Exams

 

National Council of State Boards of Nursing, NCLEX: The Pathway to Practice

 

National Council of State Boards of Nursing, NLC FAQs

 

National Council of State Boards of Nursing, NLC: Moving to Another State

 

National Council of State Boards of Nursing, Nurse Licensure Compact (NLC)

 

National Council of State Boards of Nursing, State Response to COVID-19

 

National Council of State Boards of Nursing, Test Plans

 

National Council of State Boards of Nursing, Welcome to Nursys

 

Nursing 2022, State-by-State Guide for RN License Renewal Requirements

 

PayScale, Average Licensed Practical Nurse (LPN) Hourly Pay

 

Trusted, How to Get Your License in California

 

U.S. Bureau of Labor Statistics, “Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners”

 

U.S. Bureau of Labor Statistics, “Registered Nurses”

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