Natinal Licensure Debate
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Pro national licensure debate
by Zhaojun Huang
Introduction
Suppose there is a Labor/Delivery nurse with many years of experience; a national healthcare organization employs him or her to be a teletriage nurse, a role which he or she enjoys and contributes more to the public. He or she can be located in Calofornia, giving advice to a patient in North Carolina. Software programs are used to guide patient through a series of questions. Depending on this nurseЎЇs judgment of the severity of the patientЎЇs problem, he or she gives patient advice to rest at home, go to see a health practitioner without delay or give patient the name and phone number of the nearest community hospitals.
The above-mentioned scenario is a typical case of telenursing in action. According to Greenberg, telenursing can increase access to care for those in remote or underserved areas, improve the accuracy of assessments, and increase the availability of patient education. Very often it can help the consumer reduce the healthcare costs involved. (Greenberg 2000)
The advancement in telecommunication induced telehealth, technology explosion and consumer-focused healthcare are some of the driving forces for the multistate nursing licensure a rapid emergence in the nursing profession. It is clear that licensure has been a costly and time-consuming barrier for telehealth. National Council for State Boards of Nursing has proposed a new model for nursing licensure. This new model is called multistate licensure or mutual recognition. An RN or LPN can practice nursing in any other compact state by applying for a license from the board in the newly adopted state. In order to achieve mutual recognition, each state must enact legislation authorizing the Nurse Licensure Compact. States entering the compact must also adopt administrative rules and regulations for implementation of the compact. Currently there are 20 states that signed the nursing licensure compact, which was developed as model law in 1998. A centralized data base called NURSYS provides readily available information about licensure status and the disciplinary action taken against a nurse to states board of nursing.
There are many concerns expressed regarding this model. Standards within a state, consumer protection, the authority of state boards of nursing are among the few that cause debate on the issues related to multistate practice by healthcare professional (Ginny 2006). In this paper, a positive view of this model is stated and the impact of multi-state licensure in the context of mutual recognition model is examined to prove national nursing licensure to be an unavoidable trend in the future nursing world.
The mobility of the nurses will be increased
This proves to be one of the benefits of this model. Nurses who desire to work in different states will take less time to get a license in the compact state. Nurses who travel to different places to work bring with them skills and valuable experiences. Standards of nursing practice and regulations vary from state to state. These group of nurses will help bring awareness of the nursing standards to the local nurses.
The standard of each state will be re-examined
People who oppose this model states that the standard of each individual states will be compromised. North Dakota, the only state requiring a BSN for RN licensure, is frequently quoted as an example. With mutual recognition, this standard would be undermined, thus a nurse with a lower qualification can endorse into the state of North Dakota and practice in the state. Another issue raised is in the area of continuing competency, since some states place emphasis on education and others on hours of practice. While these two concerns may be valid, they only show that the standard of each state should be re-examined. Since both concerns are related to nurseЎЇs competency to practice in each individual state, perhaps the entry- level into nursing practice should be critically examined. As alleged by Ms. Kidder, a bachelor degree should be essential for nursing to be established as a profession in the first place. Thus, the acceptance and implementation of the mutual recognition model will lead policy makers to re-look into the policies. Hopefully some promising changes can be made, which will benefit the consumers and the nursing professionals in the long run
Consumer access to care is made easier
A major concern of those who oppose the mutual recognition model is its inability to improve public protection as it originally intended to do.They argue that in the case of telehealth, both the nurse who give advice and the consumer who seek advice can be anonymous and if any incident happens, it would be almost impossible to track down the ÐŽocriminalsÐŽ± of the incident.
To error is human. The possibility of giving wrong advices on the side of an RN or misinterpreting the telephone messages on the side of consumer does exist. Thus many multistate healthcare providers lay down stringent rules when it comes to recruiting nurses.
A closer look at the standard of the nurse selection in one successful company -Tell-A-Nurse will help us understand some of the ground rules. Years of experience in nursing, commitment to patient advocacy, communication skills are some of the aspects the company looks into when it comes to nurse- selecting. In a market economy age, the cross-state healthcare companies compete with each other in providing best services to the public. With this model, the barriers of obtaining licenses for nurses in many states will be removed, this not only help