CH. 4 Education for Nursing - Key Points (Last-Minute Review)

Scope of Practice

  • Defined by state laws, which vary across the country, employer rules and professional standards.

  • You must understand your state’s scope of practice for practical/vocational nurses (LPN/LVN).

Types of Nursing Programs

Certified Nurse Aide Programs

  • 1987 OBRA mandates: state-approved programs – 7575 hours minimum; competency testing (written and practical); nurse aide registries; minimum 1212 continuing education hours per year.

  • Student nurses may be eligible for placement on the nurse aide registry.

Practical/Vocational Nursing Programs

  • Approximately 11 year of education with emphasis on nursing skills.

  • Preparation to function under supervision of: RN, physician, dentist, or nurse practitioner.

Program Overview

  • Length: 10−1810-18 months.

  • Sponsors: trade schools, technical/vocational schools, colleges/universities, junior/community colleges, hospitals, private and government agencies.

Curriculum (Core)

  • Integrated classroom theory, lab practice, and clinical experience.

  • Typically 1200−18001200-1800 hours.

  • Key areas: Fundamentals of nursing; communication skills; anatomy and physiology; nutrition and diet therapy.

Curriculum (Cont.)

  • Mental health; microbiology; maternity nursing; medical and surgical nursing; pharmacology and medication administration math; geriatrics.

Outcomes for Graduates

  • Pass licensing exam.

  • Prepared to perform entry-level tasks; meet patient needs.

  • Teach health and disease prevention; understand effects of change on health care.

  • Be active in local/national nursing associations; pursue continuing education.

Diploma Nursing Programs

  • Sponsored by hospitals.

  • Duration: 2−32-3 years; emphasis on clinical nursing practice.

  • May be affiliated with a college or university.

Two-Year Associate Degree Programs

  • Prepares for the occupation of nursing.

  • Passes RN licensure exam.

  • Duration: 22 years; sponsored by community/technical/junior colleges.

Four-Year Professional Nursing Programs

  • Professional nurse after 4+4+ years of college; pass RN licensure exam.

  • Studies nursing theory and application; adheres to a code of ethics.

  • Participates in development of nursing through organizations; engages in nursing research; works independently.

Combination Programs

  • Career Ladder Programs: pathway to bachelor’s or master’s degree in nursing; may exit/enter at certain times; supports efficient progression.

  • Articulated (Joined) Programs PN/VN to ADN: two levels of education and one or two schools.

External Degree and Distance Programs

  • External Degree Programs (RN): students work independently at own pace; no lectures or supervised clinical practice.

  • Distance Learning: off-campus learning via technology; requires computer skills; lectures via TV/computer; independent learning skills.

Approval and Accreditation

  • Approval: state approval of a nursing education program is mandatory and a prerequisite for taking nursing licensing examinations.

  • Accreditation: voluntary; done by the National League for Nursing Accrediting Commission; indicates program exceeds minimum requirements.

Organizations

Student and Alumni Structures

  • Student organizations and nursing organizations support professional development.

  • Student organizations example: Student council (elected reps from students and faculty).

  • Health Occupations Students of America (HOSA): national org for health occupations students; fosters vocational understanding, social intelligence, civic consciousness, leadership.

  • Alumni associations: networking, continuing education, job opportunities, field updates.

Professional Organizations

  • National Association of Licensed Practical Nurses, Inc. (NALPN): supports students/graduates; promotes standards and certification; sponsors chapters and honors society.

  • National Association for Practical Nurse Education and Service (NAPNES).

  • National League of Nursing (NLN).

  • Other orgs: American Association for Men in Nursing; National Association of Hispanic Nurses; Nurses Christian Fellowship; National Black Nurses Association; etc.

Standards for Licensed Practical/Vocational Nurses

  • NALPN: Nursing Practice Standards for LPN/LVN cover Education, Legal/Ethical status, Practice, Continuing Education, Specialized nursing practice.

  • NAPNES: Standards of Practice and Educational Competencies cover Communication, Assessment, Planning, Caring Interventions, Managing.

Job Responsibilities

  • State nurse practice acts and laws govern nursing practice.

  • State boards of nursing define roles, functions, and responsibilities.

  • Duties vary by employer/institution policies.

  • Know the skills LPN/LVN are expected to perform.

Licensing

Why Licensing

  • Mandatory licensing protects the public and upholds nursing standards set by law/organizations.

  • Licensing examination measures nursing practice knowledge and retention; may be taken more than once.

Licensing Requirements

  • Graduate of a state-approved nursing program.

  • Director’s signature indicating completion of theoretical and clinical requirements.

  • Official transcript submitted with application.

  • Licensure application fee.

NCLEX-PN

  • One licensing exam for LPN/LVN in all states: NCLEX-PN.

  • NCLEX-PN notifies state boards of pass/fail; state board determines licensure.

Legal Title and License

  • Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN in TX and CA).

  • Nursing license entitles practice as defined by state; license is not transferable; license is mandatory.

Boards of Nursing

  • Administer Nurse Practice Acts; can issue, revoke, or suspend licenses.

  • Ensure safety of patients; protect public welfare.

  • Comprise nurses and consumers; operate under state laws.

  • NCSBN develops licensure examinations.

Board Duties

  • Evaluate curricula; develop standards; approve schools; issue/renew licenses; disciplinary actions; continuing education.

Licensure by Endorsement

  • Allows working in another state without re-taking the exam.

  • Apply for licensure in the new state.

Nurse Licensure Compact (NLC) and Enhanced NLC (eNLC)

  • NLC: mutual recognition of licenses; allows interstate practice.

  • eNLC: adds 11 uniform requirements; enables telehealth and cross-state practice; requires explicit license application for the compact.

  • Purpose: promote safety and public protection; reduce disciplinary avoidance.

Disciplinary Sanctions

  • License can be revoked or suspended for: mental/physical illness affecting practice, felony or moral turpitude, fraud in licensure, willful neglect or negligence, chemical dependency, violations of state laws, or other licensure issues.

  • If rights to practice are questioned: notification and hearing rights.

  • Impaired Nurse Programs: rehabilitation programs for nurses at risk of license loss.

Review Questions

Question 1

  • Statement: Scope of practice for LPN/LVNs is defined by federal law only.

  • Answer: False; scope is defined by state laws, employer rules, and professional standards.

Question 2

  • Type of program where a student can exit/enter at certain times: career ladder program.

  • Answer: Career ladder program.

Question 3

  • Statement: State approval and accreditation of a nursing program are mandatory prerequisites for licensing.

  • Answer: False; state approval is mandatory, accreditation is voluntary.