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Becoming a Nurse: Overview of Standards of Practice

  • Nursing standards of practice are established by a variety of entities, including:

    • Professional organizations
    • Regulatory bodies
    • Health care institutions

  • Purpose of Standards of Practice:

    • To ensure nursing care is safe, ethical, and effective.
    • Must evolve with advancements in health care to keep up with evidence-based practices and patient needs.

Implementation of Standards of Practice

  • Organizational Process:
    • Annual review of policies and procedures is common; as seen in the role of a nurse educator.
    • The review involves checking for updates or recommendations from overseeing organizations, such as:
    • ASOS AWON (Association of Women’s Health and Neonatal Nursing).
    • Future changes may require reviews every six months due to rapid advances in health care.

Role of Various Entities in Nursing Standards

  • Professional Organizations:

    • Input into changes in practices and guidelines.
    • Examples include:
    • American Association of Nurses (ANA)

  • State Boards of Nursing:

    • Handle legal aspects of nursing practice (licensure, maintaining active status).
    • Responsible for administering licensure exams and ensuring compliance with educational standards.

  • Health Care Institutions:

    • Create tailored policies that reflect broader standards suited for local populations and services.
    • Educators and nurse managers oversee policy updates in specialized fields (e.g., ICU, pediatrics).

  • Federal and International Guidelines:

    • Include regulations and standards from:
      • US Department of Health and Human Services
      • World Health Organization (WHO)
      • Centers for Disease Control and Prevention (CDC)

  • Example: COVID-19 pandemic illustrated the vital role of these organizations in shaping health practices.

Nursing Licensure Programs

  • There are three primary educational tracks for nursing licensure:
    1. Associate of Science in Nursing (ASN)
    • Typically a two-year program that limits career advancement and salary potential.
  1. Bachelor of Science in Nursing (BSN)
    • Offers broader career opportunities and requirements for high-accreditation hospitals (e.g., Magnet Hospitals).
      • Magnet status requires that at least 80% of nurses hold a BSN or higher.
  2. Diploma Programs
    • Not awarded a college degree; focused on clinical skills with no transferable college credit.
    • As of June 2024, 51 diploma schools still exist in the U.S., primarily in Pennsylvania and Ohio.
  • All three programs require passing the National Council Licensure Examination (NCLEX) to become a Registered Nurse (RN).

Steps to Acquire a Nursing License

  1. Complete an Accredited Program:

    • Accreditation ensures eligibility to take the NCLEX.

  2. Pass the NCLEX Exam:

    • Managed by the National Council of State Boards of Nursing (NCSBN).
    • Consistent examination across all states.

  3. State-Specific Requirements:

    • Each state may have unique educational and testing requirements.
    • Requires background checks, fingerprinting, and payment of application fees (~$200).

  4. Continuing Education Units (CEUs):

    • Needed for license renewal every two years; requirements vary by state.
    • CEUs include mandatory and optional courses.

Importance of Maintaining Nursing Licensure

  • Nurses are required to renew their license every two years.
  • Failure to complete CEUs on time could lead to disciplinary actions, including fines or the requirement to retake the NCLEX.

NCLEX Examination and Results

  • Results are typically available within 48 hours post-exam.
  • If unsuccessful, candidates can retake the NCLEX after a mandatory wait period of 45 days.
  • Historical data indicates that waiting too long after graduation to take the NCLEX can increase the likelihood of failure.

Multi-State Nursing Licenses and Nursing Licensure Compact (NLC)

  • Nursing Licensure Compact:
    • Allows RN to practice in multiple states without obtaining multiple licenses.
    • Compact states (indicated as purple on maps) agree upon shared licensure.
  • California, however, remains a non-compact state, requiring a separate license for practice.

Professional Conduct and Ethical Dilemmas

  • Nurse Practice Acts:
    • Each state has its own regulations governing nursing standards and licensure requirements.
    • Includes standards, licensure requirements, and grounds for disciplinary actions.
  • Violations may include significant errors, substance use issues, or ethical misconduct.
  • Consequences for violations can involve reprimands, suspensions, or revocation of licenses.

Lifelong Learning and Professional Development

  • Nursing is a dynamic profession necessitating ongoing education and adherence to changing regulations and standards.
  • The American Nurses Association's Code of Ethics serves as a resource for ethical dilemmas encountered in practice.
  • Nurses must remember they are committed to patient safety and trustworthiness in their caregiving roles.