What are Nurse Practice Acts and Why Do They Matter?
When you visit the dentist or a doctor, you expect them to be licensed and competent, right? It’s the same way with nursing. States uphold their duty to protect the public by setting minimum standards for education, licensure, and practice for all kinds of professions.
Each state has a Nurse Practice Act (NPA), which are laws and regulations passed by state governments that guide and regulate every aspect of nursing practice. If you’re starting your career, moving, or just found out nurses in another state can do something you can’t, you may wonder what the NPA means to you. Knowing a state’s NPA is also essential for travel nurses. Read on to learn more about Nurse Practice Acts.
What Are Nurse Practice Acts?
Each state has a Nurse Practice Act approved by the state legislature. These laws then provide the framework for the Board of Nursing (BON), which has the authority to ensure compliance throughout the state.
Nursing Practice Acts typically define the following:
- Scope of Practice (What nurses can do)
- Nursing Titles - RN, LPN/LVN, APRN, etc
- Minimum education standards
- Licensure requirements
- Board of Nursing Establishment, Authority, and Responsibilities
- Grounds for disciplinary action
What does that all mean?
In simple terms, NPAs define who can use the title of nurse, what nurses can do, and what happens to nurses who do not follow the laws. The BON is responsible for enforcing the NPA, which ultimately protects both public safety and the nursing profession.
The Board of Nursing typically,
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Enforces rules and regulations
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Determines specific standards for nursing education
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Prelicensure
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Continuing education/competency
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Develops standards of practice
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Responsible for licensure
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Criminal background checks
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Verification of pre-licensure education
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Maintains records for licensed nurses within its jurisdiction
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Implements disciplinary processes
History of Nurse Practice Acts
Before Nurse Practice Acts, anyone could call themself a nurse, and there were no true definitions of what nurses could or couldn’t do. Then, around the turn of the 20th century, states started to pass legislation intended to protect the public while also legitimizing the profession.
In 1903, North Carolina was the first state to pass a NPA. It protected the title of nurse and gave the BON authority to develop nursing exams and issue licenses. In 1938, New York was the first state to define a Scope of Practice for nurses. By the 1970s, each state had an NPA in place. Since then, the profession has continued evolving, as have NPAs.
As you can imagine, it could get really messy moving from state to state if there are significant differences between NPAs. The National Council of State Boards of Nursing (NCSBN) is a national organization, comprised of each state BON and other regulatory bodies, that works to ensure nurses across the country are ready to enter practice. The American Nurses Association (ANA) is another national organization that advocates for the nursing profession at local, state, and national levels.
What Nurses Need to Know About NPAs
Your ability to practice is defined by the NPA of the state you work in. Therefore, you should understand what is allowed and restricted for nursing practice within your state. You can find your state’s NPA on your state BON website or this NCSBN tool.
As of 2023, 39 states have enacted the Nurse Licensure Compact (NLC), commonly known as “Compact Nursing States.” The NLC makes it easier for nurses to work in several states without repeatedly going through the entire licensure process. It’s great for nurses who travel or live close to state borders. Here’s what you need to know
The state where you live and are licensed governs your licensure requirements, including continuing education needs. The state in which you work holds you to their scope of practice.
So if you live in Kansas but accepted a travel assignment in Florida, you’re responsible for maintaining and renewing your license based on Kansas’ standards. While you work in Florida, your practice is defined by Florida’s rules and regulations. The Florida Board of Nursing would be responsible for an investigation if you practice outside Florida's scope.
That may sound scary, but NPAs are more similar than different throughout the country. Each healthcare system creates policies and workflows to comply with local, state, and national laws and regulations.
The Bottom Line
Overall, the Nurse Practice Act is crucial in ensuring nurses provide safe and competent patient care. By defining the scope of practice for nurses, establishing licensure requirements, and outlining the disciplinary process for violations, these laws and regulations protect public safety and the nursing profession.
