Advanced Practice Nurses Often Have Questions Regarding Regulations and Practice Issues

Winter 2004 - 2005 B o a r d o f N u r s i n g B o a r d o f N u r s i n g N e w s 2 0 0 4 - 2 0 0 5 Janet B. Younger, R.N, Ph.D., C. P.N.P, N u r s e L i c e n s u r e C o m p a c t w a s i m p l e m e n t e d o n President Richmond, Virginia J a n u a r y 1 , 2 0 0 5 . Term Expires 2005 T h e N u r s e L i c e n s u r e C o m p a c t a u t h o r i z e s a n u r s e Lynne M. Cooper, Citizen Member l i c e n s e d a n d r e s i d i n g i n a c o m p a c t s t a t e ( h o m e s t a t e ) Midlothian, Virginia Term Expires 2006 t o p r a c t i c e i n o t h e r c o m p a c t s t a t e s ( r e m o t e s t a t e s ) Linda D. Gross, Citizen Member w i t h o u t t h e n e c e s s i t y o f o b t a i n i n g a d d i t i o n a l Chesterfield, Virginia l i c e n s u r e . T h e N u r s e L i c e n s u r e C o m p a c t f a c i l i t a t e s Term Expires 2008 n u r s i n g p r a c t i c e a m o n g t h e c o m p a c t s t a t e s b y Brenda L. Hale, R.N. r e q u i r i n g t h e n u r s e t o o n l y m a i n t a i n a c t i v e l i c e n s u r e Roanoke, Virginia Term Expires 2006 i n t h e n u r s e ’s p r i m a r y s t a t e o f r e s i d e n c e a n d g r a n t i n g a “ m u l t i - s t a t e p r i v i l e g e ” t o p r a c t i c e i n o t h e r c o m p a c t Woody B. Hanes, R.N.,M.S.N., F.N.P. Dillwyn, Virginia s t a t e s . T h i s p r i v i l e g e r e q u i r e s t h a t t h e n u r s e m u s t Term Expires 2008 p r a c t i c e a c c o r d i n g t o t h e l a w s a n d r e g u l a t i o n s o f t h e Louise D. Hartz, Citizen Member s t a t e i n w h i c h t h e n u r s e p r a c t i c e s n u r s i n g o r p r o v i d e s Richmond, Virginia c a r e ( i . e . t h e s t a t e i n w h i c h t h e p a t i e n t i s l o c a t e d a t Term Expires 2005 t h e t i m e c a r e i s r e n d e r e d ) , e i t h e r p h y s i c a l l y o r Gregory J. Huber, R.N., M.S.N Charlottesville, Virginia e l e c t r o n i c a l l y. T h e p r a c t i c e o f n u r s i n g i s n o t l i m i t e d Term Expires 2007 t o p a t i e n t c a r e , a n d i n c l u d e s a l l n u r s i n g p r a c t i c e a s Carol E. King, L.P.N., M.S. d e f i n e d b y e a c h c o m p a c t s t a t e ’s p r a c t i c e l a w s . Secretary Portsmouth, Virginia E f f e c t i v e J a n u a r y 1 , 2 0 0 5 , a n u r s e w h o r e s i d e s i n Term Expires 2005 Vi r g i n i a a n d h o l d s a n u n e n c u m b e r e d n u r s i n g l i c e n s e Louisa Lief, R.N., M.S.N. w i l l b e g r a n t e d a “ m u l t i - s t a t e p r i v i l e g e ” t o p r a c t i c e Vice President i n a n y o f t h e o t h e r c o m p a c t s t a t e s . Midlothian, Virginia Term Expires 2005 L i k e w i s e , a n u r s e w h o r e s i d e s i n a n d i s l i c e n s e d b y Judith E. Piersall, R.N., B.S.N. a n o t h e r c o m p a c t s t a t e w i l l h a v e a “ m u l t i - s t a t e Portsmouth, Virginia p r i v i l e g e ” t o p r a c t i c e i n Vi r g i n i a . T h e N u r s e Term Expires 2007 L i c e n s u r e C o m p a c t o n l y a f f e c t s n u r s i n g l i c e n s u r e a n d Julia Semple, L.P.N. p r a c t i c e a m o n g t h o s e s t a t e s t h a t h a v e j o i n e d t h e Norfolk, Virginia C o m p a c t ( p a r t y s t a t e s ) . Term Expires 2005 Brenda L. Spady, L.P.N. T h e f o l l o w i n g s t a t e s h a v e j o i n e d t h i s n e w m u t u a l Eastville, Virginia r e c o g n i t i o n m o d e o f m u l t i s t a t e n u r s i n g r e g u l a t i o n : Term Expires 2007 A r i z o n a , A r k a n s a s , D e l a w a r e , I d a h o , M a i n e , JoAnn Tillett, R.N. Midlothian, Virginia M a r y l a n d , M i s s i s s i p p i , N e b r a s k a , N e w M e x i c o , Term Expires 2005 N o r t h C a r o l i n a , N o r t h D a k o t a , S o u t h D a k o t a , Te n n e s s e e , Te x a s , U t a h , Vi r g i n i a a n d W i s c o n s i n . Jay P. Douglas, R.N., M.S.M., C.S.A.C. Editor, Executive Director Board of Nursing 6603 West Broad Street, 5th Floor C o n t i n u e d o n p a g e 1 6 Richmond, Virginia 23230 Tel: (804) 662-9909 Fax: (804) 662-9512 A P U B L I C AT I O N O F T H E V I R G I N I A D E PA RT M E N T O F H E A LT H P R O F E S S I O N S F O R P R O V I D E R S A N D C O N S U M E R S I N T H E C O M M O N W E A LT H O F V I R G I N I A

A PUBLICATION OF THE VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS FOR PROVIDERS AND CONSUMERS IN THE page COMMONWEALTH 1 OF VIRGINIA F r o m t h e P r e s i d e n t

J a n e t B . Yo u n g e r , R . N . , P h . D . , C . P. N . P. P r e s i d e n t , Vi r g i n i a B o a r d o f N u r s i n g

Advanced practice nurses often have questions regarding regulations and practice issues that are specific to them. The information is available at the web site listed below and citations are provided to direct you to the appropriate area. Here are a few reminders.

What is a Clinical Nurse Specialist?

Clinical Nurse Specialist, or any title reasonably confused with that, is a protected title under the Code of Virginia (54.1-3007) and the regulations governing the practice of nursing (18 VAC 90-20-300. 2h). Therefore, to use that title without being registered by the Board is grounds for disciplinary action.

The RN license would be the affected license in the case of representing oneself as a CNS. This provision is very similar to representing oneself as an NP or as a physician. These things are generally interpreted as "leading patients to believe" or not making reasonable efforts to disabuse anyone who refers to you as a physician or CNS if not so. That is, evidence of a licensee having knowledge that it is believed that one is a physician, NP, CNS etc and doing nothing about it is equivalent to misrepresenting.

Other Titles.

Similarly, Nurse Practitioner, and Registered Nurse are protected titles. Use of title "registered nurse" or "R.N.". “Any person who holds a license to practice professional nursing in Virginia shall have the right to use the title "registered nurse" and the abbreviation "R.N." No other person shall assume such title or use such abbreviation or any other words, letters, signs or devices to indicate that the person using the same is a registered nurse (§ 54.1-3016).

Referring to an unlicensed person as “the nurse” or representing such a person to patients as a nurse, leading a patient to believe the person is a registered nurse, is a very unwise practice. Under § 54.1- 3008, it is a Class 1 misdemeanor for any person to: “knowingly employ an unlicensed person as a professional or practical nurse or knowingly permit an unlicensed person to represent himself as a professional or practical nurse; use in connection with his name any designation tending to imply that he is a professional nurse or a practical nurse unless duly licensed to practice”.

Applicants for Licensure as a Nurse Practitioner.

In seeking licensure by the Committee of the Joint Boards of Nursing and Medicine as a Nurse Practitioner, one must present a transcript showing graduation from a nurse practitioner program in an accredited school and a certification in the same area as the educational program.

F r o m t h e P r e s i d e n t , c o n t i n u e d o n p a g e 3

P a g e 2 Prescriptions.

The Drug Control Act requires that a prescriber must have a bone fide provider/patient relationship to write a legal prescription. That usually requires the patient has been assessed and there is a chart documenting health care. Therefore, casually written prescriptions as might be done for ones friends or family may well be viewed as not bone fide and are, therefore, ill advised. See § 54.1-3303 A, which reads in part:

A bona fide practitioner-patient relationship means that the practitioner shall (i) ensure that a medical or drug history is obtained; (ii) provide information to the patient about the benefits and risks of the drug being prescribed; (iii) perform or have performed an appropriate examination of the patient, either physically or by the use of instrumentation and diagnostic equipment through which images and medical records may be transmitted electronically; except for medical emergencies, the examination of the patient shall have been performed by the practitioner himself, within the group in which he practices, or by a consulting practitioner prior to issuing a prescription; and (iv) initiate additional interventions and follow-up care, if necessary, especially if a prescribed drug may have serious side effects.

A nurse practitioner must have a prescriptive authority license and, if prescribing drugs that are Schedule III thru V, must have a DEA number. Those two numbers must be on any prescription, along with the name, address and telephone number of the supervising physician and the prescribers address. Further an approved practice agreement must be on file with the Board (§ 54.1-2957.01 E).

Delegation to Unlicensed Personnel.

Regulations governing delegation to unlicensed personnel are applicable to nurse practitioner practice. These are found in 18 VAC 90-20-460 B. This means that you may not delegate to an unlicensed person any of the following

1. Activities involving nursing assessment, problem identification, and outcome evaluation which require independent nursing judgment; 2. Counseling or teaching except for activities related to promoting independence in personal care and daily living; 3. Coordination and management of care involving collaboration, consultation and referral; 4. Emergency and non-emergency triage; and 5. Administration of medications except as specifically permitted by the Virginia Drug Control Act (§ 54.1-3400 et seq. of the Code of Virginia).

To emphasize, a person licensed as an RN or LNP who delegates the administration of medications to an unlicensed person is, therefore, in violation of the regulations governing the practice of nursing.

F r o m t h e P r e s i d e n t , c o n t i n u e d o n p a g e 4

P a g e 3 Criminal Background. Many states are now requiring criminal background checks for licensure, although Virginia does not. Some individuals who falsified applications for either RN licensure or NP licensure are finding themselves in difficulty when attempting to obtain a license in those states. Likewise, in Virginia, many health care agencies are now requiring criminal background checks and are catching some earlier fraudulent applications. It is unwise to misrepresent any element of a professional application. The costs of the misrepresentation are usually greater than the cost of the truth.

National Trends in Regulation of Advanced Practice. The regulatory trend in licensure of nurse practitioners is toward avoiding licensure of sub-specialties and preferring a more general license instead (i.e., adult nurse practitioner rather than palliative care nurse practitioner, orthopedic nurse practitioner or diabetes nurse practitioner). The reasoning behind this is that the safety of the public demands that a practitioner have more general knowledge of likely co-morbidities for any condition. Further, in situation in which a licensed in a person treats a common general condition (e.g., a palliative care nurse practitioner who treats sinusitis) may well be considered outside the scope of practice. Continued Competency for Nurse Practitioners. After January 1, 2004, in order to renew a license biennially, a nurse practitioner initially licensed on or after May 8, 2002 shall hold current professional certification in the area of specialty practice from one of the certifying agencies designated in 18 VAC 90-30-90. (18 VAC 90-30-105). In addition, a nurse practitioner must complete at least 40 hours of continuing education in the area of specialty practice approved by the certifying agency. Nurse practitioners with prescriptive authority must complete an additional 8 hours of continuing education in pharmacology or pharmacotherapeutics for each biennium (18 VAC 90-40-55). Requirements for Physician Co-signature. There is no requirement in the regulations of the Board of Nursing for physician co-signature on notes or charts. http://www.dhp.virginia.gov/nursing/nursing_laws_regs.htm

H e a l t h P r a c t i t i o n e r s ’ I n t e r v e n t i o n P ro g r a m T h e H e a l t h P r a c t i t i o n e r s ’ I n t e r v e n t i o n P r o g r a m ( H P I P ) p r o v i d e s a s s i s t a n c e t o t h o s e p e r s o n s r e g u l a t e d b y t h e D e p a r t m e n t o f H e a l t h P r o f e s s i o n s w h o h a v e a p h y s i c a l o r m e n t a l d i s o r d e r, i n c l u d i n g , b u t n o t l i m i t e d t o s u b s t a n c e a b u s e , w h i c h a f f e c t s t h e a b i l i t y o f t h e p e r s o n t o s a f e l y p r a c t i c e h i s / h e r p r o f e s s i o n . I f a n y h e a l t h c a r e p r a c t i t i o n e r h a s c o n c e r n s a b o u t a n i m p a i r m e n t a f f e c t i n g t h e m s e l v e s o r a n o t h e r p r a c t i t i o n e r a n d w o u l d l i k e i n f o r m a t i o n c o n c e r n i n g H P I P, c o n t a c t m a y b e m a d e w i t h t h e p r o g r a m a s f o l l o w s : H e a l t h P r a c t i t i o n e r s ’ I n t e r v e n t i o n P r o g r a m 7 0 0 E . F r a n k l i n S t r e e t , S u i t e 3 0 0 To w e r R i c h m o n d , VA 2 3 2 1 9 ( 8 0 4 ) 8 2 8 - 1 5 5 1 o r ( 8 6 6 ) 2 0 6 - 4 7 4 7 - t o l l f r e e ( 8 0 4 ) 8 2 8 - 5 3 8 6 - f a x

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P a g e 4 C h a n g e o f N a m e ? Directions to the Board of Nursing Office E v e r y l i c e n s e e a n d c e r t i f i c a t e h o l d e r i s r e s p o n s i b l e f o r n o t i f y i n g 6603 West Broad Street, t h e B o a r d o f f i c e i n w r i t i n g o f a n y 5th Floor c h a n g e o f n a m e o r a d d r e s s w i t h i n Richmond, Virginia 3 0 d a y s o f s u c h c h a n g e . N a m e c h a n g e s m u s t b e a c c o m p a n i e d b y From points East: l e g a l d o c u m e n t s . A l l r e q u e s t s f o r Take I-64 West; exit at Exit 183-B; proceed east on Broad Street. Turn c h a n g e s M U S T i n c l u d e y o u r s o c i a l right at the first light into Reynolds Crossing (across the street from the s e c u r i t y n u m b e r , VA D M V n u m b e r , Sheraton Hotel). Proceed to the Alcoa building, the first building on the o r Vi r g i n i a l i c e n s e o r c e r t i f i c a t e right (across from Philip Morris). Parking and the entrance are in the rear n u m b e r . We w i l l n o t b e a b l e t o of the building. p r o c e s s t h e s e r e q u e s t s w i t h o u t t h i s i n f o r m a t i o n . From points North: Take I-95 South; continue to Exit 79 to I-64 West. [Do not divert to I-295 or I-195]. Proceed on I-64 West to Exit 183-B, proceed east on Broad 2005 Board Meetings Street. Turn right at the first light into Reynolds Crossing (across the street from the Sheraton Hotel). Proceed to the Alcoa building, the first building on the right (across from Philip Morris). Parking and the January 24 – 27, 2005 entrance are in the rear of the building. March 14 – 17, 2005 May 16 – 19, 2005 July 18 – 21, 2005 September 19 – 22, 2005 From Points West: November 14 – 17, 2005 Take I-64 East, exit at Exit 183 (which splits into two ramps); take 183-B (Broad Street East), proceed east on Broad Street. Turn right at the first All meetings are open to the public and are held at light into Reynolds Crossing (across the street from the Sheraton Hotel). Proceed to the Alcoa building, the first building on the right (across from the Department of Health Professions, 5th Floor, Philip Morris). Parking and the entrance are in the rear of the building. 6603 West Broad Street, Richmond, Virginia unless announced otherwise. From Points South: Take I-95 or I-295 North to I-64 West. Proceed west on I-64 to Exit 183- Open Forum B; then east on Broad Street. Turn right at the first light into Reynolds Crossing (across the street from the Sheraton Hotel). Proceed to the Alcoa building, the first building on the right (across from Philip Morris). The Board of Nursing holds an open forum at Parking and the entrance are in the rear of the building. 11:00 A.M. on the Tuesday of each Board meeting during their business meeting. Open forums are held during each Board meeting so that individuals Board of Nursing Hours may express their concerns or make inquiries of the 8:15 A.M - 5:00 P.M. Board. No appointment is necessary to make a Monday - Friday presentation; however, you should contact the (804) 662-9909 Board office to confirm the time of the open forum or if you need special accommodations. If there are no presentations, the Board will conduct regular business.

P a g e 5 S u m m a r y o f L e g i s l a t i o n f ro m t h e 2 0 0 4 G e n e r a l A s s e mb l y

T h e f o l l o w i n g b i l l s t h a t h a v e s o m e The bill also provides that whenever any law or r e l e v a n c e t o t h e p r a c t i c e o f n u r s i n g regulation requires a signature, certification, stamp, w e r e p a s s e d b y t h e 2 0 0 4 G e n e r a l verification, affidavit or endorsement by a physician, A s s e m b l y a n d h a v e b e e n s i g n e d b y it will be deemed to include a signature, certification, t h e G o v e r n o r : stamp, verification, affidavit or endorsement by a H B 5 7 7 D i s c i p l i n a r y p r o c e e d i n g s f o r nurse practitioner. These provisions will not take h e a l t h p r o f e s s i o n a l s . effect until 60 days after the effective date of the regulations adopted by the Boards of Medicine and HB 577 grants to all health regulatory boards the Nursing. authority to delegate some informal fact-finding proceedings to an appropriately qualified agency H B 11 3 3 I n f a n t s ; s c r e e n i n g t e s t s subordinate pursuant to regulations adopted by the r e q u i r e d a f t e r d e l i v e r y. relevant board. The bill also adds an immunity provision for any person who reports regarding the HB 1133 directs that the physician or certified nurse conduct or competency of a health care practitioner as midwife charged with an infant's care after delivery required by law or regulation or provides information perform the screening test for inborn errors of pursuant to an investigation or testifying in a judicial metabolism rather than the physician, nurse or or administrative proceeding as a result of such report, midwife in charge of the delivery of the baby. unless the person acted in bad faith or with malicious intent. S B 5 5 5 D e a t h ; p r o n o u n c e m e n t b y p h y s i c i a n a s s i s t a n t s . H B 6 3 3 N u r s e s ; m u l t i s t a t e l i c e n s u r e p r i v i l e g e . SB 555 authorizes a physician assistant practicing under the supervision of a physician to pronounce HB 633 makes all provisions relating to discipline, death in very specific circumstances identical to the practice protocols, and other scope of practice limited authority currently granted to registered requirements applicable to any person holding a nurses. multistate licensure privilege issued under the Nurse Licensure Compact, which became effective on H J 2 0 5 B o a r d o f N u r s i n g t o c o l l e c t January 2005. It also authorized the Board of Nursing i n f o r m a t i o n o n n u r s e to promulgate regulations to implement the provisions p r a c t i t i o n e r p r e s c r i p t i v e of the Compact. a u t h o r i t y.

H B 8 5 5 N u r s e p r a c t i t i o n e r s ; A resolution passed by the Assembly requests the a u t h o r i z e d t o s i g n v a r i o u s Board of Nursing to collect information on nurse f o r m s a n d c e r t i f i c a t e s . practitioner prescriptive authority. The Board must collect data regarding the (i) practice locations of HB 855 provides that licensed nurse practitioners may nurse practitioners and (ii) number of nurse sign various forms and certificates, and provide practitioners with the authority to prescribe each medical information or treatment in certain situations, Schedule of controlled substances and devices. including situations involving the immunization of children, examination of persons suspected of having For questions related to legislation, you may contact tuberculosis, prenatal tests, nursing homes, release of Elaine Yeatts at the Department of Health Professions certain privileged medical information, competency at (804) 662-9918 or at for driver licenses, release of certain veterinary [email protected]. records, and assisted living facilities.

P a g e 6 Clarification Regarding 54.1-2972 “ Nurses Authority to Pronounce Death Under Certain Circumstances

T h e Vi r g i n i a B o a r d o f N u r s i n g s t a f f h a s r e c e i v e d n u m e r o u s p h o n e c a l l s o n t h i s i s s u e r e q u e s t i n g c l a r i f i c a t i o n . T h e 2 0 0 2 s e s s i o n o f t h e G e n e r a l A s s e m b l y r e v i s e d e x i s t i n g l a w t h a t p e r m i t s r e g i s t e r e d n u r s e s t o p r o n o u n c e a p a t i e n t s d e a t h u n d e r c e r t a i n c i r c u m s t a n c e s . T h e C o d e o f Vi r g i n i a 5 4 . 1 - 2 9 7 2 ( B ) s t a t e s t h a t a R e g i s t e r e d N u r s e m a y p r o n o u n c e d e a t h i f t h e f o l l o w i n g c r i t e r i a a r e s a t i s f i e d : ( 1 ) t h e n u r s e i s e m p l o y e d i n t h i s C o m m o n w e a l t h b y a h o m e h e a l t h a g e n c y, h o s p i t a l , n u r s i n g h o m e , s t a t e - o p e r a t e d h o s p i t a l , o r t h e D e p a r t m e n t o f C o r r e c t i o n s ; ( 2 ) t h e n u r s e i s d i r e c t l y i n v o l v e d i n t h e c a r e o f t h e p a t i e n t ; ( 3 ) t h e p a t i e n t ’s d e a t h h a s o c c u r r e d ; ( 4 ) t h e p a t i e n t i s u n d e r t h e c a r e o f a p h y s i c i a n w h e n d e a t h o c c u r s ; ( 5 ) t h e p a t i e n t ’s d e a t h h a s b e e n a n t i c i p a t e d ; ( 6 ) t h e p h y s i c i a n i s u n a b l e t o p r e s e n t w i t h i n a r e a s o n a b l e p e r i o d o f t i m e t o d e t e r m i n e d e a t h ; a n d ( 7 ) t h e r e i s a v a l i d D o N o t R e s u s c i t a t e o r d e r f o r t h e p a t i e n t w h o h a s d i e d . T h e n u r s e s h a l l i n f o r m t h e p a t i e n t ’s a t t e n d i n g a n d c o n s u l t i n g p h y s i c i a n s o f t h e d e a t h a s s o o n a s p o s s i b l e . O n l y w h e n t h e s e c r i t e r i a a r e m e t i s i t l a w f u l f o r t h e R e g i s t e r e d N u r s e t o p r o n o u n c e d e a t h . I t i s n o t t h e r o l e o f t h e B o a r d t o a d v i s e o n h o w a n d u n d e r w h a t c i r c u m s t a n c e s f a c i l i t i e s c h o o s e t o i m p l e m e n t p o l i c i e s t o g u i d e t h i s p r a c t i c e .

S TAT I S T I C A L I N F O R M AT I O N N u m b e r o f L i c e n s e e s

To t a l - A s o f D e c e m b e r 8 , 2 0 0 4 1 6 8 , 1 4 1 R e g i s t e r e d N u r s e s 8 7 , 2 6 2 I n c l u d i n g L i c e n s e d N u r s e P r a c t i t i o n e r s 4 , 9 5 3 w i t h P r e s c r i p t i v e A u t h o r i t y 2 , 6 0 0 C l i n i c a l N u r s e S p e c i a l i s t s 4 5 9 L i c e n s e d P r a c t i c a l N u r s e s 2 5 , 5 2 9 C e r t i f i e d M a s s a g e T h e r a p i s t s 3 , 8 7 0 C e r t i f i e d N u r s e A i d e s 4 0 , 4 6 8

Ty p e a n d N u m b e r o f E d u c a t i o n a l P r o g r a m s A p p r o v e d b y B o a r d N u r s e A i d e E d u c a t i o n P r o g r a m s – 2 3 5 A d v a n c e d N u r s e A i d e E d u c a t i o n P r o g r a m s - 8 P r a c t i c a l N u r s i n g P r o g r a m s - 5 9 A s s o c i a t e D e g r e e P r o g r a m s - 1 9 B a c c a l a u r e a t e D e g r e e P r o g r a m s - 1 3 D i p l o m a P r o g r a m s - 6

P a g e 7 L i c e n s u re N e w s

O n - L i n e R e n e w a l s Wa l k - I n Vi s i t o r s T h e B o a r d o f N u r s i n g h a s r e v i s e d o u r Yo u m a y n o w r e n e w y o u r N u r s i n g L i c e n s e p r o c e d u r e s f o r m o r e e f f i c i e n t a n d ( R N & L P N ) o n - l i n e . C e r t i f i e d M a s s a g e a c c u r a t e p r o c e s s i n g o f a l l a p p l i c a t i o n s T h e r a p i s t s a n d C e r t i f i e d N u r s e A i d e s m a y r e c e i v e d . Yo u m a y c o m e i n t o o u r a l s o r e n e w o n - l i n e . W h e n y o u r e c e i v e R i c h m o n d o f f i c e a n d d r o p o f f y o u r y o u r r e n e w a l n o t i c e , y o u m a y g o t o t h e a p p l i c a t i o n s , b u t t h e B o a r d o f N u r s i n g B o a r d o f N u r s i n g w e b s i t e , a n d u s i n g y o u r n o l o n g e r p r o c e s s e s t h e a p p l i c a t i o n s p i n n u m b e r , y o u m a y r e n e w y o u r l i c e n s e w h i l e y o u w a i t . Yo u w i l l r e c e i v e a u s i n g a d e b i t o r c r e d i t c a r d . O n c e y o u r e c e i p t i n d i c a t i n g t h a t y o u h a v e h a v e r e n e w e d y o u r l i c e n s e , t h e s u b m i t t e d y o u r a p p l i c a t i o n t o t h e B o a r d i n f o r m a t i o n w i l l b e a v a i l a b l e o n o u r o f N u r s i n g , a n d y o u r a p p l i c a t i o n w i l l b e t e l e p h o n e a n d i n t e r n e t v e r i f i c a t i o n p r o c e s s e d i n t h e o r d e r i n w h i c h i t w a s s y s t e m s t h e n e x t d a y. Yo u w i l l r e c e i v e r e c e i v e d . A s l o n g a s t h e a p p l i c a t i o n i s y o u r l i c e n s e i n t h e m a i l i n a w e e k t o t e n c o m p l e t e a n d c o r r e c t , y o u s h o u l d d a y s . r e c e i v e y o u r l i c e n s e , e t c . , w i t h i n a w e e k t o t e n d a y s .

N a m e B a d g e

B o a r d o f N u r s i n g r e g u l a t i o n r e q u i r e s t h a t a n R N , L P N , o r C N A , w h i l e o n d u t y a n d w h o p r o v i d e s d i r e c t p a t i e n t c a r e , m u s t w e a r i d e n t i f i c a t i o n t h a t c l e a r l y i n d i c a t e s t h e c a r e g i v e r ’s f i r s t a n d l a s t n a m e a n d t h e a p p r o p r i a t e t i t l e f o r l i c e n s e , c e r t i f i c a t i o n , o r r e g i s t r a t i o n i s s u e d t o s u c h p e r s o n b y t h e b o a r d u n d e r w h i c h h e / s h e i s p r a c t i c i n g i n t h a t s e t t i n g .

L i c e n s e Ve r i f i c a t i o n C h a n g e o f A d d re s s a n d D u p l i c a t e L i c e n s e Vi r g i n i a b e c a m e p a r t o f t h e N u r s e L i c e n s u r e C o m p a c t i n J a n u a r y 2 0 0 5 . Yo u m a y n o w c h a n g e y o u r T h e r e f o r e , i n t h e n e a r f u t u r e , t h e a d d r e s s a n d / o r r e q u e s t a Vi r g i n i a B o a r d o f N u r s i n g w i l l n o d u p l i c a t e l i c e n s e o n - l i n e . Yo u l o n g e r b e v e r i f y i n g Vi r g i n i a l i c e n s e s m a y g o t o t h e B o a r d o f N u r s i n g t o o t h e r s t a t e s . Ve r i f i c a t i o n o f w e b s i t e , a n d u s i n g y o u r p i n Vi r g i n i a l i c e n s e s w i l l b e h a n d l e d n u m b e r, y o u m a y e i t h e r c h a n g e t h r o u g h t h e N a t i o n a l C o u n c i l o f S t a t e y o u r a d d r e s s o r r e q u e s t a B o a r d s o f N u r s i n g t h r o u g h t h e d u p l i c a t e l i c e n s e . T h e r e i s a $ 5 N U R S Y S s y s t e m . B e o n t h e l o o k o u t f e e f o r a d u p l i c a t e l i c e n s e , u n d e r “ S p e c i a l A n n o u n c e m e n t s ” o n t h e u s i n g a d e b i t o r c r e d i t c a r d . I f B o a r d o f N u r s i n g ’s w e b s i t e f o r t h e y o u r e q u e s t a d u p l i c a t e l i c e n s e , e f f e c t i v e d a t e o f i m p l e m e n t a t i o n o f y o u w i l l r e c e i v e t h e l i c e n s e t h i s n e w p r o c e s s . w i t h i n a w e e k t o t e n d a y s .

P a g e 8 L i c e n s u re N e w s C o n t i n u e d

P I N N u m b e r s P I N n u m b e r s c a n b e r e q u e s t e d a t a n y t i m e . P I N n u m b e r n o t i f i c a t i o n w i l l b e m a i l e d t o t h e a d d r e s s o f r e c o r d . I f y o u h a v e m o v e d s i n c e y o u r l a s t c e r t i f i c a t e w a s i s s u e d t o y o u , p l e a s e s u b m i t i n w r i t i n g ( b y f a x o r m a i l ) y o u r n e w a d d r e s s w i t h a r e q u e s t t h a t y o u w o u l d l i k e t o a l s o r e q u e s t t h e B o a r d t o s e n d y o u P I N n u m b e r . E i t h e r y o u r c e r t i f i c a t e o r s o c i a l s e c u r i t y n u m b e r i s n e c e s s a r y i f y o u a r e r e q u e s t i n g a n a d d r e s s c h a n g e o r d u p l i c a t e c e r t i f i c a t e s o t h a t t h e c o r r e c t r e c o r d i s a c c e s s e d .

L P N & R N F e e I n c re a s e s

T h e f o l l o w i n g B o a r d o f N u r s i n g f e e s w e n t i n t o e f f e c t o n J u l y 1 4 , 2 0 0 4 :

A p p l i c a t i o n f o r L i c e n s u r e b y E x a m i n a t i o n $ 1 3 0 A p p l i c a t i o n f o r L i c e n s u r e b y E n d o r s e m e n t $ 1 3 0 B i e n n i a l L i c e n s u r e R e n e w a l $ 9 5 L a t e R e n e w a l $ 3 5 R e i n s t a t e m e n t o f L a p s e d L i c e n s e $ 1 4 5 R e i n s t a t e m e n t o f S u s p e n d e d o r R e v o k e d L i c e n s e $ 1 8 5

R e i n s t a t e m e n t o f L a p s e d L i c e n s e s A n u r s e w h o s e l i c e n s e h a s l a p s e d m a y b e r e i n s t a t e d w i t h i n o n e r e n e w a l p e r i o d b y p a y m e n t o f t h e c u r r e n t r e n e w a l f e e a n d t h e l a t e r e n e w a l f e e . A n u r s e w h o s e l i c e n s e h a s l a p s e d f o r m o r e t h a t o n e r e n e w a l p e r i o d w i l l b e r e q u i r e d t o s h o w e v i d e n c e o f c o n t i n u i n g e d u c a t i o n , p a s s a g e o f t h e N C L E X e x a m d u r i n g t h e p e r i o d t h a t t h e l i c e n s e h a s b e e n l a p s e d , o r c u r r e n t l i c e n s u r e i n a n o t h e r s t a t e .

O v e r n i g h t / E x p r e s s P a c k a g e s

D O N 0 T S E N D R E N E WA L F O R M S V I A O V E R N I G H T / E X P R E S S M A I L PA C K A G E S T O T H E P. O . B O X A D D R E S S T H AT I S O N T H E R E N E WA L F O R M E N V E L O P E . T h i s a d d r e s s d e l i v e r s r e n e w a l s t o a b a n k f o r p r o c e s s i n g ; o v e r n i g h t / e x p r e s s m a i l d e l i v e r i e s r e q u i r e a p e r s o n f r o m t h a t b a n k t o s i g n f o r t h e p a c k a g e a t t h e p o s t o f f i c e , d e t e r m i n e w h i c h c o m p a n y t h e d o c u m e n t s b e l o n g t o , a n d t h e n d e l i v e r i n g v i a i n t e r o f f i c e m a i l t h e d o c u m e n t s a n d f e e t o t h e a p p r o p r i a t e s e c t i o n f o r p r o c e s s i n g . M a i l i n g t o t h e P. O . B o x w i l l d e l a y p r o c e s s i n g t h e c o n t e n t s o f t h e o v e r n i g h t p a c k a g i n g a n e x t r a t h r e e - t o - f i v e b u s i n e s s d a y s . S e n d a l l o v e r n i g h t / e x p r e s s m a i l p a c k a g e s t o t h e D e p a r t m e n t ’s s t r e e t a d d r e s s s o t h a t t h e y a r e d e l i v e r e d t o t h e B o a r d o f f i c e f o r p r o c e s s i n g t h e f o l l o w i n g d a y a s y o u i n t e n d e d . T h e s t r e e t a d d r e s s i s : Vi r g i n i a B o a r d o f N u r s i n g 6 6 0 3 We s t B r o a d S t r e e t , 5 t h F l o o r R i c h m o n d , Vi r g i n i a 2 3 2 3 0

P a g e 9 N U R S E A I D E R E G I S T R Y N E W S

A Look at Nurse Aide Testing Renewal of CNA Certification

Promissor is the testing company that is responsible As of January 1, 2005, nurse aides can now renew for the development, administration, and scoring of on-line. Roughly 60 days before a nurse aide’s the National Nurse Aide Assessment Program certificate is to expire, the notification of renewal (NNAAP).The exam involves both a written and with a PIN number is sent out to the nurse aide’s manual skills portion and is given in 18 test sites address of record. If the nurse aide cannot renew on- line, a paper renewal must be requested using the across Virginia. The overall pass rate in Virginia is phone number as listed on that PIN number 95% for the written portion of the exam and 70% for notification as there is a statement concerning the the skills portion of the exam. Once someone passes nurse aide’s employment history that must be the written and skills portion of the exam, they are appropriately answered and submitted to the Board placed on the nurse aide registry and they can work as along with the fee before the nurse aide’s certificate a certified nurse aide. can be considered for renewal. The Board will renew a nurse aide’s certificate for a 90-day period Recently, Promissor has changed subcontractors who following the nurse aide’s certification upon receipt oversee the application process for the NNAAP exam. of properly completed renewal form and fee (or a In November 2004, Promissor signed a contract with properly completed on-line submission and fee); the American Red Cross of the Susquehanna Valley in however, whether the nurse aide can maintain employment with an employer after the expiration Pennsylvania to process nurse aide exam applications date of the certificate is up to the policies and and monitor the nurse aide test sites in Virginia, regulations of the employer. Once the nurse aide's certificate has been expired for more than 90 days, The toll-free number to call if you have questions or however, a reinstatement application will be need application information is 1-866-257-5240. required.

Information is also available on Promissor’s website at If the nurse aide did not receive the renewal form www.promissor.com. that was mailed out, a duplicate renewal form can be resent from this office via a phone call or a faxed The Virginia Board of Nursing continues to be request to the Board office. Always include your actively involved in the testing process and works correct address and either your social security or certificate number if faxing a request for another closely with staff at Promissor and the American Red renewal form so that the correct record is accessed. Cross of the Susquehanna Valley. Reinstatement of CNA Certification The fee schedule for the NNAAP is as follows: Unlike renewal forms, Reinstatement applications Written and Skills $80.00 are available for downloading from the Board of Oral and Skills $90.00 Nursing's web site under "Forms". Downloaded Written Only $33.00 Reinstatement applications will not be accepted in Oral Only $43.00 lieu of the required renewal form with signatures if Skills Only $47.00 the nurse aide’s certificate has not been expired for more than 90 days.

P a g e 1 0 A d v a n c e d N U R S E A I D E E d u c a t i o n P r o g r a m s

R e g u l a t i o n s 1 8 VA C 9 0 - 2 0 - 3 6 1 - 3 6 4 p r e s e n t s g u i d e l i n e s f o r t h e r e q u i r e m e n t s f o r a n a d v a n c e d n u r s e a i d e e d u c a t i o n p r o g r a m a n d i n i t i a l c e r t i f i c a t i o n a s a n a d v a n c e d c e r t i f i e d n u r s e a i d e . T h e r e a r e 8 a p p r o v e d a d v a n c e d p r o g r a m s i n Vi r g i n i a . C u r r e n t l y, t h e r e a r e o n l y s i x a d v a n c e d c e r t i f i e d n u r s e a i d e s w h o c o m p l e t e d a p r o g r a m i n t h e T i d e w a t e r a r e a .

E l i g i b i l i t y t o b e a n a d v a n c e d C . N . A . r e q u i r e s :

 C e r t i f i c a t i o n a s a C . N . A . f o r a t l e a s t 3 y e a r s ;

 N e v e r h a v i n g a f i n d i n g o f a b u s e , n e g l e c t , o r m i s a p p r o p r i a t i o n o f p a t i e n t p r o p e r t y a n d n o t h a v i n g a n y o t h e r d i s c i p l i n a r y a c t i o n t a k e n b y t h e B o a r d w i t h i n t h e p r i o r 5 y e a r s ;

 A r e c o m m e n d a t i o n f r o m a l i c e n s e d n u r s e w h o h a s s u p e r v i s e d t h e C . N . A . p r o v i d i n g d i r e c t p a t i e n t c a r e f o r a t l e a s t 6 m o n t h s i n t h e p a s t y e a r ; a n d

 C o m p l e t i o n o f a n a p p r o v e d a d v a n c e d C . N . A . e d u c a t i o n p r o g r a m .

A n e d u c a t i o n p r o g r a m m u s t a l r e a d y h a v e a b a s i c n u r s e a i d e e d u c a t i o n p r o g r a m i n o r d e r t o a p p l y f o r a n a d v a n c e d p r o g r a m ; t h e a d v a n c e d C . N . A . p r o g r a m m u s t b e a t l e a s t 1 2 0 h o u r s i n l e n g t h , w i t h c u r r i c u l u m c o n t e n t i n t h e a r e a s o f l e a d e r s h i p a n d m e n t o r i n g s k i l l s , c a r e o f t h e c o g n i t i v e l y i m p a i r e d c l i e n t , r e s t o r a t i v e c a r e , a n d w o u n d c a r e . T h e a d v a n c e d c e r t i f i c a t i o n w o u l d b e i n a d d i t i o n t o t h e b a s i c C . N . A . a n d r e n e w e d b i e n n i a l l y o n t h e s a m e r e n e w a l c y c l e . C o m p e t e n c y r e q u i r e m e n t s i n c l u d e s 3 h o u r s o f c o n t i n u i n g e d u c a t i o n e a c h y e a r f o r r e n e w a l a n d r e i n s t a t e m e n t .

I n f o r m a t i o n a n d a n a p p l i c a t i o n a r e a v a i l a b l e o n o u r w e b s i t e a t w w w. d h p . v i r g i n i a . g o v .

P a g e 1 1 N C L E X ® Te s t i n g N e ws

Participating In NCLEX® Item Development The NCLEX-RN® and NCLEX-PN® are developed by many nursing professionals and testing specialists. There are three different panels: · ITEM WRITERS – nurses who write the questions (items) with the assistance of the test service · ITEM REVIEWERS - nurses who review the questions and answers submitted by the item writers · PANEL OF JUDGES – nurses who recommend the passing standard to the Board of Directors

By participating as an NCLEX® writer, item reviewer or panel judge, you will: · Promote excellence in nursing · Network with other nurses from across the country · Learn how the licensure examinations are developed, and · Have input into the NCLEX® Item Development process

You may qualify to serve on an NCLEX® Development Panel if you work in a clinical setting with newly licensed nurses or are a faculty member, and meet the academic requirements. The sessions are ongoing throughout the year and last three to five days. The item development panels are assembled one to two months before the session takes place. Your application will remain active for two years from the date of approval.

To access the item development brochure on-line and check out the qualifications, please go to: http://www.ncsbn.org/pdfs/Item_Dev_broch.pdf.

NCSBN now offers an online application which can be accessed from the NCSBN home page: WWW.ncsbn.org. It is located under the “Testing Services Announcement” heading. It is requested that potential panelists use the on-line application, not an outdated paper application form.

For questions, please contact Anne Wendt, Associate Director Testing Services-Content Management at [email protected] or 312-525-3616

To f i l e a c o m p l a i n t a b o u t a n y h e a l t h c a r e p r o f e s s i o n a l r e g u l a t e d b y t h e D e p a r t m e n t o f H e a l t h P r o f e s s i o n s :

T O L L F R E E C O M P L A I N T L I N E 1 - 8 0 0 - 5 3 3 - 1 5 6 0

T h e D e p a r t m e n t o f H e a l t h P r o f e s s i o n s h a s a n e w m a i l b o x f o r r e c e i v i n g c o m p l a i n t s b y e - m a i l . T h e a d d r e s s i s :

C o m p l a i n t s @ d h p . v i r g i n i a . g o v

F o r i n f o r m a t i o n o n t h e d i s c i p l i n a r y p r o c e s s , p l e a s e s e e o u r w e b s i t e a t

w w w. d h p . v i r g i n i a . g o v

P a g e 1 2 Massage Therapy News

Facts about Virginia Certified Massage Therapists:

* There are 3,873 Certified Massage Therapists as of December 2004.

Changes in Regulations Effective January 15, 2003:

* 18 VAC 90-50-20(C) Final Regulations Governing the Certification of Massage Therapists states “each certified massage therapist shall conspicuously post his current Virginia certificate in a public area at his practice location”.

* 18 VAC 90-50-75. Continuing competency requirements.

A. In order to renew a certificate biennially on and after January 15, 2005, a certified massage therapist shall: 1. Hold current certification by the NCBTMB; or 2. Complete at least 25 hours of continuing education or learning activities with at least one hour in professional ethics. Hours chosen shall be those that enhance and expand the skills and knowledge related to the clinical practice of massage therapy and may be distributed as follows: a. A minimum of 12.5 of the 25 hours shall be in Category A activities or courses provided by an NCBTMB approved provider and may include seminars, workshops, home study courses, and continuing education courses. b. No more than 12.5 of the 25 hours may be Category B activities or courses that may include consultation, independent reading or research, preparation for a presentation or other such experiences which promote continued learning. B. A massage therapist shall be exempt from the continuing competency requirements for the first biennial renewal following the date of initial certification in Virginia. C. The massage therapist shall retain in his records the completed form with all supporting documentation for a period of four years following the renewal of an active certificate. D. The board shall periodically conduct a random audit of certificate holders to determine compliance. The persons selected for the audit shall provide evidence of current NCBTMB certification or the completed continued competency form provided by the board and all supporting documentation within 30 days of receiving notification of the audit. E. Failure to comply with these requirements may subject the massage therapist to disciplinary action by the board. F. The board may grant an extension of the deadline for continuing competency requirements, for up to one year, for good cause shown upon a written request from the certificate holder prior to the renewal date. G. The board may grant an exemption for all or part of the requirements for circumstances beyond the control of the certificate holder, such as temporary disability, mandatory military service, or officially declared disasters.

P a g e 1 3 B e I n f o r m e d A b o u t T h e R e g u l a t o r y Board of Nursing Wo r k o f t h e B o a r d o f N u r s i n g Website

The Department of Health Professions has T h e Vi r g i n i a D e p a r t m e n t o f P l a n n i n g a n d redesigned its website to provide more B u d g e t h a s d e s i g n e d a R e g u l a t o r y To w n information in a user friendly format. The Board H a l l f o r a n y o n e i n t e r e s t e d i n t h e of Nursing page contains: p r o p o s a l o f r e g u l a t i o n s o r m e e t i n g s o f r e g u l a t o r y b o a r d s . A c c e s s t o t h e To w n  Nurse Licensure Compact Information H a l l w e b s i t e i s :  The law and regulations governing w w w. t o w n h a l l . s t a t e . v a . u s . nursing and those governing all health professions U s i n g t h e To w n H a l l , y o u w i l l b e a b l e t o :  Guidance documents developed by the Board of Nursing * T r a c k r e g u l a t i o n s Yo u c a n f o l l o w a r e g u l a t i o n t h r o u g h  Applications and other forms that t h e p r o c e s s f r o m t h e N o t i c e o f can be downloaded I n t e n d e d R e g u l a t o r y A c t i o n ( N O I R A ) t o t h e p u b l i c a t i o n o f t h e  Lists of Board members and staff with contact information r e g u l a t i o n i n i t s f i n a l f o r m .  Meeting dates * R e a d r e g u l a t o r y d o c u m e n t s T h e a g e n c y ’s d i s c u s s i o n o f a  Newsletters p r o p o s e d c h a n g e , t h e p r o p o s e d t e x t a n d t h e E c o n o m i c I m p a c t  Disciplinary actions A s s e s s m e n t w i l l a l l b e a v a i l a b l e .  Approved schools of nursing * A c c e s s t h e To w n H a l l C a l e n d a r RN—LPN– CNA I n f o r m a t i o n a b o u t a l l p u b l i c m e e t i n g s r e l a t e d t o r e g u l a t i o n s w i l l  License Look-up and On-line Renewal b e a v a i l a b l e . Yo u w i l l b e a b l e t o s e e a n n o u n c e m e n t s o f a n y m e e t i n g s  Frequently Asked Questions a s s o c i a t e d w i t h r e g u l a t i o n s . An online service at the website for employers as * S i g n u p f o r t h e To w n H a l l well as citizens wishing to check on a specific E - m a i l N o t i f i c a t i o n S e r v i c e nurse or other health professional is the “On- Yo u c a n s i g n u p t o r e c e i v e a n Line License Lookup”. By entering the license e - m a i l a u t o m a t i c a l l y w h e n e v e r number, social security number or the first and a r e g u l a t i o n s s t a t u s h a s last name of the licensee, the user will be c h a n g e d , m e e t i n g s a r e provided with the license number, name, address a n n o u n c e d a n d m e e t i n g s a r e of record, initial license date and license expiration date. The database contains r e s c h e d u l e d o r c h a n g e d . information about current, unexpired licensees as well as records of licensees whose licenses has expired during the past five years

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P a g e 1 4 Nurse Licensure Compact C o n t i n u e d f r o m P a g e 1

T h e n u r s e m u s t c o n t i n u e t o r e n e w h i s / h e r l i c e n s e i n n o n - c o m p a c t s t a t e s i n o r d e r t o p r a c t i c e i n t h a t s t a t e , e v e n i f t h e n u r s e r e s i d e s i n a c o m p a c t s t a t e . I t i s i m p o r t a n t t o r e m e m b e r t h a t a l i c e n s e i s s u e d b y a c o m p a c t s t a t e w i t h t h e m u l t i - s t a t e p r i v i l e g e t o p r a c t i c e i s o n l y v a l i d i n o t h e r c o m p a c t s t a t e s a n d i s n o t r e c o g n i z e d b y n o n - c o m p a c t s t a t e s . T h e N u r s e L i c e n s u r e C o m p a c t a p p l i e s t o r e g i s t e r e d n u r s e s a n d l i c e n s e d p r a c t i c a l n u r s e s o n l y. W i t h t h e i m p l e m e n t a t i o n o f t h i s n e w m o d e l o f l i c e n s u r e a n d t h e c o n t i n u a t i o n o f t h e s i n g l e s t a t e l i c e n s e f o r n u r s e s w h o r e s i d e i n n o n - c o m p a c t s t a t e s , i t i s m o s t i m p o r t a n t t h a t e m p l o y e r s o f n u r s e s v e r i f y t h e l i c e n s u r e s t a t u s o f a l l n u r s e s s e e k i n g e m p l o y m e n t i n Vi r g i n i a .

T h e c o m p a c t a u t h o r i z e s t h e n u r s e l i c e n s i n g b o a r d o f a n y c o m p a c t s t a t e ( h o m e o r r e m o t e s t a t e ) t o i n v e s t i g a t e a l l e g a t i o n s o f u n s a f e p r a c t i c e b y a n y n u r s e p r a c t i c i n g i n t h a t s t a t e . B a s e d u p o n t h e o u t c o m e o f t h e i n v e s t i g a t i o n , a r e m o t e s t a t e l i c e n s i n g b o a r d m a y d e n y t h e n u r s e ’s p r i v i l e g e t o p r a c t i c e i n t h a t s t a t e . O n l y t h e n u r s e ’s h o m e s t a t e l i c e n s i n g b o a r d m a y t a k e a c t i o n a g a i n s t t h e n u r s e ’s l i c e n s e . S t a t e s w i l l c o n t i n u e t o a p p l y t h e s a m e a d m i n i s t r a t i v e a n d d u e p r o c e s s p r o c e d u r e s f o r i m p o s i n g d i s c i p l i n a r y a c t i o n s . H o w e v e r, c o m p a c t s t a t e s w i l l b e a l l o w e d t o s h a r e c u r r e n t s i g n i f i c a n t i n v e s t i g a t i v e i n f o r m a t i o n w i t h e a c h o t h e r v i a t h e c o o r d i n a t e d l i c e n s u r e i n f o r m a t i o n s y s t e m ( N U R S Y S ) . F o r a d d i t i o n a l i n f o r m a t i o n c o n c e r n i n g t h e N u r s e L i c e n s u r e C o m p a c t , p l e a s e v i s i t o u r w e b s i t e a t w w w. d h p . v i r g i n i a . g o v , c l i c k o n B o a r d o f N u r s i n g a n d g o t o a s p e c i a l a n n o u n c e m e n t a b o u t t h e c o m p a c t f o r a l i n k t o f r e q u e n t l y a s k e d q u e s t i o n s a n d a m a p a b o u t p a r t i c i p a t i n g s t a t e s .

N o t i c e t o E m p l o y e r s o f N u r s e s

I n t h i s n e w m u t u a l r e c o g n i t i o n m o d e l o f m u l t i s t a t e n u r s i n g r e g u l a t i o n , n u r s e s w h o r e s i d e i n o t h e r c o m p a c t s t a t e s w i l l n o w h a v e t h e “ m u l t i s t a t e p r i v i l e g e t o p r a c t i c e ” i n Vi r g i n i a w i t h o u t h a v i n g a l i c e n s e i s s u e d b y t h e Vi r g i n i a B o a r d o f N u r s i n g . I n f o r m a t i o n a b o u t t h e N u r s e L i c e n s u r e C o m p a c t a n d h o w i t w i l l a f f e c t y o u r h i r i n g o f n u r s e s f r o m o t h e r c o m p a c t s t a t e s ( p a r t y s t a t e s ) t h a t h a v e e n a c t e d t h e C o m p a c t .

F r e q u e n t l y A s k e d Q u e s t i o n s

Q : W h a t d o e s “ m u l t i s t a t e p r i v i l e g e t o p r a c t i c e ” m e a n ? A : S i m i l a r t o t h e d r i v e r ’s l i c e n s e m o d e l , t h i s i s t h e m e c h a n i s m i n t h e N u r s e L i c e n s u r e C o m p a c t t h a t a l l o w s

P a g e 1 5 N u r s e L i c e n s u r e C o m p a c t C o n t i n u e d f r o m P a g e 1 5

a n u r s e w h o i s l i c e n s e d i n o n e c o m p a c t s t a t e ( h o m e s t a t e ) t o l e g a l l y p r a c t i c e i n a n o t h e r c o m p a c t s t a t e ( r e m o t e s t a t e ) . I t i s i m p o r t a n t t o u n d e r s t a n d t h a t t h e N u r s e L i c e n s u r e C o m p a c t r e q u i r e s t h e n u r s e t o a d h e r e t o t h e p r a c t i c e l a w s a n d r u l e s o f t h e s t a t e i n w h i c h h e / s h e p r a c t i c e s . I n t h e c a s e o f e l e c t r o n i c p r a c t i c e ( t e l e n u r s i n g ) , t h e n u r s e m u s t a d h e r e t o t h e p r a c t i c e s t a n d a r d s o f t h e s t a t e i n w h i c h t h e c l i e n t ( s ) r e c e i v e s c a r e . N O T E : E m p l o y e r s w i l l n e e d t o p ro v i d e a n y n u r s e p r a c t i c i n g i n Vi r g i n i a u n d e r t h e “ m u l t i s t a t e l i c e n s u r e p r i v i l e g e ” i n f o r m a t i o n a b o u t h o w t o a c c e s s Vi r g i n i a n u r s i n g p r a c t i c e l a w s a n d r e g u l a t i o n s . I n f o r m a t i o n c a n b e l o c a t e d o n t h e B o a r d o f N u r s i n g w e b s i t e ( w w w. d h p . v i r g i n i a . g o v ) o r b y c o n t a c t i n g t h e B o a r d o f N u r s i n g a t 8 0 4 - 6 6 2 - 9 9 0 9 ,

Q : W h e r e w i l l n u r s e s o b t a i n / r e n e w t h e i r l i c e n s e u n d e r t h i s m u t u a l re c o g n i t i o n m o d e l o f l i c e n s u r e ? A : N u r s e s m u s t m e e t t h e r e q u i r e m e n t s t o o b t a i n a n d r e n e w t h e i r l i c e n s e i n t h e i r p r i m a r y s t a t e o f r e s i d e n c e . P r i m a r y s t a t e o f r e s i d e n c e a s d e f i n e d i n t h e C o m p a c t m e a n s “ t h e p e r s o n ’s f i x e d p e r m a n e n t a n d p r i n c i p a l h o m e f o r l e g a l p u r p o s e s ; d o m i c i l e ” .

Q : H o w w i l l t h e N u r s e L i c e n s u r e C o m p a c t a f f e c t n u r s e s w h o l i v e i n C o m p a c t s t a t e s ? A : A s o f J a n u a r y 1 , 2 0 0 5 , a n u r s e w h o r e s i d e s i n o u r s t a t e a n d h o l d s a n u n e n c u m b e r e d Vi r g i n i a n u r s i n g l i c e n s e w i l l h a v e t h e “ m u l t i s t a t e p r i v i l e g e t o p r a c t i c e ” i n a n y o f t h e o t h e r c o m p a c t s t a t e s . L i k e w i s e , a n u r s e w h o r e s i d e s i n a n d i s l i c e n s e d b y a n o t h e r c o m p a c t s t a t e w i l l h a v e t h e “ m u l t i s t a t e p r i v i l e g e t o p r a c t i c e ” i n Vi r g i n i a . O n l y w h e n a n u r s e c h a n g e s h i s / h e r p r i m a r y s t a t e o f r e s i d e n c e t o a n o t h e r c o m p a c t s t a t e w i l l h e / s h e b e r e q u i r e d t o a p p l y f o r a n d o b t a i n a n u r s i n g l i c e n s e i n t h a t s t a t e . A n u r s e w h o l i v e s i n a c o m p a c t s t a t e w i l l n o l o n g e r o b t a i n ( o r r e n e w ) a l i c e n s e i n a n y o f t h e o t h e r s t a t e s t h a t h a v e e n a c t e d t h e N u r s e L i c e n s u r e C o m p a c t .

Q : Wi l l t h e n u r s e w h o l i v e s i n a n o n - c o m p a c t s t a t e a n d p r a c t i c e s i n Vi r g i n i a s t i l l n e e d t o h a v e a l i c e n s e t o p r a c t i c e i n Vi r g i n i a ? A : Ye s . N u r s e s w h o p r a c t i c e n u r s i n g i n Vi r g i n i a b u t l i v e i n a n o n - c o m p a c t s t a t e , s u c h a s Wa s h i n g t o n D . C . o r We s t Vi r g i n i a ,

m u s t c o n t i n u e t o h o l d a l i c e n s e i s s u e d b y t h e Vi r g i n i a B o a r d o f N u r s i n g . T h e N u r s e L i c e n s u r e C o m p a c t w i l l n o t c h a n g e h o w t h e y o b t a i n o r r e n e w t h e i r Vi r g i n i a l i c e n s e . H o w e v e r, t h e Vi r g i n i a n u r s i n g l i c e n s e w i l l b e a s i n g l e s t a t e l i c e n s e f o r n o n - c o m p a c t s t a t e r e s i d e n t s . I t w i l l n o t i n c l u d e t h e m u l t i s t a t e l i c e n s u r e p r i v i l e g e t o p r a c t i c e i n o t h e r c o m p a c t s t a t e s . T h i s p r i v i l e g e i s e x t e n d e d o n l y t o t h o s e n u r s e s w h o r e s i d e i n Vi r g i n i a .

Q : H o w w i l l e m p l o y e r s v e r i f y l i c e n s u r e s t a t u s o f n u r s e s u n d e r t h i s m u t u a l re c o g n i t i o n m o d e l ? A : F o r n u r s e s w h o h o l d a l i c e n s e i s s u e d b y t h e Vi r g i n i a B o a r d o f N u r s i n g , e m p l o y e r s w i l l c o n t i n u e t o v e r i f y s t a t u s v i a t h e w e b s i t e w w w. d h p . v i r g i n i a . g o v o r t h r o u g h t h e a u t o m a t e d t e l e p h o n e v e r i f i c a t i o n s y s t e m a t 8 0 4 - 6 6 2 - 7 6 8 6 . P l e a s e n o t e t h a t v e r i f i c a t i o n v i a i n t e r n e t a n d a u t o m a t e d p h o n e v e r i f i c a t i o n w i l l i n c l u d e m u l t i s t a t e p r i v i l e g e t o p r a c t i c e f o r t h o s e n u r s e s w h o r e s i d e i n Vi r g i n i a .

F o r n u r s e s w h o a r e l i c e n s e d i n a n o t h e r c o m p a c t s t a t e a n d a r e s e e k i n g e m p l o y m e n t i n Vi r g i n i a , e m p l o y e r s a r e a s k e d t o c o n t a c t o u r L i c e n s u r e D e p a r t m e n t a t 8 0 4 - 6 6 2 - 9 9 0 9 t o a s s i s t i n t h e l i c e n s u r e v e r i f i c a t i o n p r o c e s s . I n t h e n e a r f u t u r e , e m p l o y e r s w i l l b e a b l e t o e l e c t r o n i c a l l y a c c e s s t h e n a t i o n a l l y c o o r d i n a t e d l i c e n s u r e i n f o r m a t i o n s y s t e m c a l l e d N U R S Y S . B a s i c l i c e n s u r e i n f o r m a t i o n a s w e l l a s d i s c i p l i n a r y h i s t o r y f o r a l i c e n s e e w i l l b e p r o v i d e d t h r o u g h t h i s s y s t e m . A s s o o n a s N U R S Y S i s a v a i l a b l e , o u r B o a r d w i l l p o s t t h a t i n f o r m a t i o n o n o u r w e b s i t e , o n o u r a u t o m a t e d t e l e p h o n e s y s t e m , a n d i n t h e B U L L E T I N . E m p l o y e r s m a y a l s o a c c e s s l i c e n s u r e i n f o r m a t i o n d i r e c t l y t h r o u g h e a c h B o a r d o f N u r s i n g .

N O T E : W i t h t h e i m p l e m e n t a t i o n o f t h i s n e w m o d e l o f l i c e n s u r e a n d t h e c o n t i n u a t i o n o f t h e s i n g l e s t a t e l i c e n s e f o r n u r s e s w h o r e s i d e i n n o n - c o m p a c t s t a t e s , i t i s m o s t i m p o r t a n t t h a t e m p l o y e r s v e r i f y t h e l i c e n s u r e s t a t u s o f a l l n u r s e s s e e k i n g e m p l o y m e n t i n Vi r g i n i a .

Q : H o w w i l l e m p l o y e r s b e i n f o r m e d o f n e w s t a t e s j o i n i n g t h e N u r s e L i c e n s u r e C o m p a c t ?

A : T h i s v e r i f i c a t i o n w i l l b e a v a i l a b l e o n o u r w e b s i t e a s w e l l a s o n t h e w e b s i t e f o r t h e N a t i o n a l C o u n c i l o f S t a t e B o a r d s o f N u r s i n g ( w w w. n c s b n . o r g ) . I t i s m o s t i m p o r t a n t t h a t e m p l o y e r s r e m a i n i n f o r m e d a s o t h e r s t a t e s j o i n t h e C o m p a c t . S e v e r a l o t h e r s t a t e s a r e p l a n n i n g t o s e e k l e g i s l a t i o n f o r i m p l e m e n t i n g t h e C o m p a c t i n t h e n e x t f e w y e a r s .

Q : H o w w i l l c o m p l a i n t s a b o u t n u r s e s b e h a n d l e d w i t h i n t h i s m u t u a l re c o g n i t i o n m o d e l ? A : T h e c o m p a c t a u t h o r i z e s t h e n u r s e l i c e n s i n g b o a r d o f a n y c o m p a c t s t a t e ( h o m e o r r e m o t e ) t o i n v e s t i g a t e a l l e g a t i o n s o f u n s a f e p r a c t i c e b y a n y n u r s e p r a c t i c i n g i n t h a t s t a t e . B a s e d u p o n t h e o u t c o m e o f t h e i n v e s t i g a t i o n , a r e m o t e s t a t e l i c e n s i n g b o a r d m a y d e n y t h e n u r s e ’s m u l t i s t a t e p r i v i l e g e t o p r a c t i c e i n t h a t s t a t e . O n l y t h e n u r s e ’s h o m e s t a t e ( s t a t e o f r e s i d e n c e ) l i c e n s i n g b o a r d m a y t a k e a c t i o n a g a i n s t t h e n u r s e ’s l i c e n s e . S t a t e s w i l l c o n t i n u e t o a p p l y t h e s a m e a d m i n i s t r a t i v e a n d d u e p r o c e s s p r o c e d u r e s f o r i m p o s i n g d i s c i p l i n e a s t h e y h a v e a l w a y s d o n e . H o w e v e r, c o m p a c t s t a t e s w i l l h a v e m o r e t i m e l y a c c e s s t o i n f o r m a t i o n , i n c l u d i n g c u r r e n t s i g n i f i c a n t i n v e s t i g a t i v e i n f o r m a t i o n a n d t h e d i s c i p l i n a r y h i s t o r y o f n u r s e s , t h r o u g h t h e c o o r d i n a t e d l i c e n s u r e i n f o r m a t i o n s y s t e m ( N U R S Y S ) . S h o u l d y o u h a v e a c o m p l a i n t t o r e p o r t a b o u t a n u r s e p r a c t i c i n g i n Vi r g i n i a , s u b m i t i t t o t h e E n f o r c e m e n t D e p a r t m e n t o f t h e Vi r g i n i a D e p a r t m e n t o f H e a l t h P r o f e s s i o n s a t 1 - 8 0 0 - 5 3 3 - 1 5 6 0 .

Q : H o w d o I g e t m o r e i n f o r m a t i o n a b o u t m u t u a l r e c o g n i t i o n a n d t h e N u r s e L i c e n s u r e C o m p a c t ? A : T h e N u r s e L i c e n s u r e C o m p a c t a n d o t h e r i n f o r m a t i o n r e l a t e d t o t h e m u t u a l r e c o g n i t i o n o f n u r s i n g r e g u l a t i o n i s a v a i l a b l e o n o u r w e b s i t e w w w. d h p . v i r g i n i a . g o v . T h e N a t i o n a l C o u n c i l o f S t a t e B o a r d s o f N u r s i n g ( N C S B N ) w e b s i t e ( w w w. n c s b n . o r g ) l i s t s a l l t h e s t a t e s t h a t h a v e e n a c t e d t h e N u r s e L i c e n s u r e C o m p a c t a n d p r o v i d e s i n - d e p t h i n f o r m a t i o n o n t h e m u t u a l r e c o g n i t i o n m o d e l .

T h e Vi r g i n i a B o a r d o f N u r s i n g i s e x c i t e d a b o u t t h e i m p l e m e n t a t i o n o f t h i s n e w m o d e l o f m u l t i s t a t e n u r s i n g r e g u l a t i o n . We b e l i e v e t h a t i t w i l l e n h a n c e t h e d e l i v e r y o f n u r s i n g c a r e a s w e l l a s i m p r o v e o u r p r o c e s s e s f o r p u b l i c p r o t e c t i o n . We e n c o u r a g e y o u t o c o n t a c t t h e B o a r d w i t h a n y o t h e r q u e s t i o n s o r c o n c e r n s y o u m a y h a v e a s w e i m p l e m e n t t h e N u r s e L i c e n s u r e C o m p a c t i n Vi r g i n i a .

P a g e 1 8 B O A R D O F N U R S I N G S TA F F J a y P. D o u g l a s , R . N . , M . S . M . , E x e c u t i v e D i r e c t o r 8 0 4 - 6 6 2 - 7 0 5 4 C . S . A . C . J o d i P. P o w e r, R . N . , J . D . D e p u t y E x e c u t i v e D i r e c t o r, 8 0 4 - 6 6 2 - 7 3 1 1 N u r s e A i d e R e g i s t r y M a n a g e r S u s a n B e l l R o s e n , R . N . , F. N . P. , D e p u t y E x e c u t i v e D i r e c t o r, 8 0 4 - 6 6 2 - 9 9 5 1 J . D . D i s c i p l i n e ( R N ’s , L N P ’s , C M T ’s ) P a u l a B . S a x b y, R . N . , P h . D . D e p u t y E x e c u t i v e D i r e c t o r, 8 0 4 - 6 6 2 - 7 3 1 5 E d u c a t i o n ( N u r s i n g a n d N u r s e A i d e ) C i n d y C o c h r a n , R . N . D i s c i p l i n e C a s e M a n a g e r 8 0 4 - 6 6 2 - 9 9 5 2 J e s s i c a R e s s l e r, R . N . C . , M . S . N . N u r s i n g E d u c a t i o n C o n s u l t a n t 8 0 4 - 6 6 2 - 7 0 3 0 C h a r l o t t e M . C r e e d O f f i c e M a n a g e r, l i c e n s u r e f o r 8 0 4 - 6 6 2 - 9 9 4 6 n u r s e p r a c t i t i o n e r a n d p r e s c r i p t i v e a u t h o r i t y, N u r s e L i c e n s u r e C o m p a c t K i m b e r l y B a l d w i n A d m i n i s t r a t i v e s u p p o r t f o r 8 0 4 - 6 6 2 - 9 9 5 0 d i s c i p l i n a r y p r o g r a m – l i c e n s e d n u r s e s S h a R o n C l a n t o n N u r s e A i d e R e g i s t r y 8 0 4 - 6 6 2 - 7 3 1 0 r e c e p t i o n i s t , n u r s e a i d e v e r i f i c a t i o n s A m y D a v i s M a s s a g e t h e r a p y, c l i n i c a l n u r s e 8 0 4 - 6 6 2 - 9 9 4 9 s p e c i a l i s t , a d m i n i s t r a t i v e s u p p o r t f o r t h e B o a r d R e n e é G r a y - E p p s A d m i n i s t r a t i v e s u p p o r t N u r s i n g 8 0 4 - 6 6 2 - 7 5 4 4 a n d N u r s e A i d e F r a n c i n e G r e e r N u r s e A i d e R e g i s t r y i n i t i a l 8 0 4 - 6 6 2 - 7 3 1 2 c e r t i f i c a t i o n , r e n e w a l s M a r i a M . H o l t A d m i n i s t r a t i v e s u p p o r t t o 8 0 4 - 6 6 2 - 9 4 8 8 l i c e n s u r e B e v e r l y H u t s o n - B r y a n L i c e n s u r e b y e n d o r s e m e n t - 8 0 4 - 6 6 2 - 9 5 7 2 n u r s e s S h a y K n i g h t N u r s i n g r e n e w a l s , 8 0 4 - 6 6 2 - 7 6 6 6 r e i n s t a t e m e n t s , v e r i f i c a t i o n s , d u p l i c a t e l i c e n s e s D o r c a s L e t t A d m i n i s t r a t i v e s u p p o r t f o r 8 0 4 - 6 6 2 - 9 9 4 8 d i s c i p l i n a r y p r o g r a m s , F O I A r e q u e s t s ( N u r s i n g , N u r s e A i d e s ) L a u r a L . M u e l l e r L i c e n s u r e b y e x a m i n a t i o n – 8 0 4 - 6 6 2 - 9 9 4 7 R N ’s a n d L P N ’s J a ’ N i t a R o y a l A d m i n i s t r a t i v e s u p p o r t f o r 8 0 4 - 6 6 2 - 9 0 7 5 d i s c i p l i n a r y p r o g r a m s – N u r s i n g a n d N u r s e A i d e S a n d y W. Ta t u m N u r s i n g r e c e p t i o n i s t , e m p l o y e r 8 0 4 - 6 6 2 - 9 9 0 9 v e r i f i c a t i o n s

P a g e 1 9