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Return to table of contentsVII. State licensure and regulationThe regulatory structure under which an NP may practicein the states is complex. In the majority of states,advanced practice nurses are first licensed as RNs,and only then can they be recognized by the states asadvanced practice nurses and/or NPs.Licensure as an RNAccording to the NCSBN, “Licensure is the process bywhich an agency of state government grants permissionto an individual to engage in a given profession uponfinding that the applicant has attained the essentialdegree of competency necessary to perform a uniquescope of practice.” Licensing requirements define whatis necessary for the majority of individuals to be ableto practice the profession safely and validate that theapplicant has met those requirements. 216 The NCSBNhas developed the following “Uniform Core LicensingRequirements” for RNs:• Individual must have graduated from or possess eligibilityfor graduation from state-approved registerednursing program• Individual must pass the NCLEX-RN examination• Individual must self-report regarding all felony convictionsand all plea agreements and misdemeanorconvictions of lesser-included offenses arising fromfelony arrests• Individual must self-report regarding any drug-relatedbehavior that affects the candidate’s ability to providesafe and effective nursing care• Individual must self-report regarding any functionalability deficit that would require accommodation toperform essential nursing functions. 217Recognition as an advanced practice nurseand/or NPNPs must meet certain qualifications in all states andthe District of Columbia. Laws vary by state. Accordingto the NCSBN, the majority of jurisdictions grant NPsauthority to practice advanced nursing through certificates,recognition, registration or similar means. Ingranting authority to practice beyond the RN scope ofpractice, boards rely upon conventional authority mechanisms,including graduation from approved educationalprograms and, in many cases, certification examinations.Currently 41 states rely upon national certification programsto measure competency. 218Licensure reciprocityAccording to NCSBN, RNs are granted licensurereciprocity in all states that have adopted the NurseLicensure Compact (NLC), subject to each state’s practicelaw and regulation. Having mutual recognition, anurse may practice across state lines unless otherwiserestricted. Each state must enact legislation authorizingthe NLC and adopt administrative rules and regulationsfor implementation of the compact. Once the NLC isenacted, each state designates an administrator to facilitatethe exchange of information between the statesrelating to NLC nurse licensure and regulation. 219In 2000 the NCSBN, with APRN 220 stakeholders,established the Uniform APRN Licensure/Authority toPractice Requirements for an APRN compact, whichwould “promote consistent access to quality advancedpractice nursing care within states and across statelines.” NCSBN stipulates, “A state must either be amember of the current nurse licensure compact for RNand LPN [licensed nurse practitioner], or choose toenter into both compacts simultaneously to be eligiblefor the APRN Compact. No date has been set for theimplementation of the APRN Compact, but the statesof Utah, Iowa and Texas have passed laws authorizingjoining the APRN Compact.” 221216. Web. NCSBN. www.ncsbn.org/regulation/nlc.asp. Retrieved October 4, 2006.217. Web. NCSBN. www.ncsbn.org/667.htm. Retrieved June 28, 2008.218. Web. NCSBN. www.ncsbn.org. Retrieved August 22, 2006 and verified with information from Figure 1 in the Appendix.219. Web. NCSBN. “Nurse Licensure Compact Information.” www.ncsbn.org/nlc.htm. Retrieved October 5, 2006.220. APN and APRN (advanced practice registered nurse) are interchangeable terms.221. Web. NCSBN. “APRN Compact.” www.ncsbn.org/917.htm. Retrieved April 25, 2008.Scope of Practice Data Series: Nurse practitioners • VII. State licensure and regulation44