- Competing a nursing education program is a significant accomplishment that requires commitment, perseverance, and focus. You're entering a dynamic profession, with many career options, opportunities for growth, and potential for leadership. As a nurse, you can dramatically improve people's health, even save lives. The practice of nursing is one of the most highly-regarded professions in the country. In Gallup polls, the public consistently ranks it as the most ethical and honest profession in America. - I chose a career in nursing because I wanted to make a real difference in patients' lives. My education prepared me to provide high quality clinical care to patients, and now that I'm practicing, I'm recognizing how important the laws are to providing excellent care and maintaining a safe environment for my patients. - Like other health care professions, nursing is regulated by law to ensure safe practice. In the next few moments, we'll talk more about the ways the profession is regulated, through nurse licensure, state boards of nursing, and state laws called Nurse Practice Acts. ♪ [music] ♪ With more than 4.5 million individuals holding a nursing license, nurses are the largest group of licensed health care professionals in the United States. You need to pass the National Council Licensure Examination, or NCLEX, to receive a license. But becoming a Registered Nurse involves more than just meeting this standard. Think of becoming licensed as a privilege that's been granted by the law. In fact, it's a commitment between you and the public. - Nurses need specialized knowledge, skills, and abilities to make decisions about patient care. Patients come to us in their most vulnerable state. The public sees nursing care as something so valuable and significant, something that embodies such trust and expert knowledge, that laws have been established to regulate our practice. Licensure is one aspect of that regulation. - Once you're licensed, it's your responsibility to keep your nursing license current. The renewal process varies across states. For instance, a majority of states require that nurses complete continuing education credits, including specific coursework in some cases, before they can renew their licenses. The consequences of not renewing your license can vary from a fine, to other types of discipline. You may even be required to re-take the NCLEX. - I recently accepted a tele-health nursing position, so now I care for patients in multiple states. Since practice is where the patient is, I need to be licensed in every state where my patients are located. - There's one important exception to needing a separate license to practice in each state where patients are located. Many states belong to the Nurse Licensure Compact. If your state is a member, you may be eligible for a multi-state license, which allows you to practice in other Compact states, without obtaining a license in those particular states. Your state's Nurse Practice Act and regulations will confirm whether your state is part of the Nurse Licensure Compact. ♪ [music] ♪ The legal authority to practice in the nursing profession comes from each state or territorial government. More than 100 years ago, Boards of Nursing were established to protect the public's health and welfare. Boards of Nursing serve many functions, which typically include granting and renewing licenses, developing practice standards, writing administrative rules and policies, disciplining unsafe nurses, and accrediting or approving academic nursing programs. - I encourage my team to learn about how our Board of Nursing works, and to familiarize themselves with the Nurse Practice Act. I also suggest that they read our Board's newsletter and visit its website to stay informed about any changes in nursing regulation. ♪ [music] ♪ - Each state or territory's Nurse Practice Act is a law enacted by the state's legislature and enforced by the Board of Nursing. The specific content of Nurse Practice Acts vary from one jurisdiction to another, but, there are three basic components included in every Nurse Practice Act. Standards and scope of nursing practice, requirements for licensure, and grounds for disciplinary action. A Nurse Practice Act is the law governing practice, and administrative rules or regulations provide more specific information. - Keeping the public safe is a shared responsibility and everyone on the team has to play an active part. - As a nurse manager, I've seen a few problems over the years with nurses who violate the Nurse Practice Act. Being aware of your Nurse Practice Act helps prevent violations. - Even new nurses who are just entering the profession need to be aware of their role in preventing, detecting, and reporting potential violations. These may include significant practice- related errors, drug-related issues or a substance use disorder, professional boundary violations, sexual misconduct, patient abuse, fraud, and criminal background. Depending on the severity of the violation, the Board of Nursing sanctions may include: a reprimand, probation, remediation, fines, license suspension, or even license revocation. ♪ [music] ♪ - Professional boundaries may seem obvious, but sometimes there are gray areas, and a nurse can cross a line without realizing it. For example, I use Facebook, instagram, and twitter a lot, but I have to be careful when I'm talking about work. Discussing my patients or posting pictures of them on social media violates their patient confidentiality, even if I don't mention their names. - Decisions around professional boundaries can be especially challenging for new nurses. Even a seemingly harmless act like giving your personal phone number to a patient could constitute a boundary crossing and could lead to a violation. I provide guidance to nurses on issues related to maintaining professional boundaries, and how to use social media responsibly. - You may face many ethical dilemmas throughout your career about professional boundaries, and the many other challenges nurses encounter when caring for others. In addition to familiarizing yourself with your Nurse Practice Act, and the practice standards set by your board of nursing, they're tools to help you navigate ethical issues, to maintain patient safety. The American Nurses Association's Code of Ethics for Nurses is particularly useful. - My advice to new nurses is to always focus on patient safety and remember that you are your patient's last line of defense. - Always use care and think about what you're doing, to prevent errors. And make sure to ask questions if you're unsure about something. - I think of my license as a reminder of the responsibility entrusted to me by my patients. So my advice is to never take that responsibility we've been given lightly. - You have a promising future ahead of you, and a reputation of honesty and trustworthiness to uphold. Your education has given you a strong foundation for successful practice, but the practice of nursing is a life-long learning experience. Your state Board of Nursing and the NCSBN website can help answer your questions about nursing regulation, and lead you to resources that will help to maintain professionalism and integrity throughout your career. ♪ [music ♪