West African

educated nurseGetting started with licensure

“

”

A license issued by a

governmental entity provides

assurance to the public that the

nurse has met predetermined

standards.

National Council of States Board of Nursing (NCSBN)

Nursing Licensure in the United States

Objectives

This presentation provides you with basic information and

resources for information required to obtain your nursing

license in the U.S.

You will also learn what information you need to return to

school to further your education should you choose.

Introduction

Licensure is the process by which boards of nursing grant permission to an individual to engage in nursing practice after determining that the applicant has attained the competency necessary to perform a unique scope of practice.

Licensure is necessary when the regulated activities are complex, require specialized knowledge and skill and independent decision making.

The licensure process determines if the applicant has the necessary skills to safely perform a specified scope of practice by predetermining the criteria needed and to evaluate licensure applicants to determine if they meet the criteria.

Licensure of Nurses is an integral part of public protection(NCSBN, 2011).

Types of Licensure

There are two types of licensure in the U.S.

Licensure by NCLEX and

Licensure by Endorsement.

If you are educated outside of the U.S. you must

first get licensure by taking and passing the

NCLEX examination.

To Become a nurse in the

U.S.

You must first apply for initial licensure in a U.S.

state or territory, take and pass the NCLEX-RN or

NCLEX-PN examination.

The NCLEX-RN is the nurse licensure examination

given for licensure as a registered nurse (RN).

The NCLEX-PN or VN depending on the state or

territory is the licensure examination given for

licensure as a licensed practical nurse (LPN) or

licensed vocational nurse (LVN).

Licensure by Endorsement.

Licensure by Endorsement is used after

you have passed NCLEX examination

and has at least one U.S. state or

territorial nursing license, and apply to

another state for a nursing license.

It is your responsibility to contact the

BORN in a state where you expect to

practice to obtain an application and

information about licensure within that

state.

Nurse Licensure Compact

Nurse Licensure Compact (NLC): is the mutual

recognition model of nurse licensure that allows a nurse

to have one license(in his or her home state of

residency) and to practice (both physically and

electronically) in other states that participate in this

model of nursing regulation.

Practice under the NLC is subject to each state’s

practice laws and rules.

Currently there are 24 states that participate in the

mutual recognition model of the Nurse Licensure

Compact (NLC).

To learn more about Nurse Licensure Compact visit

https://www.ncsbn.org/nlc.htm

Requirement for Nursing

Licensure in the U.S.

A requirement for nursing licensure in the U.S. is the passage

of a secure, high-stakes, psychometrically sound licensure

examination.

Across all U.S. jurisdictions, the national nursing licensure

examination is the National Council Licensure Examination

for Registered Nurses (NCLEX-RN).

Passage of this exam indicates that the individual has the

minimal competency needed to practice nursing safely.

Importance of Licensure

Licensure also ensures that foreign educated nurses meet U.S. standards.

Extensive analyses (credentials evaluation) are done on all foreign nurse applicants for licensure in the U.S. to ensure

they have met the same education requirements as domestic graduates,

have passed the licensure exam,

have passed tests of the English language and

have had no history of discipline on their license in the country of origin.

The licensure process holds foreign educated nurses to the same standards as U.S. nurses, ensuring the public that these nurses are as qualified to practice as nurses educated in the U.S.

Obtaining Licensure to

Practice Nursing in the U.S.

Your responsibility:

Prove of graduation from a nursing program comparable to a Member Board approved RN prelicensure program in the U.S.

Successful passage of an English proficiency exam that includes the components of reading, speaking, writing and listening, except for applicants from countries where English is the native language, and the nursing program where the applicant attended was taught in English and used English textbooks.

You’re licensed as a Registered Nurse (RN) in your country.

Self disclosure of nursing licensure status in country of origin, if applicable.

Criminal Background Check for public protection. Provide self disclosure of all misdemeanors, felonies, and plea agreements.

Submit state and federal finger print checks.

Successful completion of the NCLEX-RN examination.

Obtaining Licensure to

Practice Nursing in the U.S.

Depending on which country you’re from, you’ll likely be

required to take one of the tests below:

You can take the Test of English as a Foreign Language (TOEFL),

the Test of English for International Communication (TOEIC) or

the International English Language Testing System (IELTS).

You may be exempt from taking one of the exams above, if

you meet the three criteria below:

From a country where English is the native language,

The spoken language of your nursing school was English.

Your nursing school textbooks were written in English.

Obtaining Licensure to

Practice Nursing in the U.S.

Your state Board of nursing responsibility

Verification by a credentials review agency of graduation from a nursing program comparable

to a Member Board approved RN prelicensure

program.

What you need:

A copy of nursing licensure or registration from

country of origin.

Education transcript.

CGFNS certificate if you have one.

Commission on Graduate of

Foreign Nursing Schools (CGFNS)

CGFNS prescreens foreign educated nurses wishing to practice in the U.S.

Prescreening involves

a review of the nurses education;

licensure in the home country;

English language proficiency testing; and

a predictor exam that provides an indicator of the nurse's ability to pass the U.S. national licensure exam (NCLEX).

Note: you do not have to take the predictor exam prior to taking the NCLEX-RN examination unless your state's board of nursing requires it.

CGFNS

CGFNS provide Credentials Evaluation Service (CES)professional report.

This report meets the specific requirements of individual state boards of nursing.

It includes a statement of comparability of an applicant’s education when measured against U.S. standards.

The CGFNS International CES Professional Report provides a detailed analysis of the credentials earned at multiple levels of nursing education received outside the United States according to requirements specific to a state.

Nurses use this service for licensure, immigration, and employment purposes.

For more information on these services visit http://www.cgfns.org/services/ces-professional-report/

NCLEX Requirements

Each state in the U.S. is responsible for the licensure of nurses within that state.

The NCLEX examination is required by all state boards for licensure,

Variations exist among the states.

Each state board has its own requirements to determine educational comparability of those educated outside of the United States.

Some states may require you to complete a Foreign Educated Nurses (FEN) refresher course.

NCLEX Requirements

The course consists of 120 hours in the classroom and 120 hours of clinical practice under the supervision of a licensed Registered Nurse.

Almost all 50 U.S states board of nursing will require a service that can be provided by CGFNS International prior to authorizing nurses educated outside of the United States to sit for the NCLEX exam.

For specific licensure information visit your state’s board of nursing website.

This process takes time be patient and be diligent in providing all necessary information.

After registering with NCLEX you will receive an Authorization To Test letter (ATT).

Now you’re a U.S. Nurse. What to

do next?

“Ignorance of the law is no excuse.”

Be sure to ask for a copy of the Nursing

Practice Act (NPA)in the state in which you

are licensed to practice nursing.

Your state’s NPA sets forth the requirements

for licensure and defines the scope of nursing

practice within that state.

The NPA contains the state’s regulations and

all nurses are accountable to practice

according to those regulations.

Licensure renewal

You should become familiar with renewal procedures

so you always remain current and legally authorized to

practice in your state.

The Board of Registration of nursing establish

procedures for nurses to apply for periodic renewal of

their licenses.

Some states require demonstration of continuing

education, practice hours or other activities as part of

the renewal requirements.

The RN scope of practice The RN scope of practice define nursing actions and procedures

that are permitted by law based on specific experience and educational qualifications.

The RN scope of practice is independent and comprehensive in all steps of the nursing process.

RN practice doesn't require assignment or supervision by a higher level healthcare provider.

The RN uses his or her skills, knowledge, and professional judgment to determine appropriate action based on the scope of practice, standards of practice, nurse practice acts from state boards of nursing, and legal regulations.

You should know your scope of practice and that of those to whom you delegate.

Going Back to School

For several years, policymakers, researchers and practice leaders have identified that education does make a difference in how nurses practice.

It is important for a West African educated nurse in the United States to return to school to get a baccalaureate degree.

Baccalaureate nursing education provides the nurse with a more in-depth study of the physical and social sciences, nursing research, nursing leadership and management, community and public health nursing, and the humanities.

This broader and more in-depth education enhances the nurses professional development and allows the baccalaureate graduate to better understand the many social, cultural, economic and political issues that impact patients and influence healthcare.

Going Back to School

Going back to school helps improve your sense of accomplishment

Improves your communication with others in the health professions.

By earning a baccalaureate degrees, you will have better career opportunity, you are also more likely to continue to graduate level.

RNs reported transformative experiences when returning for their baccalaureate degree in nursing, which included raising their potentials, changing their perspectives about nursing practice, and seeing the big picture.

Returning to school will improve your knowledge and professionalism, and may help you become more effective change agents and patient advocate.

Going back to school may help increase the number of minority nurses in leadership and academic settings, who serve as role models for other minority nurses.

Going Back to School

The choice to go back to school depends, in part, on your goals:

Where do you want to be in 5 years? In 10 years?

Will a baccalaureate degree be helpful—or even necessary—to achieve your goals?

If you love what you’re doing and don’t anticipate that you’ll need a baccalaureate degree to continue doing it, there’s no reason to go back to school.

If you plan to become a nurse manager, educator, or specialist, you’ll need a BSN degree as a stepping stone to your new career.

Going Back to School

If you are looking to return to school for your Baccalaureate education there are several options available to you.

Traditional RN to BSN in class, part-time, fulltime, evening programs, weekend programs, online and hybrid programs.

To do this you will need a current State RN license.

You will need complete educational transcript from your country of origin.

It is important to contact several schools to explore different options and requirements.

Beware of schools that expect you to repeat all your nursing courses.

Going Back to School

Research if your employer offer incentives to return to school. Such as;

Scholarship or tuition reimbursement.

Will your manager/employer be flexible enough to schedule your work hours around your class schedule?

Will your benefits continue if you need to reduce your work hours to ensure success in completing the program?

Will you receive a pay differential or be rewarded by placing you on a higher rung on a clinical ladder once you earn your degree?

If you have no other reason to go back to school, do it for yourself.

CGFNS services

CGFNS provides Credentials Evaluation Service Academic Report.

This report is designed to meet the needs of applicants pursuing further education in U.S. institutions of higher learning.

The CGFNS International Credentials Evaluation Service (CES) Academic Report provides a detailed analysis of the nursing education received outside the United States.

Nurses use this service primarily for academic admissions purposes.

Center for Educational

Documentation (CED)

The Center for Educational Documentation provides

professional assistance in interpreting the educational

background of persons educated abroad.

For more information on credential evaluation from

CED visit http://www.cedevaluations.com/

National Association of

Credential Evaluation Services

(NACES) NACES is an association of independent, private

credential evaluation services, whose members serve

persons who have completed part or all of their

education outside of the United States and who are

seeking further education, professional licensure,

immigration to or employment in the United States.

To learn more about their services and member

organizations visit http://www.naces.org/index.html

Providing Educational

Transcript

Secondary School Information.

For nurses from West Africa you will need your

WAEC, GCE,

A complete academic record or transcript from each educational institution you attended for the profession being evaluated is required.

Nursing license from your country.

School of nursing transcript showing course work, number of hours completed and grades.

Transcript must contain full education, course-by-course report;

Theoretical instructional hours.

Laboratory and clinical (Ward)hours completed

Educational Transcript

The academic transcript from your school of nursing must be sent directly to the credential evaluation centers.

It is important to request two copies of you transcript one for yourself so you are aware of what is being reviewed.

This process must be started at least 6 to 12 month prior to the anticipated date beginning classes.

Be sure that you are speaking to the right individual at the institution prior to paying fees and stating classes, to avoid the pitfall most have faced of having to repeat all nursing classes despite practicing nursing in the United States for several years.

Educational Transcript

The Credential Evaluation report provided by the

above mentioned entities is advisory in nature, they do

not make specific placement recommendations.

The final determination for course credits and

requirements is made by the institution to which you

are applying to continue your education.

Resources

An excellent resource for foreign-educated nurses is the

NCSBN Learning Extension course entitled Acclimation of

International Nurses into U.S. Nursing Practice. This course

includes information on:

Process and organizations that regulate U.S. nursing practice.

Personal challenges of adapting to life in U.S.

Professional challenges of practicing nursing in the U.S. as a

foreign-educated nurse.

Resources for the foreign-educated nurse.

To access this course and others go to

http://learningext.com/nurses/p/acclimation_intl_nurses.aspx

References

NCSBN (2011). Licensure of Nurses: An Integral Part of Public Protection. Retrieved January 3, 2014 from https://www.ncsbn.org/LicensureofNurses_Aug2011.pdf

CGFNS international (nd). Retrieved January 3, 2014 from http://www.cgfns.org/

CGFNS International Online Knowledge Base. (nd). Choosing the Correct CGFNS International Service for Nurses. Retrieved January 3, 2014 from https://cgfns.zendesk.com/entries/24669126-Choosing-the-Correct-CGFNS-International-Service-for-Nurses

Orsolini-Hain, L. (nd). What’s all the Fuss? Working Towards a Baccalaureate or Graduate Degree in Nursing. Retrieved January 3, 2014 from http://www.nsna.org/careercenter/fuss.aspx

Powers, J. (2013). Are you practicing to your full potential? Nursing Made Incredibly Easy! (11(3), 4. doi: 10.1097/01.NME.0000428434.46662.5d