Nurse Practitioner License Requirements: Change is in the Air and Inevietable

A future nurse practitioner will have the most options if his or her education and third party certification meet the national standard.

One thing prospective nurse practitioners can expect is change: Nurse practitioner requirements are set at the state level, but there is also an emerging national model. Some states have made legislative changes to conform to the National Council of State Boards of Nursing APRN Consensus Model (https://ncsbn.org/738.htm). The plan is to make requirements more consistent and licenses more portable, to train APRNs well and then allow them to practice at the extent of their training.

Some states have not made changes to licensing requirements in a number of years, but the requirements in place today won’t necessarily reflect the standards in place a few years from now. A future nurse practitioner will have the most options if his or her education and third party certification meet the national standard.

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Meeting Education and Certification Requirements

A nurse practitioner will need to complete a graduate nursing program that is aligned to his or her role and intended population. The population may be as broad as ‘families and individuals across the lifespan’ (Family Nurse Practitioner Programs). However, the graduate student may choose to focus on a narrower age band: neonatal, pediatrics, or adult and gerontological populations. Other NP options include women’s health or psychiatric and mental health practice. The certification agency and licensing board may both expect that the program – not just the institution – be accredited.

After graduation, the nurse will seek national certification. There are multiple certifying agencies. Each state chooses the organizations and/ or certifications that it will accept. However, there are national organizations that state boards often look to when making decisions. The NCSBN has rigorous criteria in place for acceptance; the NCSBN is so influential that the certification agencies themselves are making changes to align to the APRN Consensus Model.

States may approve certifying agencies or approve individual certification examinations. Some states defer to organizations that accredit certification agencies. They may reference the National Commission for Certifying Agencies and/or the American Board of Nursing Specialties.

The candidate will present academic qualifications to the certification agency. The timeframe will vary. In many cases, graduates can be issued permits by their state boards that will allow them to practice for a limited time pending certification. Those who do so need to follow strict timelines. In most cases, examination failure invalidates a temporary credential.

Meeting Licensing Prerequisites

RN licensure is a prerequisite to APRN licensure/ authorization. In most cases, a nurse will hold the RN and APRN credentials simultaneously; the APRN credential may be referred to as a license, certificate, or authorization. In some cases, an RN will upgrade his or her status from RN to APRN licensure.

RN licensure and APRN licensure are not always held in the same state. Approximately half of U.S. states belong to the nurse license compact at the RN level. A registered nurse who lives in a party state can work as an RN (but not an APRN) in any other compact state on the strength of a multi-state license issued by his or her own state of residence.

Currently, there is no operational APRN Licensure Compact. However, this, too is likely to change. The NCSBN drafted a new consensus model in 2015.

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Meeting Other State-Specific Requirements

States set additional minor requirements that must be completed before licensure. Some, for example, require fingerprint-based background checks even of those who already cleared background checks at the RN level.

Some states require that a prospective APRN complete a supervised or collaborative practice requirement. This doesn’t necessarily mean that the state places more obstacles in the path of a practitioner. It may be that the nurse practitioner will ultimately be rewarded with a higher scope of practice. Connecticut, for example, recently passed legislation allowing independent practice for nurse practitioners who had completed their three years of collaborative practice (http://www.medscape.com/viewarticle/824465).

In many states, nurse practitioners apply separately for prescriptive authority. There is a good deal of variability in terms of what types of prescriptions require a separate authorization.

The licensing board of the individual state is the source for both licensing and practice information.

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Nurse Practitioner License Requirements: Change is in the Air and Inevietable

Meeting Education and Certification Requirements

Meeting Licensing Prerequisites

Meeting Other State-Specific Requirements

State Specific Nurse Practitioner License Requirements