36 unit 1 | Professional Considerations
licensure. This information can usually be found on
the board of nursing Web site for that particular state.
Multistate Licensure
The concept of multistate licensure allows a nurse
licensed in one state to practice in additional states
without obtaining additional licenses. NCSBN cre-
ated a Multistate Licensure Compact that permits
this practice. States that belong to the compact
have passed legislation adopting the terms of this
agreement and are known as party states. The
nurse’s home state is the state where he or she lives
and received his or her original license. Renewal of
the license is completed in the home state.
A nurse can hold only one home-state license. If
the nurse moves to another state that belongs to
the compact, the nurse applies for licensure within
that state based on residency. The nurse is expected
to follow the guidelines for nursing practice for
that new state. The multistate licensure applies only
to a basic registered nurse license, not to advanced
practice. More information on multistate licensure
can be found on the NCSBN Web site.
Disciplinary Action
State boards of nursing maintain rules and regula-
tions for the practice of nursing. Violation of these
regulations results in disciplinary actions as delin-
eated by these boards. Issues of primary concern
include but are not limited to the following:
■Falsifying documents to obtain a license
■Being convicted of a felony
■Practicing while under the influence of drugs
or alcohol
■Functioning outside the scope of practice
■Engaging in child or elder abuse
Nurses convicted of a felony or found guilty in a
malpractice action may find themselves before their
state board of nursing or, in Canada, the provincial
or territorial regulatory body.
Disciplinary action may include but is not lim-
ited to the suspension or revocation of a nursing
license, mandatory fines, and mandatory continu-
ing education. For more information regarding the
regulations that guide nursing practice, consult the
board of nursing in your state or, in Canada, your
provincial or territorial regulatory body.Conclusion
Nurses need to understand the legalities involved
in the delivery of safe health care. It is important
to know the standards of care established within
your institution and the rules and regulations in
the nurse practice acts of your state, province, or
territory because these are the standards to which
you will be held accountable. Health-care con-
sumers have a right to quality care and the expec-
tation that all information regarding diagnosis
and treatment will remain confidential. Nurses
have an obligation to deliver quality care and
respect client confidentiality. Caring for clients
safely and avoiding legal difficulties require nurses
to adhere to the expected standards of care and
document changes in client status carefully.
Licensure helps to ensure that health-care con-
sumers are receiving competent and safe care from
their nurses.Study Questions1.How do federal laws, court decisions, and state boards of nursing affect nursing practice? Give an
example of each.
2.Obtain a copy of the nurse practice act in your state. What are some of the penalties for violation
of the rules and regulations?
3.The next time you are on your clinical unit, look at the nursing documentation done by several
different staff members.Do you believe it is adequate? Explain your rationale.
4.How does your institution handle medication errors?
5.If a nurse is found to be less than proficient in the delivery of safe care, how should the nurse
manager remedy the situation?