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 and 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 evaluating licensure applicants to determine if they meet the criteria.
Components of nursing licensure:
- Verification of graduation or eligibility for graduation from an approved prelicensure RN or LPN/VN nursing education program
- Verification of successful completion of NCLEX-RN or NCLEX-PN examination
- In some states, criminal background check
To begin the licensure process, search the particular state board of nursing website for applications.
The responsibilities of a licensed nurse include knowledge of, and adherence to, the laws and rules which govern nursing as outlined in the nurse practice act and regulations. Review the nursing law and rules by locating your state nurse practice act and regulations.
What You Need to Know About Nursing Licensure and Boards of Nursing
This brochure explains the importance of nurse licensure, including:
- Why nurses are required to be licensed
- How BONs safeguard the public by evaluating, issuing and renewing nurse licenses
- How the nurse practice act (NPA) is implemented
- Why disciplinary actions are taken against nurses who violate the NPA
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State and Territorial Boards of Nursing: What Every Nurse Needs to Know
This brochure offers nurses an explanation of what boards of nursing (BONs) do for the profession and those who work in it. This brochure provides information regarding:
Your education is just part of the process of earning nursing credentials. Find out what’s next after your degree.
The process of getting your nursing license can seem complicated, time consuming, and costly. There are multiple license types, different rules in different states, and easy-to-confuse destinations like license, certification, and credential. We’re here to help. We’ve broken down the steps, the states, and more, so you can plan your path to licensure.
Your first step to getting any kind of nursing license will be getting the education and training you need. You can then take an exam to earn your license. Just like earning a driver’s license, you’ll need to get your training first, then demonstrate that training by passing a test.
Nursing Programs That Require Licensure
There are four different types of nursing programs that require state-issued licenses. It’s important to note each state has slightly different regulations, and you will want to make sure the school you choose prepares you for the requirements of the state you want to work in.
- Certified Nursing Assistants (CNAs), called Licensed Nursing Assistants (LNAs) in multiple states
- Registered Nurses (RNs)
- Licensed Practical Nurses (LPNs), called Licensed Vocational Nurses (LVNs) in Texas and California
- Advanced Practice Registered Nurses (APRNs)
While you might be able to find work as a nursing assistant without a license in some states and at some facilities, you typically won’t be able to use the CNA title. Generally, unlicensed nursing assistant roles pay less and have less room for growth. Plus, many hospitals, medical centers, and other facilities only hire licensed CNAs.
Just like earning a driver’s license, you’ll need to get your training first, then demonstrate that training by passing a test.
While fees and testing requirements can vary, you’ll need about the same level of training and education for each level or nursing in every state. For example, while one state might have lower initial application fees for RNs than a nearby state, you’ll still need to complete either an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN) to start the licensing process.
Complete an Accredited, State-Approved Nursing Program
Choosing the right nursing program can make a huge difference in your education. One of the most important considerations when you’re looking at programs is accreditation. If a program isn’t accredited, you could run into the following issues:
- You won’t be able to get financial aid from the federal government
- Your credits won’t transfer if you want to go back to school later
- You might not be eligible to take the exams you need for licensure
- You might not be eligible for credentials or certifications
Nursing programs are accredited nationally by a few agencies, including:
Both agencies ensure that programs are at a high standard and providing students with the information they need to know to be successful in their nursing careers. You can check if your school or program is accredited in a few ways. The institution most likely declares its accreditation on its website, most often in the “About” section. You can also visit the Department of Education’s database of accredited postsecondary institutions and programs website and search for your school or program.
New Guidelines Clarify State-Level Requirements for Nursing Grads
A new licensing disclosure rule from the U.S. Department of Education requires higher education institutions to tell prospective students whether or not their specific degree program will qualify them to work in all 50 states. The rule, which went into effect in July, 2020, is intended to prevent students from completing a school’s program, only to discover upon graduation that the program doesn’t meet state-level requirements for employment.
Apply for a License with Your State’s Licensing Board
Once you’ve finished a state-approved, accredited nursing program, you’re ready to apply for your nursing license with your state’s licensing agency or nursing board. A nursing board is a government agency in each state that oversees nursing licensing. Most states have a single nursing board for LPNs, RNs, and APRNs, although few states separate them. Some nursing boards also cover CNAs, but in many states, CNAs are overseen by separate professional licensing agencies. You can check out details of the boards for each nursing type in the maps below.
Most states have similar licensing requirements. You’ll need to have completed a state-approved, accredited program before you apply. You’ll send your transcripts along with your application and fees to your state’s board. LPNs, RNs, and APRNs need to pay application fees in every state. This isn’t always the case for CNAs. In some states, CNAs don’t pay any fees at all, while in other states you’ll only pay for your exam. Even in states that do charge fees, CNAs often have those fees included in their training program or paid by their employer. Some states require clinical hours; some don’t.
State Nursing Licensing Requirements
Want to Work in the U.S. as a Foreign Nurse?
If you’ve worked as a nurse in another country and want to become a registered nurse in the U.S., there are a few more steps you’ll need to take before applying for your license, including passing an English language proficiency test, taking a special exam top prove your readiness to work as a nurse, and completing a screening for a work visa.
Register for the NCLEX or Other Required Exam
RNs and LPNs
Once you’ve applied for your license, you can sign up to take the National Council Licensure Examination (NCLEX); a standardized test that state regulatory boards use to determine if a candidate is ready to become licensed as an entry-level nurse.
In every state, RNs and LPNs need to take the (NCLEX) to be licensed. LPNs will take the NCLEX-PN, while RNs will take the NCLEX-RN. The NCLEX-PN is an entry-level exam that tests the knowledge LPNs have gained, while the NCLEX-RN is more in-depth and designed for RNs.
You can register for the NCLEX online or by phone. You’ll need to provide proof of your education and proof you’ve been approved by your state to take the NCLEX. This is called an Authorization To Test (ATT). Your state will notify you when your application has been received. You’ll have a window to take your NCLEX once you receive your authorization. Most states will grant a 90-day ATT window.
What About APRNs?
APRNs will need to take an exam in their specialty or practice area. These exams allow you to earn national certification. The test you take will be the same no matter what state you live in. In most states you’ll need to earn certification before you’ll be granted your state license. The test you take will depend on your specialty, but some common APRN certifications include:
- American Association of Nurse Practitioners (AANP) Family Nurse Practitioner Certification (FNP)
- American Nurses Credentialing Center (ANCC) Adult Nurse Practitioner Certification (ANP-BC)
- American Nurses Credentialing Center (ANCC) Emergency Nurse Practitioner Certification (ENP-BC)
- American Nurses Credentialing Center (ANCC) Pediatric Primary Care Nurse Practitioner Certification (PPCNP-BC)
- National Certification Corporation (NCC) Certification as a Neonatal Nurse Practitioner (NNP-BC)
What About CNAs?
Your CNA exam will depend on your state. Some states have their own exams, while others use CNA exams from large national organizations like Pearson VUE, a popular online testing portal. No matter the case, you’ll need to complete your CNA program before you can take the exam.
Take and Pass the Test
For RNs and LPNs/LVNs, the NCLEX is a multiple-choice exam administered on a computer at an approved testing center. The exam is responsive to you. When you get a question right, your next question will be harder. When you get a question wrong, your next question will be slightly easier. You’ll have a set number of questions and a set amount of time depending on your exam.
In a typical year:
NCLEX-RN
As many as 265 questions over six hours
You’ll answer a minimum of 75 questions.
NCLEX-PN
As many as 205 questions over five hours
You’ll answer a minimum of 85 questions.
You’ll receive your results within about six weeks after taking the exam. If you don’t pass, you can take the exam again, but you’ll be subject to an additional charge. You’ll have to wait at least 45 days before you take the exam again. You can take the NCLEX as many as eight times in a single year, although some states limit the number of times you can retry the exam within a year.
You’ll receive your NCLEX results about six weeks after you take the exam.
Your nursing program will likely have review sessions and study groups set up for the NCLEX. You can also take practice exams on the NCLEX website, or look into other online study guides. Many online practice exams use the same question style as the real NCLEX exam, so you know what to expect.
For other levels of nursing, your test procedure will vary depending on your state (CNAs) or your specialty (APRNs). Your program’s administrator should be able to give more specific information and might be able to provide practice exams or other study aids.
NCLEX Test Changes Due to COVID-19
In response to the unprecedented circumstances of the COVID-19 pandemic, the NCSBN has modified the testing procedures for both the RN and PN exams. The council has capped the exam time at five hours and modified the number of questions for both tests (minimum of 75 questions and a maximum of 145) to allow testing centers to provide CDC-recommended social distancing while scheduling the maximum number of candidates per day. The NCSBN says the changes preserve the difficulty of the exams and passing standards. Find more details on the NCSBN website.
Complete Additional State Requirements
Most states have multiple other requirements you’ll need to meet before you’re fully licensed. Generally, this includes:
- A background check including FBI fingerprints
- Self-reporting of any addiction concerns or past legal trouble you’ve had
- Proof of English language proficiency
- References from professors or supervisors
Most states also require that nurses be of “good moral character.” Normally, this is demonstrated by things like your background check and reference letters. Some nursing boards might also check in with your former employers.
Some states grant temporary licenses while you’re waiting for your full license to be processed, but not all. Your temporary license might have some restrictions. For example, you might only be allowed to work under supervision. You can normally begin applying for jobs once you have a temporary license or when the application is in process. You’ll be able to take on the full range of job duties for your role when your state approves and sends you your license.
Cross-State Licensing is Available
Keep in mind that your license is generally intended for use in your state only. However, many states participate in a program called Nurse Licensure Compact (NLC). Under the NLC, licenses from participating states can be used in multiple states. So whether you’re moving to a new state long term or taking on a two-month assignment as a travel nurse, you can likely use your current license.
Current NLC States and Status
Nurse Licensure Compact map ©2020 data courtesy of National Council of State Boards of Nursing (NCSBN). New Jersey is allowing nurses who hold active, unencumbered, multi-state licenses issued by Nurse Licensure Compact member states to practice in New Jersey under their multi-state licenses.
What if Your License Expires and You Want to Work Again?
Generally, RN licenses are valid for two years. If you haven’t been working for a while and want to get back into nursing, there are a few things you need to do. First: check with your state’s board of nursing to find out what the rules are in your particular state.
“Most states allow these nurses to take refresher courses—for both the LPN and RN—and some require a skills test,” says Robert Rosseter, chief communications officer for the American Association of Colleges of Nursing. “Most boards maintain a list of schools that offer the refresher courses.”
Similarly, you’ll need to check with your state if your APRN or CNA license expires. Depending on how long ago your license expired, you might need to pay a late fee, take a course, or take an exam.