National Nurses United

hour remotely? That's what makes telehealth so attractive and why the compact license, which facilitates telehealth, is constantly cham- pioned by industry forces. J ust as corporate right-to-work groups lobby through the American Legislative Exchange Council (ALEC) to submit model legislation to change state laws, so do the NCSBN and its allies for compact licensure. This past year, legislation enacting compact licensure was introduced in eight new states: Minnesota, Illinois, Michigan, New York, Vermont, Massachusetts, New Jersey, and Rhode Island. Minnesota nurses worked hard to defeat compact licensure in their state. Various bills, pushed by the Minnesota Business Partnership and the hospital industry, were introduced this past legislative session. In addition to hundreds of letters, phone calls, emails, and visit members of the Minnesota Nurses Association generated to oppose various compact bills in their state, Jean Ross on March 20 testified before the Minnesota Senate Health and Human Services Finance and Policy Committee. "Minnesota has higher standards [for our registered nurs- es] compared to other states, including a statutory duty and right to advocate in the best interest of individual patients," said Ross in her testimony. "The NLC practice requirements, however, will be deter- mined by the politics of the lowest common denominator." Ross pointed out how nurses who may not be familiar with Min- nesota's education and competency laws threaten the scope of RNs and LPNs, and the work of unlicensed personnel alike—jeopardizing patient safety. "Unlike Minnesota, some states do not require two RNs for blood products administration," said Ross. "Other states also allow licensed practical nurses and unlicensed personnel to do tasks that Minnesota does not permit. For instance, LPNs in some states can give blood products and, in other states, LPNs are permitted to give IV push medications. In Minnesota, tasks performed by LPNs and other healthcare workers must be delegated by and completed under the direction of an RN, but an out-of-state nurse unfamiliar with Minnesota practice could delegate incorrectly and unlawfully." In late May, Minnesota nurses managed to defeat the compact bills and hold off compact licensure, for this year at least. In Illinois, National Nurses Organizing Committee in Chicago fights off compact licensure legislation every year. The failure of Illi- nois to join the compact is particularly embarrassing for the NCSBN because Illinois is its home state; the organization is headquartered in Chicago. "Yes, it happens every year and we fight it and defeat it every year," said Marti Smith, RN and the Midwest staff lead for CNA/NNOC in Chicago who monitors such legislation. The last time proponents approached California to consider compact licensure was 2014. They received a most chilly reception. During the June 11 meeting of the California Board of Registered Nursing, a number of nurses came to speak in favor of California becoming a compact state. Louise Bailey, the board's executive offi- cer, then presented her own report, raising many of the same con- cerns outlined in this article. The board voted unanimously to not join the nurse licensure compact, and that is the current official position of the California BRN. "Why would we give up our rights in terms of state sovereignty?" asked RN Michael Jackson, a current California BRN member and chair of its education and licensing committee. He also works as an ER nurse at UC San Diego Medical Center, is on the faculty of Southwestern College, and is a vice president of NNU. "We want to be able to make our own decisions. California has some of the high- est standards and, you know what? We have some of the country's highest NCLEX scores." Jackson pointed out that California licenses nurses from other states all the time, but that it prefers to do its own due diligence in terms of requiring a background check, fingerprinting, education review, requesting school transcripts, and confirming the degree conferred. "You are more than welcome to get your license in Cali- fornia," he said. "But first you are going to have to be endorsed, approved, and vetted by us." Ross sees no reason to change something that isn't broken. "The bottom line is that the compact is not good for nurses," she said. "There's no reason to change things. There are reasons people seek to practice in another state, and there's plenty of opportunity to do so, and all they have to do is approach that state to get licensure in that state." Lucia Hwang is editor of National Nurse. M A R C H | A P R I L 2 0 1 8 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 17 "You are more than welcome to get your license in California. But first you are going to have to be endorsed, approved, and vetted by us." —Michael Jackson, RN, current California BRN member and chair of its education and licensing committee. COUNCIL OF PRESIDENTS Deborah Burger Zenei Triunfo Cortez Jean Ross SECRETARY-TREASURER Martha Kuhl VICE PRESIDENTS Representing NNU members from the Minnesota Nurses Association Bernadine (Bunny) Engeldorf Candy Matzke Representing NNU members from the DC Nurses Association Margaret Shanks Representing NNU members from California Nurses Association/ National Nurses Organizing Committee Fong Chuu Kathy Dennis Kathy Donohue Cokie Giles Amy Glass Michael Jackson Catherine Kennedy Marissa Lee Katy Roemer Jane Sandoval Dahlia Tayag Irma Westmoreland NNU National Officers for the 2018–2021 Term

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