Home / Healthcare Degrees / Be the Good Nurse: What to Know About Nursing Laws & Regulations October 7, 2024 Be the Good Nurse: What to Know About Nursing Laws & Regulations By B&SC Blog Team Many suspenseful books, TV shows, and movies focus on nurses and the challenges they face in their personal and professional lives. These stories are relatable for current nurses and insightful for future healthcare professionals. They’re often as entertaining as they are educational. There’s nothing wrong with enjoying these for the pure sake of fun, but they’re even more rewarding when consumed with a critical mindset. This means searching for hidden lessons, which can prove just as memorable as the overarching story. These insights don’t always center around healthcare procedures but rather may involve concepts such as ethics or even malpractice. Below, we explain how this critical lens can be applied to one of the most popular nurse-oriented titles of the last decade. The Good Nurse – Book & Movie No two healthcare professionals will have the exact same taste in books or movies, but a significant share was enthralled by The Good Nurse: A True Story of Medicine, Madness, and Murder. While Charles Graeber’s 2013 true crime hit details the horrendous crimes of Charles Cullen, a nurse who maintained his professional status for years despite being culpable for countless patient deaths, the titular “Good Nurse” is actually Amy Loughren, his friend and coworker who acted as an informant to help detectives take him down. The book was followed by a movie adaptation in 2022, which saw positive reviews and a lot of excellent feedback from actual healthcare professionals. The most salacious aspects of the book and film kept readers and moviegoers on the edge of their seats, but there are also several practical lessons for nurses. The story of Charles Cullen highlights the necessity for oversight in healthcare to ensure that no monsters are lurking among the legions of hardworking, kindhearted nurses who sacrifice so much for the good of their patients. It can also act as an inspirational tale for other Amy Loughran’s of the nursing profession who aren’t afraid to take action to protect patients. The following laws and regulations exist to help “Good Nurses” like Amy Loughren step up and do the right thing. Law for Nurses While reading The Good Nurse or watching the movie adaptation, it’s only natural to wonder: could Cullen have been stopped sooner? While Cullen’s actions were obviously horrific, it’s also clear that he was allowed to continue unchecked, even as fellow healthcare professionals were clearly concerned. A myriad of issues stood in the way, such as behind-the-scenes drama at the organizational level, staffing issues, and a general fear of accountability. The good news is that while unacceptable behavior occurs in nursing and other areas of the healthcare sector, there are also countless regulations and initiatives in place to prevent issues such as those detailed in The Good Nurse. Significant oversight is currently provided by the following resources: Department of Health & Human Services Tribal Law. The HHS relies on its Office of Intergovernmental and External Affairs (IEA) to handle tribal affairs, providing a much-needed liaison to determine how HHS programs will be implemented on reservations. Health Information Technology. Committed to creating and maintaining secure health information systems, the Office of the National Coordinator for Health Information Technology (ONC) aims to administer and oversee impactful technology to improve the patient experience while reducing the cost of care. Public Health Service. Encompassing the National Institutes of Health (NIH), the Centers for Disease Control & Prevention (CDC), the Food & Drug Administration (FDA), and several other crucial agencies, the Public Health Service functions as the front line for public health in the US. State Board of Nursing Every state has its own nursing board, but these are also linked by an overarching council that emphasizes the need for strong nursing regulations. Known as the National Council of State Boards of Nursing (NCSBN), this not-for-profit includes the state board for all 50 states, as well as the nursing boards in D.C. and many other US territories. In addition to playing a huge role in federal advocacy, the NCSBN is responsible for creating and adapting the National Council Licensure Examination (NCLEX). The NCLEX-RN and NCLEX-PN determine whether nurses are sufficiently prepared for licensure. In addition to covering medical and surgical care, the exam also addresses various ethical concerns, including some of those brought up in The Good Nurse. Nursing Practice Act As we’ve discussed, appropriate nursing conduct is largely established at the state level, although there is some element of oversight from various federal laws and, of course, the NCSBN. At the state level, however, everything begins with the local version of the Nursing Practice Act (NPA). The NPA sets standards for each state, which are interpreted to create local laws. These, in turn, are administered by the aforementioned nursing boards. While there are variations between states, the NPA typically focuses on a few key areas: Defining terms as they apply to the law Determining board member composition Identifying educational standards for the state’s nursing programs Highlighting continuing education requirements and opportunities Outlining the scope of nursing practice Explaining grounds for disciplinary action Common Rules & Regulations Collaborative Practice Statute. Outlining when and under what circumstances physicians can engage in collaborative practice with nurses, these statutes determine how agreements should be structured. Additionally, they may outline necessary oversight for the advanced practice registered nurses (APRNs) involved in these arrangements. Nurse Licensure Compact. It is possible for nurses who are licensed in one state to practice in others without obtaining additional licensure. Under the Nurse Licensure Compact (NLC), multistate nursing licenses function much like driver’s licenses in that they are recognized across state lines. Standard of Practice The American Nurses Association (ANA) outlines professional expectations with its influential Scope and Standards of Practice. This functions as a powerful framework for the nursing profession as a whole. It begins with a definition of nursing and goes on to describe the nursing process, encompassing the actions that facilitate responsible decision-making: Assessment Diagnosis Outcomes identification Planning Implementation Coordination of care Health teaching and health promotion State-Specific Laws & Examples By now, it should be abundantly clear that nursing statutes, regulations, and standards can differ between states. Below, we’ve illustrated this with several examples of state-specific laws that impact both nurses and their patients: New York New York is one of the most noteworthy states on this list, as it is in the process of enacting a requirement not held in most other states: those who graduate from associate or diploma-based nursing programs must obtain their Bachelor of Science in Nursing within ten years. Often referred to as the BSN in 10 rule, this is meant to equip RNs with the advanced skills and extensive knowledge they’ll need to provide high levels of care in an increasingly complex and demanding field. Ohio Ohio’s Board of Nursing facilitates a Practice Intervention and Improvement Program (PIIP), which provides nurses opportunities to obtain remedial education when deemed necessary to safeguard their patients. These remedial programs may be provided in lieu of disciplinary action and will, therefore, not restrict or remove nursing licenses. Virginia Virginia participates in the Interstate Commission of Nurse Licensure Compact Administrators. Within Chapter 30 of the Code of Virginia, specific statutes outline how the Commission meets, how it’s financed, and which powers it holds. Meanwhile, the state’s Regulations Governing the Practice of Nursing delve into procedures for delegation. This determines when registered nurses can authorize unlicensed individuals to complete specific tasks — and which tasks should not be delegated. Wisconsin Every state has different procedures for when and how aspiring nurses can obtain temporary permits. In Wisconsin, it’s possible to secure one of these prior to passing the NCLEX. This permit enables practice solely under the strict supervision of a registered nurse. It is valid for three months (with the potential to renew for another three months) or until the applicant has failed the exam. Wisconsin also offers RN Refresher Courses, designed for those who have not recently been employed in positions that call for nursing licensure. In Wisconsin, such applicants can seek limited licenses that allow them to complete approved refresher courses, followed by full licensure once the courses are completed. Helpful Organizations, Societies & Agencies With so many rules and regulations to follow, it’s only natural to feel a bit overwhelmed at the onset of your nursing career — and as your career progresses via a new position or opportunity. Thankfully, several organizations provide valuable insight into relevant federal and state laws, as well as specific concerns such as medical records, procedures for malpractice cases, and more. Key resources include: ANA Center for Ethics and Human Rights The Code of Ethics for Nurses with Interpretive Statements National Student Nurses’ Association National Association of Licensed Practical/Licensed Vocational Nurses Nurses Service Organization Start Your Journey as a Good Nurse Today Are you ready to make your mark as an LPN or RN? First, you’ll need to commit to an excellent education. With targeted coursework and hands-on learning opportunities, you can gain the skills necessary to begin your professional journey. The right degree or diploma can give you a head start. Bryant & Stratton offers several programs designed to help you ace the NCLEX, get your license, and begin your career on a high note. If you’d like to further advance your career, the BS Degree in Nursing (New York), or BS Nursing Generalist (OH, WI) could be a great option, or if you are already an RN, we offer an RN to BSN program. We also offer comprehensive ADN programs at our campuses in New York, as well as a Practical Nursing Diploma. If you’re ready to take the next step, request more information to learn about our diploma, associate, and bachelor’s programs. We’d love to discuss your goals — and to highlight the role our degree programs can play as you pursue your passion.
