Vital Views

Unknown Speaker 0:01
My name is Imelda Reyes, and I'm so excited to be here with vital views today. I am the Associate Dean of advanced education for the UNLV School of Nursing. And I have with me, Jennifer Vanderlaan, who will introduce herself.

Unknown Speaker 0:14
Hi, Imelda. I'm Dr. Jennifer Vanderlaan. I'm an assistant professor in the School of Nursing. And I am here to talk about av 108. Because I am really interested in health policy. It's what I researched.

Unknown Speaker 0:27
Excellent. Thank you so much for being with us today. So let's get started first by talking about the Nevada Assembly Bill 108. So can you tell us a little bit about what this bill would introduce for the state of Nevada?

Unknown Speaker 0:41
Sure. Assembly Bill 108 is about the nursing compact. So what you need to know is that, in in the world right now in the country we live in, nurses are licensed in a single state. And that license isn't transferable to another state. So when a nurse has to go to another state, maybe because their spouse moves or there's a job opportunity, they have to get a different license. What the compact does is it allows nurses licenses to work more like a driver's license, where you still have to follow the laws of the state that you're working in. But if I get licensed in Texas, I can move to Nevada, and my license will just transfer to Nevada automatically.

Unknown Speaker 1:23
Excellent. So can you tell us one of the benefits of having I know you mentioned already being able to cross state lines. But what's another benefit of having the nurse light licensed or compact for like, say a personal nurse who works here in the state?

Unknown Speaker 1:38
There's there's several advantages to having what we call multi state license. For example, nurses who work telehealth, you actually need to be licensed in the state where the patient is not in the state where you are as a nurse. And so having the licensure compact will allow Nevada nurses to participate in telehealth work. caring for patients in other compact states. And for the people of Nevada, it will allow them to receive telehealth services from nurses who are residing in another compact state. Perfect.

Unknown Speaker 2:12
So. So can you tell me would this modify like the licensure requirements for a nurse, say, from what we currently have to go into a compact licensure state?

Unknown Speaker 2:27
No, Nevada would maintain the standards for nursing licensure, there would be two options for nurses nurses could have their single state Nevada license, or nurses who may be reside in Nevada, but work in Arizona or maybe they reside in Nevada, but work in Utah, those are already compact states. So their Nevada license, they could opt to get what's called the multi state license and work under their Nevada license in Utah or in Arizona. That doesn't change the laws for what it takes to become a nurse. All it does is simplifies using your license in another state.

Unknown Speaker 3:06
Perfect. So for those of you that maybe are asking which states are part of this nurse compact licensure agreement, there are actually 37 states plus two different territories that are currently part of this Nurse License compact. And like Jennifer was saying, this allows for anyone within the states to go from, you know, say one state to another and continue their practice without having to stop and possibly get a temporary or a different license. So I can give an example. Just recently, I was in the state of Georgia, and I was eligible for a multi state licensure or license. And I opted because at that time, I was living in Georgia. And I thought, Well, I'm not really planning on moving. So I just got a single state license. And then I ended up getting a job in Texas where that would have required another license. And so I did for my education position, get another license in the state of Texas. And then within the year, I ended up moving to Nevada, and I had to apply for another license. And so now I'm having to maintain three licenses across these different states. And not to mention that my original state of licensure was Michigan. So essentially, if I wanted to maintain a license, I would have to keep up the CEU requirements for each of those different states. And then also, you know, every whatever, whether it's once a year or twice a year, you know, I might have to like go and renew those different states I have to maintain and keep track of all of these different dates. And so it really is quite cumbersome if you're a nurse and you're traveling among the different states.

Unknown Speaker 4:46
So the listeners might wonder what would that look like if you had a multi state license and what is fascinating about it is it it is one license but what changes is your state of residence with a multi state license. So if you had the multi state law license in Georgia, you then take that license to Texas, you change your residency to Texas, which means you are now responsible to the Texas Board of Nursing for maintaining that license, they get your licensing fees you do your CE use with them. They're responsible for any discipline if there's any complaints against you, but you keep that license. And then when you move to Nevada, again, you'd would change your residence to Nevada and the Nevada Board of Nursing would become the Board of Nursing who oversees your license. It's a much smoother and simpler process for nurses.

Unknown Speaker 5:32
Absolutely. And what are some of the benefits that the people of Nevada could expect by passing something like the Nurse Licensure compact?

Unknown Speaker 5:41
Well, the big reason we need the nursing compact is because we have a severe shortage of nurses. I'm not sure if you're aware of the smell, because you're new to Nevada. We are short over 7000 nurses and the number of nurses that we graduate every year, if we can't catch up, we need to attract nurses to the state. And one thing that we know from the research is that states that have these compact licenses, they actually grow their nurses faster than other states. And it seems that when nurses are considering relocating or starting their career, they're choosing to start their career and be located in compact states, which is fabulous. The other thing that it benefits the people of Nevada is like I said with telehealth, it would allow Nevada to get telehealth services from other states that are part of the Compact.

Unknown Speaker 6:30
Excellent. And what would you say? If there are any, like differences in the practice of nursing, if I'm going from like state to state?

Unknown Speaker 6:40
Oh, there was a, you know, we just went through COVID. And with COVID, we had a lot of nurses that needed to cross state lines to meet the sudden demand and sudden change. And what happened during COVID is states had to sort of catch up if they weren't compact states, they had to make a way for nurses to work under a license from another state. And this caused some real big problems, because it's the state of licensure that is responsible for discipline if there's a complaint against a nurse. And one of the stories that came out of this was a complaint in New York State with a nurse who was working there, not from a compact state just under under an executive order. But New York didn't have any authority to investigate because they weren't part you know, it wasn't a compact license. And she wasn't licensed in New York. And so unless the home state chooses to investigate, there may not be any discipline taken against the nurse. And so one of the one of the benefits that people don't think about with the Compact is that it takes care of that problem that we had during COVID to make sure that nurses are practicing safely. And in fact, one of the things that we know is that when you look across compact States looking at both the single state licenses and the multi state license, because remember, a nurse doesn't have to get a multi state license. There are actually fewer complaints against nurses with multi state licenses.

Unknown Speaker 8:06
That's really great to know. And so one of the questions you just brought up, you know, a nurse has the choice of getting either a single state license or a multi state license. If Nevada were to go ahead and pass this bill, would this be an increase of a nurse here in the state of Nevada wanting to get a Nurse License, multi state license, we do

Unknown Speaker 8:27
know that nurses choose to start their career or choose to relocate to compact states, which is what we're we're hoping would do. One of the things that people get really concerned about is that nurses on border states will rush in and take all of our jobs, right. But the data doesn't show that actually happening when they look at nape at compact states where they have cities that sort of cross borders. There's no change in the number of nurses that are working across borders. It doesn't seem to make nurses want to do that. It just makes the licensing easier for nurses who do work across borders. And we do have nurses that work across borders in Nevada. We have some nurses that would work in Utah nurses that work in Arizona.

Unknown Speaker 9:09
And so how would this affect nurses who maybe are part of a military family and find themselves moving? Oh,

Unknown Speaker 9:15
this is like any other multi state license when a military spouse moves to Nevada, they would change their residency on their license to Nevada, and they could immediately start working in Nevada.

Unknown Speaker 9:31
And do you see any downfalls to the state of Nevada and you know, enacting the NLC?

Unknown Speaker 9:39
There is there's always concerned that we'll lose nurses that if they have multi state licenses, they're going to go somewhere where the pay is better. And like I said, we don't really see that happening. We don't even see that happening across state lines. The other concern is that the the State Board of Nursing has to has to pay I think it's 6000 I don't know what it is. But there's an annual fee to be part of the multi state compact because of the way that they organize things administratively. But Nevada, the Board of Nursing is able to absorb that cost right now, which is amazing, because it means that at least for now, there will not be an increased cost for getting a multi state license in states where they are not able to absorb that cost, they have a increased cost for the multi state license.

Unknown Speaker 10:27
That's really, it's wonderful to know that the state of Nevada has the resources available to make this something real and it won't actually cost the nurses something extra to like be a part of it. And are there any other things that you wanted to share about the Nurse Licensure compact?

Unknown Speaker 10:48
Well, there's, there's one more thing that people might not think about when we think about a nursing shortage. We think about not having nurses and hospitals, right. But hospitals have to maintain safe staffing. And so what it means is that the nurses that Nevada has right now, are really being overworked to make sure that patients get care. And one of the pieces of information that came out of COVID, that was really eye opening was finding out that when nurses have these heavier loads, patients are there leave from the hospital, they're discharged from the hospital is delayed, and so their length of stay in the hospital is longer for no reason other than there's not enough nurses to get them discharged. So this isn't just good for the nurses in Nevada. This is really good for the people of Nevada.

Unknown Speaker 11:34
And I think one of the things that I definitely you've touched upon, in our conversation here is just the fact that from from a resident of the state of Nevada increases your your accessibility to like good care. Yeah, like not only will you be discharged on time, but just getting the right resources at the right time, I think is really important. How will this affect advanced practice nurses within the state?

Unknown Speaker 11:59
There is no advanced practice compact yet. So advanced practice nurses, this is nurse midwives. This is family nurse practitioners, they're still going to need to have a Nevada license to get their Nevada APRN license. Unfortunately, there is some model legislation for the advanced practice nurse compact, but it's not enacted anywhere yet.

Unknown Speaker 12:23
Excellent. So if people are interested in getting more information, you can definitely go to the Nevada State Board of Nursing For more information, and and then also if you'd like to contact your local legislators and let them know that you support this bill. You can definitely contact them via phone call or letter. Is there anything else that you wanted to share with us today?

Unknown Speaker 12:46
Now I just that I 100% support AB 108 I think it's great for Nevada nurses. I think it's great for the people of Nevada, and I hope it passes.

Unknown Speaker 12:56
Excellent. Well, thank you so much in the fridge for joining us today. And again, thank you again for listening to vital views, the School of Nursing podcast and I hope you have a wonderful day.

Transcribed by https://otter.ai