Globalizing Standards and Increasing Mobility: The Future in Nursing

1. Globalizing Standards and Increasing Mobility:  The Future in Nursing Maryann Alexander, PhD, RN Associate Executive Director Regulatory Programs National Council of State Boards of Nursing Chicago, Illinois USA

2. National Council of State Boards of Nursing Mission To Promote the Health, Safety and Welfare of the Public through Regulatory Excellence.

3. NCSBN 60 State Boards of Nursing Set regulatory standards for the US and territories. Develop and Administer the National Council Licensure Exam (NCLEX). Provide Models for Nursing Licensure/Regulation. Promote Uniformity among the States. The Center of Research for Nursing Regulation.

4. Roles of the State Boards of Nursing in U.S. Administer/Regulate the Nurse Practice Act in their State. Approval of Nursing Programs Issue Licenses. Investigate Violations of the Nurse Practice Act/Discipline.

5. NCSBN Endorsement Model for Internationally Educated Nurses Education Equivalent to U.S./Credentials Review. English Proficiency. Passage of NCLEX. Unencumbered License from Country of Origin. Additional state requirements.

6. Advanced Practice Nursing Requirements for RNs. Master of Science Degree in Nursing from an accredited nursing program. Passage of a certification exam. Unencumbered license.

7. Standardization of Licensure Requirements. States have diverse requirements. Countries have diverse requirements.

8. The United States Nursing Shortage

10. Reasons for Shortage: 2000 Aging workforce. Decreased Enrollment in Nursing Programs. Numerous career options for nurses. Large number of RNs not employed as bedside nurses.

11. Reasons for Shortage: 2006 150,000 applicants for nursing. programs were not accepted last year. Insufficient number of Faculty. Insufficient number of Clinical Sites.

12. Pending Legislation Congressional bill that would remove the limit on the number of nurses that can migrate to the US.

13. Global Nursing Shortage Canada Europe Ireland Great Britain Austria Norway

14. Global Nursing Shortage Asia Japan Middle East Saudi Arabia Africa Sub-Saharan Regions

15. Philippines, India and Korea Feb.2005: 100,000 Filipino nurses working in non-professional positions. Nurses in India are unemployed. Korea also has an abundance of nurses.

16. Affect on other Countries Raising nursing education standards in other countries. Philippines is designing curriculum to meet the standards of the US and other countries. Language of instruction is English. U.S. textbooks.

17. European Organization of Nurse Regulators Seven Countries European agreement Free Mobility between countries. Standardization of licensure requirements

18. Australia and Tasmania Mutual Recognition Agreement

19. Role of NCSBN in Fostering Mobility and International Standards NCLEX offered around the world for nurses wishing to practice in the U.S. Consultation to other countries: Setting up organization equivalent to NCSBN. Licensure and Testing Requirements. Research on the Transition to nursing in the U.S.

20. Affect on the U.S. Transitional Programs to acculturate nurses needed. Concern over language differences. Internationally educated nurses are acclimating and functioning in many roles including faculty, researchers and excellent clinicians. Meeting language and cultural needs of patients

21. Affect on Other Countries. Concern that “best nurses” leave. Nurses return to country with new knowledge, more experience and leadership skills. 16 Billion US Dollars annually sent to the Philippines from nurses working in the U.S.

22. Opportunities: The Korean Model Provides for nurses to work abroad, gain knowledge and experience that is brought back to their own country.

23. Summary Currently there are no mutual recognition models involving the US and other countries. Nursing programs/licensure requirements are not standardized. Nursing shortage is raising standards in nursing education in other countries. First step towards mutual recognition. NCSBN will be working in the coming years to assist state boards with international workforce issues, ensuring patient safety and collaborating with other countries to continue to assist in the development of international standards.

24. Thank you! Gracias!

25. Accreditation v. Approval Two accrediting bodies for nursing in the US (Professional Organizations). State Board of Nursing approves programs. Accreditation usually a part of the Approval Process. Approval is dependent on yearly performance of first time NCLEX takers.

26. Licensure Requirements for U.S. Graduates Graduation from an approved Nursing Program/Credentials Review. Passage of the NCLEX. Unencumbered License from another state.

27. Issues for Internationally Educated Nurses Working in the United States Education is at Baccalaureate level, but transition can be difficult. Less focus on: Independent Practice/Decision-making/critical thinking. Communication with the multidisciplinary team. Cultural Differences.

28. What Needs to be Done? Standardize Curriculum. International Accreditation Process for Nursing Programs. Competency Exam that is accepted world-wide.

29. Global Nursing Shortage Canada Europe Ireland Great Britain Austria Norway

30. Global Nursing Shortage Asia Japan Middle East Saudi Arabia Africa Sub-Saharan Regions

31. Pending Legislation Congressional bill that would remove the limit on the number of nurses that can migrate to the US.

32. Affect on other Countries Raising nursing education standards in other countries. Raise standards related to working environment/salary. Raising awareness of the professional expertise of nurses.