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- Competing a nursing education program is
a significant accomplishment that requires

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commitment, perseverance, and focus.
You're entering a dynamic profession,

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with many career options, opportunities
for growth, and potential for leadership.

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As a nurse, you can dramatically improve
people's health, even save lives.

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The practice of nursing is one of the
most highly-regarded professions in the

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country. In Gallup polls, the public
consistently ranks it as the most ethical

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and honest profession in America.

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- I chose a career in nursing because I
wanted to make a real difference

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in patients' lives. My education prepared
me to provide high quality clinical care

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to patients, and now that I'm practicing,
I'm recognizing how important the laws are

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to providing excellent care
and maintaining a safe environment

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for my patients.

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- Like other health care professions,
nursing is regulated by law to ensure safe

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practice. In the next few moments, we'll
talk more about the ways the profession is

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regulated, through nurse licensure, state
boards of nursing, and state laws called

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Nurse Practice Acts.

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♪ [music] ♪

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With more than 4.5 million
individuals holding a nursing

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license, nurses are the largest group
of licensed health care professionals

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in the United States. You need to pass the
National Council Licensure Examination, or

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NCLEX, to receive a license. But becoming
a Registered Nurse involves more than just

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meeting this standard. Think of becoming
licensed as a privilege that's been

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granted by the law. In fact, it's a
commitment between you and the public.

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- Nurses need specialized knowledge,
skills, and abilities to make decisions

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about patient care. Patients come to us
in their most vulnerable state. The public

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sees nursing care as something so valuable
and significant, something that embodies

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such trust and expert knowledge, that laws
have been established to regulate our

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practice. Licensure is one aspect of that
regulation.

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- Once you're licensed, it's your
responsibility to keep your nursing

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license current. The renewal process
varies across states. For instance, a

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majority of states require that nurses
complete continuing education credits,

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including specific coursework in some
cases, before they can renew their

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licenses. The consequences of not renewing
your license can vary from a fine,

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to other types of discipline. You may even
be required to re-take the NCLEX.

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- I recently accepted a tele-health
nursing position, so now I care

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for patients in multiple states. Since
practice is where the patient is, I need

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to be licensed in every state where my
patients are located.

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- There's one important exception
to needing a separate license to practice

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in each state where patients are located.
Many states belong to the Nurse Licensure

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Compact. If your state is a member, you
may be eligible for a multi-state license,

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which allows you to practice in other
Compact states, without obtaining a

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license in those particular states. Your
state's Nurse Practice Act and regulations

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will confirm whether your state is part
of the Nurse Licensure Compact.

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♪ [music] ♪

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The legal authority to practice

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in the nursing profession
comes from each state or

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territorial government. More than 100
years ago, Boards of Nursing were

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established to protect the public's health
and welfare. Boards of Nursing serve many

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functions, which typically include
granting and renewing licenses, developing

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practice standards, writing administrative
rules and policies, disciplining unsafe

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nurses, and accrediting or approving
academic nursing programs.

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- I encourage my team to learn about how
our Board of Nursing works,

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and to familiarize themselves with the
Nurse Practice Act. I also suggest that

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they read our Board's newsletter and visit
its website to stay informed

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about any changes in nursing regulation.

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♪ [music] ♪

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- Each state or territory's Nurse Practice
Act is a law enacted by the state's

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legislature and enforced by the Board
of Nursing. The specific content of Nurse

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Practice Acts vary from one jurisdiction
to another, but, there are three basic

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components included in every Nurse
Practice Act. Standards and scope

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of nursing practice, requirements

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for licensure, and grounds
for disciplinary action.

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A Nurse Practice Act is the law
governing practice, and administrative

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rules or regulations provide more specific
information.

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- Keeping the public safe is a shared
responsibility and everyone on the team

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has to play an active part.

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- As a nurse manager, I've seen a few
problems over the years with nurses who

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violate the Nurse Practice Act. Being
aware of your Nurse Practice Act helps

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prevent violations.

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- Even new nurses who are just entering
the profession need to be aware of their

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role in preventing, detecting,
and reporting potential violations.

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These may include significant practice-
related errors, drug-related issues or a

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substance use disorder, professional
boundary violations, sexual misconduct,

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patient abuse, fraud, and criminal
background. Depending on the severity

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of the violation, the Board of Nursing
sanctions may include: a reprimand,

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probation, remediation, fines, license
suspension, or even license revocation.

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♪ [music] ♪

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- Professional boundaries may seem
obvious, but sometimes there are gray

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areas, and a nurse can cross a line
without realizing it. For example, I use

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Facebook, instagram, and twitter a lot,
but I have to be careful when I'm talking

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about work.

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Discussing my patients or posting
pictures of them on social media violates

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their patient confidentiality, even if I
don't mention their names.

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- Decisions around professional boundaries
can be especially challenging for new

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nurses. Even a seemingly harmless act
like giving your personal phone number

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to a patient could constitute a boundary
crossing and could lead to a violation. I

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provide guidance to nurses on issues
related to maintaining professional

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boundaries, and how to use social media
responsibly.

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- You may face many ethical dilemmas
throughout your career about professional

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boundaries, and the many other challenges
nurses encounter when caring for others.

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In addition to familiarizing yourself
with your Nurse Practice Act, and the

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practice standards set by your board
of nursing, they're tools to help you

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navigate ethical issues, to maintain
patient safety.

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The American Nurses Association's Code

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of Ethics for Nurses
is particularly useful.

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- My advice to new nurses is to always
focus on patient safety and remember that

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you are your patient's last line
of defense.

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- Always use care and think about what
you're doing, to prevent errors. And make

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sure to ask questions if you're unsure
about something.

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- I think of my license as a reminder
of the responsibility entrusted to me

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by my patients. So my advice is to never
take that responsibility

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we've been given lightly.

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- You have a promising future
ahead of you, and a reputation of honesty

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and trustworthiness to uphold. Your
education has given you a strong

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foundation for successful practice,

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but the practice of nursing
is a life-long learning experience.

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Your state Board of Nursing
and the NCSBN website can help answer your

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questions about nursing regulation,
and lead you to resources that will help

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to maintain professionalism and integrity
throughout your career.

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♪ [music ♪