On Wednesday, February 8, registered nurse members of National Nurses Organizing Committee-Nevada/National Nurses United (NNOC/NNU) will appear before Nevada’s Committee on Commerce and Labor to speak out against AB 18, “Ratification of the Nurse Licensure Compact”—legislation which would allow nurses in a multi-state compact to share a single license across state lines.

“This bill is intended to reduce patient protections by requiring Nevada and other states that are part of the Compact to accept the lowest common denominator for nurse licensure from the least regulated state. The last thing our patients need is to be subject to a race to the bottom,” said Tamara Erickson, RN, of Reno. “Our current protections, through the Nevada Board of Nursing (BON), can become diluted when we try to combine them with other states, which may not have the same standards. Nevada patients and nurses deserve better.”

WHAT: RNs Appear at Committee on Commerce and Labor Hearing To Testify Against AB 18 (Ratifies Nurse Licensure Compact)

WHEN: Wednesday, February 8, 1:30 p.m.

WHERE: Room 4100 of the Legislative Building, 401 S. Carson St., Carson City, NV
Videoconferenced to Room 4406 of the Grant Sawyer State Office Building, 555 E. Washington Ave., Las Vegas, NV

The following are issues of concern to NNOC/NNU nurses:

• Lower standards for Nevada RNs. Revoking state sovereignty, say nurses, means that registered nurses practicing within Nevada would not have to meet the stringent initial and continuing education standards that ensure nurses have consistently excellent educational preparation for practice.
• Inability to sanction/revoke licenses for nurses deemed unsafe. Nurses who are deemed unsafe elsewhere should not be allowed to move into Nevada to practice. Despite assurances to the contrary, states such as Ohio have refused to join the Compact because of consistent reports that unsafe nurses are able to avoid sanctions by relocating as needed.
• Encourages nurses to seek licenses in the least regulated state with the lowest registration fees. The Nevada BON is mainly self-funded by its own licensure and renewal fees, fulfilling its mandate to protect the public through this revenue stream. With a Nurse Licensure Compact, nurses would be incentivized to obtain licensure through the cheapest, lowest common denominator state board of nursing, say nurses. Passage of AB 18 would result in both a sharp decrease in funding for Nevada, as well as raising the concern of RNs practicing in Nevada without the patient protection standards established by Nevada law.
• Jobs for Nevadans being taken by ongoing flow of out of state residents. The Compact scheme uses tax dollars to encourage out of state registered nurses to come in and take good jobs from Nevadans. The scheme also encourages a casual relationship between caregivers and the citizens of this state, whereby nurses from other compact states can move in and out of the state readily—not ensuring consistent care for the patients in Nevada hospitals.
• Lack of funding to enforce standards. The bill provides no direction for how the BON would continue to supervise, investigate, and sanction its own Nevada licensees with the significant decrease in funding that will follow implementation of Compact licensure in Nevada.  Nevada nurses warn passage of AB 18 could result in loss of staff positions and increasing delays in provision of services to licensees and complaint investigations, which will endanger the public.
• Technology over RN professional judgment. Healthcare corporations increasingly use technology-driven care that ignores individual patient needs through a rigid standardization of care, overrides the RN independent professional judgment, has a chilling effect on the RN’s ability to advocate for her patient and depersonalizes the RN relationship with patients.
• Public confusion. The variations in educational preparation of the nursing workforce, coupled with Nevada's increasingly difficult and underfunded investigatory capacity, say nurses, will lead to public confusion and frustration.

“Given the substantial concerns, we strongly oppose this bill,” said Elizabeth Bickle, RN, of Las Vegas. “We’re deeply concerned that a Nurse Licensure Compact would be detrimental to advocating for and ensuring the appropriate nursing resources necessary to meet the healthcare needs of the citizens of Nevada.”