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Nursing Associations History
In contrast to the customary practices of today where upon nurses are hired by hospitals or other healthcare facilities, early in the 20th century United States nurses would typically be enrolled into private duty registry systems. (D'Antonio, Connolly, Wall, Whelan, & Fairman, 2010). These registries operated as a third party, matching qualified nurses with patients or facilities in need, and were responsible for negotiating and standardizing hours of employment, financial compensation, and scope of professional practice (D’Antonio et al, 2010). Some of these registries were owned and operated by private individuals, while others were run by local professional nursing groups and associations. Increasingly, these nursing led registries became more and more affiliated with the American Nurses Association.
The roots of the American Nurses Association are grounded in 1896, when a convention of fewer than 20 nurses from the Nurses Associated Alumnae of the United States and Canada met at the Manhattan Beach Hotel, in New York (History, n.d.). Two years later, the convention participant numbers swelled to over 10,000, and in 1911 the organization became known as the American Nurses Association (ANA). Without a uniformed organization, early nurses had no leverage to improve the quality of their profession or the betterment of healthcare by and large. The ANA was poised to change this. In the 100+ years of its existence, the ANA had been a stalwart in the advocacy of professional nursing. Many of the benefits that we enjoy today are a result of the ANA’s tireless efforts, including the 8-hour workday, and the Fair Pay Act of 1995 (History, n.d.).
Interview with PSNA Government Relations Specialist, Noah Logan
Membership in the ANA is not just comprised of individual constituents, but also includes state and local nursing associations. Among them is the Pennsylvania State Nurses Association (PSNA). Over 100 years old, the PSNA is the largest nursing group in Pennsylvania and employees Mr. Noah Logan, Government Relations Specialist (personal communication, October 4, 2021). Mr. Logan has been a lobbyist with PSNA since May of 2020 and serves as a liaison between Pennsylvania (PA) state nurses and the government. On interview, Mr. Logan was asked to relate PSNA’s efforts toward changing an existing problematic healthcare policy, to which he proudly related PSNA’s successful campaign of passing of Senate Bill 115 (now Act 68 of 2021), into law. Act 68 of 2021 authorizes PA to join the Nurse Licensure Compact (NLC). Mr. Logan explained that the PSNA introduced the initial proposed legislation in 2020 but had to reintroduce in in 2021 following delays. He credited the submission of thousands of messages to legislators, coming in from nurses across the state, urging them to pass the bill, as the driving force behind its success. The need to pursue this policy change was evident. In addition to the burden imposed by extra time and money associated with the previous policy of requiring nurses to obtain separate licensure to practice in PA, the pandemic luminated just how critically important it was to have a rapid system of reciprocity in place to receive out-of-state assistance in a timely manner. After being fully implemented, PA registered nurses and licensed vocational nurses shall be able to apply for a multistate license, allowing them to practice in the other NLC states.
Nursing Licensure Compact
The NLC [now referred to as the Enhanced Nursing Licensure Compact (eNLC)] was created in 2000, with the support of a plurality of state nursing associations, hospital associations, and other healthcare facilities, to promote public protection and improve access to care by creating a singularly recognized nursing license across the nation (Leader to Leader, 2017). The eNCL allows not only for the unencumbered mobility of nurses across state lines, nursecompact.com lists a host of other benefits:
Benefits of the NLC
• Access to Care: Expands access to nursing services across the
country quickly and efficiently, which is essential for the health of
many rural and underserved communities.
• Teleheath: Enables nurses to practice in person or provide
telehealth nursing services to patients located across the country
without having to obtain additional licenses.
• Disaster Relief: Allows nurses to immediately cross state borders
and provide vital services in the event of a natural disaster or
other emergency, without the need to wait for a declaration of
• Military Families: Allows military spouse nurses to seamlessly
continue working without having to obtain a new license each
time they relocate.
• Online Education: Facilitates online nursing education by
reducing educators’ need for multiple licenses.
For Nurses: Nurses do not have to obtain additional nursing
licenses, making practicing across state borders affordable
For Employers: The NLC also removes a burdensome
expense for organizations that employ nurses and mayshare
the expenditure of multiple licenses.
• Flexible Licensure: Allows nurses who are ineligible for a
multistate license to still obtain a single state license based on
their state’s requirements and statutes.
(Unlocking Access to Nursing Care Across the Nation, n.d.)
The eNLC is currently 38 state members strong. With the obvious benefits of inclusion, surely it is only a matter of time before the remaining states opt to change their flawed policies of isolation and exclusion. In very short order this shall become one nation of nurses, providing a unified front of care, due in large part to the tireless efforts of organized nursing associations working to challenge flawed policies.
D'Antonio, P., Connolly, C., Wall, B., Whelan, J., & Fairman, J., (2010). Histories of nursing: The power and the possibilities. Nursing Outlook. 58(4):207-213. doi:10.1016/j.outlook.2010.04.005
History. (n.d.). ANA. https://www.nursingworld.org/ana/about-ana/history
Leader to Leader. (2017). What educators need to know about the enhanced nurse licensure compact: A brief history of the Nurse Licensure Compact (NLC). ASBN Update, 22(3), 18.
Unlocking Access to Nursing Care Across the Nation. (n.d.). https://nursecompact.com/Updated_onepaged_NLC.pdf
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