RNs are prepared in three forms of education programs: baccalaureate programs (generally four years), associate degree programs (generally three years), and hospital diploma programs without formal higher education credit (generally three years).2 RNs provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and emotional support to patients and their family members. The professional nurse licensing exam is the same for graduates of these three types of RN programs.3 A different licensing exam is administered to LPNs.
APNs are RNs with specialties in Nurse Anesthetists, Nurse Practitioners, Nurse Midwives, and Clinical Nurse Specialists.8 The APN licensure process is usually more complicated than for LPN or RN licenses. Most states require an applicant to have a current RN license to be eligible to apply for an APN license. Every state board requires APN applicants to first complete a master’s or doctor of nursing practice program at a four-year accredited university. Finally, applicants for an APN license must also earn an advanced certification in their field of specialization and complete a specified number of clinical practice hours before they are eligible to receive their license. The scope of practice for APNs varies from state to state; nonetheless, most states permit APNs to provide and coordinate patient care, and some states permit the provision of primary and specialty health care.3
The politics of nursing regulation
The politics of nursing have been characterized by low collaboration, strong opposition, and women’s rights. As aforementioned, regulations vary between states, which signals lack of national leadership and cohesion. The industry has also struggled to obtain landmark legislative goals set forth in 1965 by its national association, the American Nurses Association (ANA). Once again, lack of a consolidated voice to advocate for nurses issues has been a hindrance to achieving political goals.9 This impediment is exacerbated by the contrasting large and established professional organizations for physicians, the American Medical Association (AMA), and for hospitals the American Hospital Association (AHA).
The suppressed voice of nurses might also be due in part to the profession’s association with females in the workplace. The historical path of nursing politics has paralleled the changing role of women in society and the evolution of healthcare knowledge and technologies.10 The nursing field has long been chiefly occupied by women. Indeed the term, “nursism” has been coined to describe “a form of sexism that specifically maligns the caring role in society.”11 Education concerns have also contributed to the regulation within the field auspiciously due to concerns about quality and the advances in healthcare that took place largely absent nurses. The development of nursing regulation was founded in education concerns, but laws and politics have also come to...