Skip to Content
Board of Nursing

Legislative Updates


Legislative Updates:Current through July 1, 2011

If you wish to review any of the following Public Chapters in their entirety, please visit:
http://www.tennessee.gov/sos/acts/index.htm.

Board Specific Updates

Public Chapter 75- Provides that each licensed and certified advanced practice nurse (nurse practitioner, nurse anesthetist, nurse midwife, or clinic nurse specialist) shall conspicuously display an original or a copy of his/her license or certification displayed in the office or place of practice and shall conspicuously display a sign in intelligible lettering and not less than one inch (1”) in height, containing the name of such licensee immediately followed by the recognized abbreviation indicating the professional degree, if any held by such licensee, and containing immediately below the licensee’s name, in equal size lettering, the following words:  “Advanced practice nurse”, “nurse practitioner”, “nurse anesthetist”, “nurse midwife” or “clinical nurse specialist”.  A licensee may substitute a specialist designation for these words for any specialized field that is recognized or approved by the appropriate board licensing that profession.  The licensee shall also affirmatively communicate the licensee’s specific licensure through one (1) of the following methods:  (1)  licensee shall wear a photo identification name tag during all patient encounters that contains a recent photograph of the licensee with the licensee’s full name and license type; or (2)  licensee shall communicate to a patient the licensee’s full name and license type in writing at the patient’s initial office visit after January 1, 2012.  In communicating the license type, the licensee shall use one of more of these words:  “Advanced practice nurse”, “nurse practitioner”, “nurse anesthetist”, “nurse midwife” or “clinical nurse specialist”.  All licensees are required to comply with these requirements at each practice setting.  These requirements do not apply to licensees working in licensed health care facilities or to licensees who are not working in patient care settings who have no direct patient care interactions.  A licensee who provides information regarding healthcare services on the internet that is directly controlled or administered by the licensee or licensee’s agent, shall prominently display on the internet the licensee’s full name and type of license using one (1) or more of the following words:  “Advanced practice nurse”, “nurse practitioner”, “nurse anesthetist”, “nurse midwife” or “clinical nurse specialist”.  A licensee who violates the provisions of this law may be subject to disciplinary action by the Board of Nursing.  The provisions of this law shall become effective January 1, 2012. 

Public Chapter 166- Provides that a prescription label for any legend drug for all patients shall contain an indication or indications for which the drug is being prescribed if the indication or indications are requested by the prescriber, patient or patient’s caregiver and the prescriber, patient or caregiver provides the indications to the pharmacist dispensing the drug. 

Public Chapter 324- Continues the Board of Nursing until June 30, 2011.


Updates Applicable to All Boards

Public Chapter 340 -

Establishes the regulation of pain management clinics by the Department, authorizing the Department to grant, deny, renew and discipline a clinic license. A pain management clinic is defined as a privately-owned facility in which a medical doctor, osteopathic physician, advanced practice nurse and/or physician assistant who provide pain management services. Each pain management clinic must have a medical director who provides onsite supervision. On or before October 1, 2011, the Commissioner of Health, in consultation with the Board of Medical Examiners, the Board of Osteopathic Examination, the Board of Nursing, and the Committee on Physician Assistants, shall promulgate rules to implement the law.

Public Chapter 230 -

Provides that each health-related board shall establish a procedure to expedite the issuance of a license, certificate, or permit for an applicant who is certified or licensed in another state to perform the same profession that is the subject of the application; whose spouse is a member of the armed forces; whose spouse is the subject of a military transfer to Tennessee; and who has left employment to accompany the person’s spouse to Tennessee. The procedure shall include issuing the applicant a license, certificate, or permit if the licensure requirements in the other state are substantially equivalent to Tennessee’s requirements or developing a method to authorize the applicant to practice in Tennessee with a temporary permit in accordance with current law (T.C.A. §63-1-142).

Public Chapter 435 -

Provides that any governmental entity or private business or establishment that provides or offers a place of assembly or entertainment, transportation, lodging, dining, educational, medical or leisure activities or services, or any business or any establishment licensed by the State or any political subdivision thereof, or that is engaged in commerce in this State is strongly encouraged to post a sign indicating that certain information regarding the Tennessee human trafficking resource center hotline is in a location within the establishment that is visible to employees and the general public. The Department of Labor and Workforce Development shall provide the sign authorized by this section on its internet website for entities or establishments to print as needed.


Statutes and Rules


Statutes

Statutes are proposed and made law by the Tennessee State General Assembly (Legislature). The Board, following specific notice requirements and hearings, adopts rules. Both have the force of law and may be used in the regulation of a profession. The statutes pertaining to this Board are found at T.C.A. 63-1 (Division of Health Related Boards) and T.C.A. 63-7 (Nursing).

Click here to review the Tennessee Code Annotated. (This link will take you to a website that is not maintained by the Tennessee Department of Health).

 

 

Rules

Click here for Rules and Regulations pertaining to the Tennessee Board of Nursing

Policies


Policies

Multi-State Regulation


Nurse Licensure Compact Law

DESCRIPTION

This law enacts the interstate nurse licensure compact that allows for the mutual recognition of nurses licensed by participating states. The compact sets up a model for nurse licensure that is similar in many ways to the driver's license model. Under the compact, a nurse holds one license-- in the state of residence. The nurse is able to practice nursing in other states that have passed the compact under the authorization of the multistate privilege. If the nurse chooses to move his/her residence to another compact state, the nurse has 30 days to practice while the new home state license is being processed. Once the new license is issued, the original license becomes invalid.

States within the compact (party states) cooperate with each other by sharing licensure, discipline and significant investigative information with each other to protect citizens from nurses who might attempt to evade board disciplinary action by moving to another state. Nurses today frequently practice across state lines through telephone or Internet communication. When those nurses fail to obtain licensure in every state in which they practice, patients are left with no recourse through the regulatory process when violations of the practice act occur.

Until all or most states participate there will not be a financial impact on the board. The compact provides for transition issues such as allowing nurses to hold more than one license when licensed in a party state and a state that is not a party state.

Article 1 sets out the findings and purpose of the compact. Nurse licensure laws protect the public. Nurses are increasingly mobile and frequently use advanced technology to deliver patient care across state lines. A simpler licensure system promotes compliance with licensure laws and cooperation among states. The compact establishes that the nurse is accountable for the licensure law in the state in which the patient is located at the time care is rendered.

Article 2 speaks to definitions used in the compact that must be understood the same by cooperating party states.

Article 3 describes the general provisions and jurisdiction. A license issued by the home state will be mutually recognized by each party state as authorizing a multistate licensure privilege to practice in the party state. Party states may, in accordance with due process laws, limit or revoke the multistate privilege. All licensure actions must be reported promptly to the coordinated licensure information system and this information will be relayed promptly to the home state. Nurses must practice according to the licensure laws of the state where the patient is located and that practice will be subject to the jurisdiction of state licensure board and courts. Nursing practice is defined not only as patient care but also all nursing practice as defined by the state licensing board. This compact does not affect the advanced practice of registered nursing. Individuals who are not a resident of a party state shall still be able to apply for a license in a party state, but that license will not grant them the multistate privilege in other party states.

Article 4 describes the licensure process in a party state. The licensure board in a party state is required to check the coordinated licensure information system to determine if an applicant holds or has held a license in any other state and if there is disciplinary action against the license or privilege. A nurse shall hold a license in only one party state at a time that is issued by the home state. When a nurse changes residence between two party states, the nurse applies for licensure in the new home state and the former home state license is no longer valid. When moving from a non party state to a party state and obtaining licensure, the non party state licensure is not affected and will remain in force. In moving from a party state to a nonparty state, the license issued by the prior home state converts to an individual state license valid only in the former home state without the multistate privilege.

Article 5 addresses adverse actions. The licensing board of a party state is required to promptly notify the administrator of the coordinated licensure information system of any remote state actions and any significant investigative information yet to result in remote state action. The licensing board shall have the authority to complete any pending investigation on a nurse who changes residence during the course of the investigation. A remote state may take action affecting the multistate privilege. Only the home state may take action against the license. The licensing board shall give the same priority and effect to reported conduct received from a remote state as it would if the conduct occurred in the home state and shall apply its own state laws to determine action. Nothing in the compact shall override a party state's decision to allow participation in an alternative program (professional assistance) in lieu of licensure action. Party states must require nurses participating in an alternative program to not practice in any party state during the term of the contract with the alternative program without the prior authorization of the other party state.

Article 6 speaks to additional authorities invested in the party state licensing boards. If permitted by state law, the state may recover the costs of investigation and disposition of cases resulting in adverse action. The state may issue subpoenas, issue cease and desist orders and promulgate uniform rules and regulations.

Article 7 describes the coordinated licensure information system. All party states will cooperate in creating a database for all registered and licensed practical nurses that will contain the disciplinary history of each nurse. All party states will promptly report adverse actions against a nurse's license, actions against a multistate privilege, any current significant investigative information, denials of applications and the reasons for denial. Current significant investigative information will be made available only to party state licensing boards. Any information contributed to the coordinated licensure information system that is subsequently required to be expunged by the laws of the party state contributing the information shall be expunged from the coordinated licensure information system.

Article 8 addresses compact administration and interchange of information. The executive director of the state licensure board or his/her designee shall be the administrator of the compact for his/her state. The compact administrator shall provide the compact administrator of each party state information to facilitate administration of the compact. Compact administrators have the authority to develop uniform rules to administer the compact that shall be adopted by the party states.

Article 9 speaks to immunity. The party states shall not be liable on account of any act or omission in good faith while engaged in the performance of their duties under this compact.

Article 10 addresses entry into force, withdrawal and amendment. The compact shall become effective when it has been enacted into law. A party state may withdraw from the compact by enacting a statute and providing six months notice of the withdrawal to the executive heads of all other party states. Withdrawal shall not affect the validity of states remaining in the compact. This compact will not invalidate or prevent a party state from any nurse licensure agreement with a non party state. The compact may be amended by the party states, but will not become effective and binding unless and until it is enacted into the laws of all party states.

Article 11 speaks to construction and severability. The provisions of the compact shall be severable if any part is declared to be contrary to the constitution of any party state or of the United States. In the event of settling disputes arising under the compact, the party state may submit the issues to an arbitration panel composed of the administrator in the home state, the compact administrator of the remote state involved and a compact administrator agreed upon by all the party states involved. The decision of the majority will be binding.

FAQ


Nurse Licensure Compact Law Frequently Asked Questions (FAQs)

The Tennessee General Assembly enacted the Nurse Licensure Compact in 2002. As of July 1, 2008, the following states belong to this mutual recognition model of multistate nursing regulation: Arizona, Arkansas, Colorado, Delaware, Idaho, Iowa, Kentucky, Maine, Maryland, Mississippi, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia and Wisconsin. Nurses who reside in other compact states who hold a multistate license “have the “multistate privilege” to practice in Tennessee without the requirement for a license issued by the Tennessee Board of Nursing. The following questions and answers provide information about the Nurse Licensure Compact and how it will affect employment of nurses from other compact (party) states that have enacted the Compact.

Q:        What does a ‘multistate privilege to practice’ mean?
A:         Similar to the driver’s license model, this is the mechanism in the Nurse Licensure Compact that allows a nurse who is licensed in one compact state (home state) to legally   practice in another compact state (remote state). It is important to understand that the Nurse Licensure Compact requires the nurse to adhere to the practice laws and rules of the state in which the client(s) receives care.

Q:        Where will nurses obtain/renew their license under this mutual recognition model of licensure?
A:         Nurses must meet the requirements to obtain and renew their license in their primary state of residence.  Primary state of residence as defined in the Compact means “the person’s fixed permanent and principal home for legal purposes; domicile”.

Q:        How will the Nurse Licensure Compact affect nurses who live in Compact states?
A:         As of July 1, 2003, a nurse who resides in Tennessee and holds an unencumbered Tennessee multistate nursing license will have the ‘multistate privilege to practice’ in any of the other compact states. Likewise, a nurse who resides in and is licensed by another compact state and holds a multistate license will have the ‘multistate privilege to practice’ in Tennessee.  When a nurse changes his/her primary state of residence to another compact state he/she will be required to apply for and obtain a nursing license in that state. A nurse who lives in a compact state no longer must obtain (or renew) a license in any of the other states that have enacted the Nurse Licensure Compact.

Q:        Will the nurse who lives in a non-compact state and practices in Tennessee still need to have a license to practice in Tennessee?
A:         Yes.  Nurses who practice nursing in Tennessee but live in a non-compact state, such as California or Georgia, must continue to hold a license issued by the Tennessee Board of Nursing. The Nurse Licensure Compact will not change how they obtain or renew their Tennessee license.  However, the Tennessee nursing license will be a single state license for non-compact state residents. It will not include the multistate licensure privilege to practice in other compact states.  This privilege is extended only to those nurses who reside in Tennessee.

Q:        How will employers verify licensure status of nurses under this mutual recognition model?
A:         For nurses who holds a license issued by the Tennessee Board of Nursing, employers will continue to verify licensure status via the internet (www.tennessee.gov/health) or through our automated telephone verification system at 888-778-4123.  Please note that verification via internet will include the multistate privilege to practice for those nurses who reside in Tennessee and hold an unencumbered license.

For those nurses who are licensed in another compact state and are seeking employment in Tennessee, employers are asked to access the nationally coordinated licensure information system called NURSYS. Basic licensure information as well as disciplinary history for a licensee will be provided through this system at www.nursys.com, or contact the website/office of the state of licensure.

NOTE: With the implementation of this new model of licensure and the continuation of the single state license for nurses who reside in non-compact states, it is most important that employers verify the licensure status of all nurses seeking employment in Tennessee.

Q:        How will employers be informed of new states joining the Nurse Licensure Compact?
A:         This information will be available on the website of the National Council of State Boards of Nursing (www.ncsbn.org).  It is most important that employers remain informed as other states join the Compact. Please note that there may be a lag time between enactment of the Nurse Licensure Compact and implementation.

Q:        How will complaints about nurses be handled within this mutual recognition model?
A:         The compact authorizes the nurse licensing board of any compact state (home or remote)           to investigate allegations of unsafe practice by any nurse practicing in that state.  Based upon the outcome of the investigation, a remote state licensing board may deny the nurse’s multistate privilege to practice in that state.  Only the nurse’s home state (state of residence) licensing board may take action against the nurse’s license.  States will continue to apply the same administrative and due process procedures for imposing discipline as they have always done.  However, compact states will have more timely access to information, including current significant investigative information and the disciplinary history of nurses, through the coordinated licensure information system (NURSYS).  Should you have a complaint to report about a nurse practicing in Tennessee, submit it to the Health Related Boards Investigative Division (1-800-852-2187).

Q:        How do I get more information about mutual recognition and the Nurse Licensure  Compact?
A:         The Nurse Licensure Compact and other information related to the mutual recognition of nursing regulation are available on the Board website. The National Council of State Boards of Nursing (NCSBN) website (www.ncsbn.org) lists the states that have enacted the Nurse Licensure Compact and provides in-depth information on the mutual recognition model.  NCSBN may be accessed directly or through a link on the Tennessee Board of Nursing’s website.  If you have specific questions about this new model of nursing regulation please contact the Board office.