Nursing Laws in Other States

I was curious to find out how Direct-Entry nursing programs operate in states other than Wisconsin, so I randomly chose another program similar to Marquette's and did some research on it.

Vanderbilt University is located in Nashville, Tennessee, and offers a 3 year program similar to Marquette's. Vanderbilt's web site says that the pre-MSN portion of their program prepares "students for the NCLEX exam to become a Registered Nurse (RN) and provides the foundation equivalent to the bachelor's degree in nursing." I don't know for certain, but I would guess that this implies that they do not grant a degree to their students when they complete the first portion of the program although they are able to become RNs.

Let me preface this by saying that I am not a lawyer, and I don't know much about the law. This is totally new territory for me. As a pretty much completely uninformed layperson I was able to find the Tennessee Nurse Practice Act on the web. The section related to the licensing of nurses states that it is required that an RN applicant:

has successfully completed a course of study in an approved school of nursing, as defined by the board, and the applicant holds a diploma or degree from an approved school of nursing, or the approved school has certified to the board that the applicant has met all requirements for a diploma or degree.

(Emphasis mine) It looks like it is perfectly legal for Vanderbilt students to become RNs even though they are not issued BSNs.

Compare this to the portion of the Wisconsin Nurse Practice Act that deals with requirements to sit for NCLEX:

Any person who has graduated from a high school or its equivalent as determined by the board, does not have an arrest or conviction record . . . holds a diploma of graduation from an accredited school of nursing, and if the school is located outside this state, submits evidence of general and professional educational qualifications comparable to those required in this state at the time of graduation may apply to the department for licensure by the board as a registered nurse, and upon payment of the fee . . . shall be entitled to examination.

(Emphasis mine again) To me it appears as though the procedure that Vanerbilt and Marquette follow with their Direct-Entry programs (having students become RNs without issuing them a degree) is perfectly legal in Tennessee but not in Wisconsin.

My Demands

There is only one way for Marquette University to ethically resolve the conundrum of the Direct-Entry program:

Grant a degree & provide a graduation date for every student (past, present and future) who successfully completes, or has completed, the first 15 months of the Direct Entry program.

The only other option would be to immediately shut down the Direct-Entry program and revoke the nursing licenses of all of the students who have been a part of it. If these students do not have a degree, then they are not eligible to sit for the NCLEX-RN exam, which is required for licensure. If Direct-Entry students are not registered nurses then they cannot complete the graduate portion of the program because they must be RNs in order to participate in graduate level clinical courses. Therefore Marquette can not run the Direct-Entry program unless they grant degrees to students after the first 15 months of the program. (I got an A in logic.)

I have a feeling that Marquette would prefer not to have to shut down the Direct-Entry program. I'm willing to bet that they would also prefer to avoid the bad press that would result from retroactively revoking the licenses of many nurses - some of whom have been practicing for years. Especially since Direct-Entry students complete all of the nursing theory and practical courses that Marquette requires of their regular BSN students.

Step #1: Letter to the Associate Dean for Graduate Programs, Marquette College of Nursing

February 22, 2007

Dr. Judith Miller
Associate Dean for Graduate Programs
Marquette University College of Nursing
P. O. Box 1881
Milwaukee, WI 53201

Dear Dr. Miller:

I believe that you are already aware that I was a member of the 6th cohort of the Direct-Entry program, and that I have been unable to obtain a valid nursing license in the state of Mississippi where I am currently living.

Mississippi state law regulating nurses states that one must graduate from an accredited nursing program in order to hold a license. The same is true in Wisconsin (Nurse Practice Act: 441.04) . How can the Direct-Entry program qualify people to obtain a nursing license in Wisconsin, but not in other states? When I applied to take NCLEX I filled out a "graduation statement" for the Wisconsin State Board of Regulation & Licensing. On this form my classmates and I were told by Marquette staff members to check the box for "BSN" and to list August 13, 2005 as a graduation date - yet there is no graduation date listed on my official Marquette transcript.

Either my Direct-Entry classmates and I hold BSNs with Marquette University, or we do not. It is unethical for Marquette to choose when, and to whom, it is to their advantage to provide proof of graduation. If I have earned a BSN with Marquette University then my transcript should list a graduation date so that I can obtain a license in other states. If I have not obtained a BSN from Marquette University then I should not have been eligible for a license in the state of Wisconsin, and neither should any other students who have gone through the Direct-Entry program.

When I tried to obtain a nursing license in Mississippi I was denied solely because my Marquette transcript does not contain a graduation date. I am now in repayment of over $35,000 in student loans that I took out in order to attend Marquette although I am now unable to work as a nurse. My husband is an Episcopal priest in rural Mississippi and is currently supporting our family of three on only a few thousand dollars a year more than the amount of my outstanding student loans.

Marquette University should be ashamed for engineering this loophole in the legal regulation of registered nurses for its own purposes. I would have expected a Catholic University to behave with integrity. If the issue of whether or not individuals who have completed the Direct-Entry program have earned BSNs at Marquette University is not resolved, I will be forced to take further action.

Sincerely,

Lydia Bertrand

Some Backround Information

I was in the 6th cohort of the Direct Entry nursing program at Marquette University. This program is designed for individuals who have a bachelor's degree in an unrelated field to get an RN and a master's degree in a nursing specialty in an accelerated 3 year program. The program seemed perfect for me at the time: I already had a B.A. in Mathematics and English Literature, and my dream was to become a Certified Nurse-Midwife (CNM). Going through a more traditional path would mean starting from scratch to earn a BSN (bachelor's of science in nursing) and then working for two years as an RN before I could even apply to a CNM program.

There was no way for me to have known at the time that I was applying to Marquette that I had just met the man who would become my husband. We got engaged about half way through the RN portion of my program. He was in seminary, and the following summer was obligated to head down to Louisiana to serve there in his home state. I decided to complete the RN portion of the Direct-Entry program at Marquette, and then move to Louisiana after our wedding in August.

My husband had been assigned to a church in New Orleans, which was destroyed with our home in Hurricane Katrina only 9 days after our wedding. We were stranded in Wisconsin so I went ahead and passed NCLEX and got my nursing license in Wisconsin. We were homeless until March of 2006 when he was called to serve two small parishes in southern Mississippi.

This is where the problems with my nursing license began. I applied for a nursing licence in Mississippi as soon as we moved. In June, just a few weeks before I gave birth to our first child, I received a letter notifying me that my application for a license had been denied. The only reason that they cannot grant me a license is because my official Marquette transcript does not contain a graduation date. Mississippi state law states that in order to be eligible for an RN, one must graduate from an accredited nursing program.

But what about Wisconsin? As it turns out, a similar law is part of the Nurse Practice Act in Wisconsin (check out the pdf in the links section). So how on Earth did I get an RN in Wisconsin?

Well, Marquette University provided the Wisconsin Department of Regulation & Licensing with a "Statement of Graduation" for me, but they will not put a graduation date on my transcript.