Saturday, September 15, 2007

A Good Question

People frequently ask me why I didn't try other ways of getting a Mississippi nursing license before beginning this campaign with Marquette. The answer is that I did: I tried every other reasonable method of getting a license before I discovered that there was a legal problem with the RN licensure of Direct Entry students in Wisconsin. The following is a revised version of the answer I posted to a comment on this post detailing all of the other ways I tried to get a nursing license:

As soon as I moved to Mississippi I applied to the Mississippi Board of Nursing for a Mississippi nursing license by endorsement ("licensure by endorsement" means transferring a license from another state). My application was denied because Marquette does not provide Direct Entry students with graduation dates at the completion of the pre-MSN phase. This seemed very strange to me since Marquette did provide the Wisconsin Department of Regulation & Licensing with a graduation date on my Wisconsin RN licensure application in the form of a "Statement of Graduation." [this part of the RN licensure application in Wisconsin has since been changed to have a "direct entry" box, so Marquette no longer marks that students have earned a "BSN." While Marquette no longer lies on the licensure apps for DE students, it does not matter because "completion of a direct entry program" still does not meet the legal criteria for licensure under the Wisconsin Nurse Practice Act 441.04]

There are two ways to become licensed as an RN. The very first time you get your first license it is called "licensure by examination." You must pass NCLEX to get a license by examination. If you are transferring a license from one state to another it is called "licensure by endorsement." Ordinarily getting a license by endorsement is a rubber-stamp operation: nothing more complicated than paying some fees and filling out some paperwork with the new state Board of Nursing. Some people from the Wisconsin Department of Regulation & Licensing tried to tell my parents after the August 30th Wisconsin Board of Nursing meeting that once I practice nursing in one state, then it will be much easier to transfer my license to another state. They claimed that if I were able to get a Mississippi license by appealing Mississippi's rejection of my application, that once I practice nursing then I would not have any trouble transferring my license to another state if I move again in the future. This is completely false. Whether or not I ever practiced nursing before is irrelevant: the only thing that matters is that I have a valid license in another state.

There is no use in appealing the Mississippi Board of Nursing's denial of my licensure application because the Mississippi Board of Nursing Rules & Regulations 2.3 (a)(1) clearly requires proof of graduation from a school of nursing - and I can not provide this. The criteria for RN licensure in Mississippi is exactly the same as it is in Wisconsin: you must graduate from a school of nursing and pass NCLEX. Mississippi cannot grant me a nursing license in their state even if they want to unless I can provide them with proof of graduation. They already have a copy of my "Certificate of Completion" of the pre-MSN phase of the Direct Entry program and a letter from Dr. Judith Miller explaining the program. These things do not indicate that I have graduated from a school of nursing, so Mississippi still had to deny my application.

Nobody will hire me as a nurse in Mississippi without a Mississippi nursing license because I can not legally practice nursing in this state without a Mississippi license - my Wisconsin license is meaningless here. The only exception to this would be for individuals who can take advantage of the Nurse Licensure Compact (NLC). But the NLC is for people who live in one state but work in another state - in that case you can use the license you hold in your state of residence (where you live, vote, pay taxes) to work in another state as long as both states belong to the NLC. Under the NLC you must hold a license in the state that you are a resident in. Mississippi and Wisconsin both belong to the NLC, but I am obviously not commuting to work from Wisconsin. Since I am a Mississippi state resident I must hold a Mississippi nursing license in order to work in Mississippi.

After my application for a Mississippi license was denied by the Mississippi Board of Nursing, I looked into applying to other schools of nursing in my area.The first thing I tried was to apply to a local community college ADN program. My main concern was getting someone to issue me a "graduation date" so that I could become licensed in Miss and start working to help support my family. I thought that an ADN would be cheaper and faster than a BSN even though it is below my current level of education. The director of the ADN program called me up personally after she got my application to tell me that the community college could not accept me as a student. I had already taken every single course in their entire curriculum, and they can not issue me an ADN degree from their institution unless I take at least 25% of the nursing courses at their school. I practically begged her to allow me to re-take 25% of the required classes at their school, just so that I can get a graduation date from somewhere so that I can get a valid Mississippi nursing license so that I can work to support my family. They did not allow me into the ADN program. I live in rural Mississippi and there are not any other ADN programs within driving distance of my home.

Next I tried to apply to the RN-to-BSN program at a nearby university since I do have a (Wisconsin) RN. They would not allow me into this program because you must have an ADN and a Mississippi nursing license in order to get into the program. (Even though there are no clinicals, only academic work for this kind of program). But I can't get an ADN because I am overqualified for an ADN program. And I can't get a Mississippi nursing license unless I get either an ADN or a BSN. Catch-22. The nursing department even discussed my situation at a board meeting, and still would not allow me to apply to the RN-to-BSN program, even though I am perfectly qualified for it.

My only other option at this point would be to enter a 4 year university BSN program as a freshman. I would need to re-take many courses that I have already taken because they have time limits. For example: I took sociology and statistics more than 10 years ago, so I would have to re-take those classes. I took two semesters of anatomy & physiology more than 5 years ago, so I would have to re-take those classes, too. Re-taking so many courses that I already took, and did very well in, seems quite ridiculous since I am already a nurse. I would also have to re-take the entire core curriculum for another bachelor's degree at that university. In addition, I'd have to re-take a good percentage of the nursing classes that would not transfer from Marquette. It would take a good 3 years of full-time coursework to get a BSN this way when all I really want is to get a nursing license.

I would be closer to getting a Mississippi nursing license if I had never taken a single nursing course before in my life. If I had never entered the Direct Entry program at Marquette, then at least I would have the option of going to a community college and getting an ADN in two years.

The "Memorandum of Understanding" that I signed when I entered the Direct Entry program said that I could get a license in Wisconsin without a BSN degree. It was not unreasonable for me to assume that this meant that the pre-MSN phase of the Direct Entry program would legally meet the requirements for RN licensure in Wisconsin - but this is simply not the case.