Monday, February 22, 2010

A Lone Star Nurse

Having left Massachusetts for the great American West, I am in the process of applying for a nursing license in Texas, the state where I now have legal residence. Having only received a license in Massachusetts in the past, I am somewhat overwhelmed by the circuitous and complicated nature of the application process in the Lone Star State, bearing in mind that a Texas nursing license will allow me to practice in 20 other states thanks to the Nurse Licensure Compact.

Once I had begun the online application process to apply for a Texas nursing license, I was interested to learn that the application required me to present myself to the nearest Sheriff's office for fingerprinting. Never having had the opportunity for such an indignity in the past, this novel experience was indeed quite novel, and I left the Georgetown, Texas Sheriff's Department with a very official-looking set of fingerprints, paying the paltry sum of five dollars for the privilege.

Delving further into the application procedures found me calling the Massachusetts Board of Registration in Nursing to ascertain the date on which I took my nursing board exams (good thing they didn't ask for my score!), as well as paying an additional fee to have an electronic verification of my Massachusetts license sent to the Texas Board of Nursing.

The fees for my new license application were as follows:
  • Fingerprinting: $5.00
  • Online application: $200.00
  • Online license verification: $30.00
Finally completing the application and mailing the fingerprint card to Austin, I learned that yet another step would be required in order for me to receive my permanent Texas nursing license. This final step entails studying over 250 pages of rules and regulations pertaining to the practice of nursing in the state of Texas, and subsequently taking an online exam that may require up to two hours to complete. Passing this exam of "nursing jurisprudence" will be the last hoop through which I will need to jump in order to ultimately be allowed to practice in the Lone Star State, as well as in 20 other states mentioned earlier.

The most disconcerting aspect of this application was a question which required me to reveal if I have been treated or diagnosed in the last five years with Antisocial Personality Disorder, Borderline Personality Disorder, Paranoid Schizophrenia, Schizoaffective Disorder, or several other mental illnesses. While I understand the reasoning behind such questions (images of Nurse Ratched come to mind), it seems a grave violation of privacy to demand such personal and confidential medical/psychiatric information from a licensure applicant. While I'm not certain what may have occurred had I selected "yes" for a psychiatric treatment history, it seems fairly apparent that revealing such information would not necessarily win over the hearts and minds of the members of the Texas Board of Nursing who would be reviewing my application.

While I admit to feeling both inconvenienced and annoyed at the frankly burdensome nature of this process, I understand that it is indeed a privilege to practice as a nurse in any state or country, and both nursing education and licensure are difficult for a reason: to winnow down the applicants to the hearty few who can see the transaction through to the bitter end. From seeking admission to nursing school to surviving clinical to passing the nursing boards, nothing about becoming a nurse---or remaining one---is simple, and perhaps that is, in fact, for the best.

I will indeed be grateful to receive my Texas nursing license---and the rights and responsibilities therein---and will frankly breathe an enormous sigh of relief when the red tape has been sufficiently satisfied. It has been an intimidatingly complicated business, and obtaining that license will be a moment of great satisfaction indeed.
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