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After the passage of the BSN in 10 law in New York last month, I wrote a blog that prompted many comments from nurses who are concerned they are no longer valued or able to work.
But the new law has a grandfather clause that applies to many nurses. Understanding what such a clause allows may help calm some fears. Grandfathering is not a new concept to the nursing profession. For instance, the practice has been used as education requirements for nurse practitioners have changed over the past 30 years. So, what is grandfathering? How does it apply in law changes and to you?
How the clause affects BSN in 10
The grandfather clause is a statutory provision exempting persons or other entities already engaged in an activity from rules or legislation affecting that activity. When this clause is added to a piece of legislation that becomes a law, it allows the current status of something pre-existing to remain unchanged regardless of whether changes are made in the future.
In the New York BSN in 10 law, it specifically states in Section 4 a-c to whom the grandfather clause does not apply. Those individuals include: a -- any student entering a generic baccalaureate program preparing registered professional nurses after the effective date of this act; b -- any student currently enrolled in, or having an application pending in, a program preparing registered nurses as of the effective date of this act; c -- any person already licensed as a registered professional nurse or any unlicensed graduate professional nurse who is eligible to take the National Council Licensure Examination as of the effective date of this act.
Regardless of your educational background, if any of these apply to you, then you aren't legally required to get your BSN in 10.
How grandfathering has been used before
In 1989, only 90% of NP programs were either master's degree programs or post-master's degree programs. Into the early 1990s, many state boards of nursing still allowed ADN-prepared RNs, who graduated from certificate granting nurse practitioner education, to be nurse practitioners. There are still ADN-prepared NPs in practice today because they were grandfathered in as educational requirements changed to a minimum of a master's degree and national certification. For instance, NPs in Arizona were required to have a national certificate or re-certification as an APRN if their certification was issued after July 1, 2004. There isn't always a grandfather clause in legislative changes affecting your license. More and more state boards are requiring continuing education credits. When these laws are enacted, usually no one is exempt.
It is important to follow and watch legislation in your state. Your RN license and right to practice, regardless of your education, is granted in state legislation.
Your state board of nursing's (which could be called something different in your state) main purpose is actually to protect the public and regulate nursing practice. They are granted this ability to do this by your state legislators. State legislators also are the ones to change and update your scope of practice in addition to your minimum educational requirements, so get familiar with your representatives at the state level. I've heard some nurses say that nurses don't belong in politics. We live in a democracy, therefore to uphold our democracy, each person must be involved. And as nurses, we are nurses in all that we do, including as voters. Every aspect of our democracy requires us to participate and to let our voices be heard. The ANA Code of Ethics states in provision 7, "The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy." Nursing education is a complex topic. But as our profession advances and we are called on to take care of sicker individuals, our education and ability must match our patient needs. There are many ways to do this, with legislative changes -- and grandfathering of current nurses.
