California employs more than 99,000 nursing assistants, more than 294,000 registered nurses(RNs), more than 15,000 advanced practice nurses (APRNs) and more than 64,000 licensed vocational nurses (LVNs). It also leads the nation in pay for all of these categories. The state’s size and geographic features offer jobs in multiple work settings from metropolitan university hospitals to small rural clinics to home care. Scope of practice is relatively broad compared to other states, especially for APRNs.
California licenses registered nurses, advanced practice registered nurses, licensed vocational nurses and certified nursing assistants (CNA). APRNs include Nurse Practitioners(NP), Certified Registered Nurse Anesthetists (CRNA), Clinical Nurse Specialists (CNS) and Certified Nurse-Midwives (CNM). RNs and APRNs are licensed by the Board of Registered Nursing (BRN). LVNs are licensed by the Board of Vocational Nursing and Psychiatric Technicians (BVNPT). The California Department of Public Health (CDPH) certifies CNAs. California is not a nursing licensure compact state, which means that a California license does not allow you to practice in other states – you must take an examination or undergo a screening process to obtain a second license.
Each level of nursing practitioner has different licensure requirements. In all cases, however, the applicant must supply a 2-inch X 2-inch front view, head and shoulders photograph and submit his or her fingerprints for a criminal background check.
A current active license is required to practice nursing in California. A licensee who wants to maintain the license but does not want to practice can choose inactive status. CE requirements are waived for inactive status. The final option is to allow a license to lapse or become delinquent if the applicant no longer wants to practice nursing. A lapsed license of less than eight years can be returned to active status through payment of a fee and completion of CE requirements. After eight years, the applicant must submit the fee, complete required CE and provide either verification of licensure in another state or retake the licensure examination.
California applicants who were educated/licensed in another state or a foreign country can become licensed in California. The process is known as endorsement or reciprocity. The process for gaining reciprocity from California to another state is similar, but specific requirements depend on the state. Some states will require the CNA or nurse to pass the licensing exam in the state where the candidate wants to practice. To qualify for reciprocity in California:
The CNA applicant must submit a copy of the out-of-state CNA certificate, proof of employment for compensation in a resident facility under the supervision of a licensed health care professional within the preceding two years and the Verification of Current Nurse Assistant Certification completed by the applicant and the state agency from the state in which the applicant is currently certified.
The LVN applicant must hold a current active license as an LVN or licensed practical nurse (LPN) in another US state or territory and have passed the NCLEX-PN or National League for Nursing State Board Test Pool Examination for Practical Nurse (SBTPE). Applicants licensed in a foreign country can only apply for endorsement if the country administers one of the two exams mentioned.
The RN or APRN applicant must hold a current, active RN license in another state, US territory or Canada. In addition, the applicant must have completed an educational program that meets all California requirements and have passed either the NCLEX-RN or the State Board Test Pool Examination. APRNs must also provide proof of certification in their specialty.
Veterans who received corpsman training in the military can apply for licensure as a CNA or LVN in California as noted above.
There are no options for paramedics to become licensed as CNAs, LVNs or RNs in California without completing the required course of study and passing the necessary examinations.
There is no option for a foreign-born or foreign-educated CNA to become certified in California. The applicant must complete the required training and examination.
Foreign-born or foreign-educated nurses must have completed a program that meets the requirements of a California LVN or RN program and pass the NCLEX-PN or NCLEX-RN examination.
The CDPH, BVNPT, and BRN offer a variety of online services. All include ways to contact the relevant organization as well as:
The mandate of all licensing or certification boards is to ensure a competent, safe practitioner and to protect the public. To that end, they require applicants and those applying for certification or license renewal to provide information about criminal offenses. A licensee who provides this information to the relevant board must also supply a detailed written explanation of the circumstances, documents related to the arrest, including court documents, and any mitigating circumstances or evidence of rehabilitation.
The CDPH, BVNPT, and BRN may take action in cases when criminal convictions, substance abuse or unprofessional behavior is confirmed in a CNA, LVN, RN or APRN. In most cases, the focus is on crimes substantially related to the qualifications, functions, and duties of the licensee. Once a report is filed or the licensee reports a conviction, the relevant licensing organization will investigate. The accused individual has an opportunity to make a defense at an administrative hearing. The board will then make recommendations for action against the licensee. The action taken depends on the specific charges, the outcome of the case and the severity of the individual’s actions. For example, substance abuse may result in a temporary suspension of the right to practice, but if the individual completes a rehabilitation program, the suspension may be lifted. The individual may still have some restrictions, however, such as not being able to access controlled substances. Among the most common reasons for a license restriction or termination are ongoing substance abuse, exceeding the scope of practice, theft from patients or clients, embezzlement, gross negligence, battery, and abuse of patients, children or a spouse. Failure to report abuse witnessed by the licensee is also cause for disciplinary action.
Scope of practice in nursing is defined by the individual state. In California, the CDPH defines the scope of practice for a CNA. The BVNPT defines the scope of practice for an LVN and the BRN defines the scope of practice for an RN or APRN.
Resources for more information: