Nursing License Requirements in Illinois
Nurses in the state of Illinois tend to be concentrated in more urban areas, although some do practice in rural areas. The US Bureau of Labor Statistics reports that Illinois employs 129,400 registered nurses (RNs) and 20,340 licensed practical nurses (LPNs). In addition, Illinois has 61,140 certified nursing assistants (CNAs) and 7,250 advanced practice registered nurses (APRNs). The smallest group of APRNs is that of certified nurse-midwives (CNMs), with only 200 in the entire state. Pay is in the middle range compared to the rest of the nation, except for certified registered nurse anesthetists (CRNAs), who are in the top range. Work settings range from large university to small rural hospitals and also include clinics, doctor’s offices, and home care.
The Illinois Department of Financial and Professional Regulation is responsible for licensing LPNs, RNs and APRNs. The Illinois Department of Public Health certifies and maintains a registry for CNAs. As of April 2019, Illinois was not a nursing compact state but had legislation pending to attain that status. Nursing compact states allow nurses who are licensed in one state to practice in another. In non-compact states, the nurse must pass an examination or submit to a screening process to obtain a second license.
Initial Licensure in Illinois
Licensure requirements vary for each level of nursing practice in Illinois. Background checks and fingerprinting are required for candidates in all categories to become licensed in Illinois.
CNAs must complete an Illinois-approved nursing assistant program. Such a program includes at least 80 hours of theory and at least 40 hours of clinical experience. The program must address at least 12 hours of dementia training, including Alzheimer's disease. Total training time ranges from three weeks to 120 days. The CNA applicant must then pass a 21-item manual skills test and a written competency test. In order to work as a CNA in Illinois, the candidate must submit an application, complete performance and written evaluations such as the Illinois Nurse Aide Competency Exam and be placed on the state registry list. However, an RN or LPN who is licensed in Illinois and wants to work as a CNA does not have to sign up for the registry. There is a fee for the examination; candidates who no-show can reschedule for an additional fee. The competency evaluation is normally offered in English. However, an applicant can apply to take the exam in another language if at least half the residents in their facility speak the other language. The state does not offer a license or certificate – the registry is used in its place for verification.
LPNs in Illinois must first graduate from an approved program. The candidate must then pass the NCLEX-PN, and submit to fingerprinting and a background check. Candidates must pass the NCLEX within three years of graduation. Fees are required for testing and licensure. Candidates who pass the exam can work as “license-pending” practical nurses.
RNs must graduate from an associate or baccalaureate degree program that has been approved by the state of Illinois. Candidates must submit proof of graduation and an official transcript, complete an application, pay an application fee and pass the NCLEX-RN examination. A fee is also required for testing. Fingerprinting and background checks are also required. Applicants must pass the examination within three years of graduation. An applicant who has passed the examination may work as a “licensing-pending” nurse until the state issues or denies a license.
APRNs in Illinois must be licensed as both RNs and APRNs in that state. An APRN must hold a minimum of a master’s degree and must be certified in his or her specialty. APRNs are certified by different organizations such as American Association of Nurse Anesthetists Council on Certification, the American Midwifery Certification Board or the American College of Nurse-Midwives, the American Academy of Nurse Practitioners Certification Program or one of several specialty certification boards.
Advanced practice registered nurses who otherwise meet the qualifications and have applied for a qualifying national certification examination may practice pending certification with a temporary permit. The candidate must provide proof of the date the certification examination is scheduled. Applicants from outside Illinois must supply proof of licensure from the original state of licensure, the current state and any state in which the applicant has practiced in the previous five years. An application fee is required. For those who request certification in more than one specialty, fees are required for each certification. APRNs in Illinois have prescriptive authority as long as they have a collaborative agreement in place in the work setting. Controlled substance licenses are available if the collaborating physician signs the application.
Other Routes to Licensure
Military personnel who have received training as medical services specialists or hospital corpsman are also eligible for certification as a nursing assistant. The applicant must present copies of certificates or DD 214s and transcripts must show hours of training completed.
Paramedics are not eligible to become CNAs, LPNs or RNs in Illinois unless they meet the basic requirements as noted above.
Nursing students who have completed a course such as Fundamentals of Nursing or Nursing 101, including at least 40 hours of clinical experience, are eligible to apply for CNA certification. A school official must verify their coursework and clinical experience.
Foreign-educated RNs and LPNs can be certified as CNAs in Illinois. The applicant must present a diploma and transcripts that show the hours or training and have been translated into English. If the applicant does not hold US citizenship, work authorization is required.
CNAs from another state can be placed on the registry; the applicant must meet requirements found in the Code of Federal Regulations (42 CFR, Sections 483.151 and 483.152). These include being on the registry of another state or holding an active CNA certification. However, a competency test is still required in Illinois.
Former CNAs can re-certify by passing both written and manual skills tests and completing a background check.
LPNs who are licensed in another state or US territory can apply for licensure by endorsement.
LPNs who are from outside the US must have their education evaluated and must demonstrate proficiency in English.
RNs who are licensed in another state must present validation of their current out-of-state license, documentation from the original state in which they were licensed and documentation from any other state in which the license holder has practiced in the last five years. Fees are required for endorsement.
RNs who graduated from a school that Illinois deems unapproved must have practiced for two full years following graduation or complete a program that does have clinical concurrent practice.
Foreign-educated nurses are eligible for licensure in Illinois if they hold a current, valid license in another country. A credential report from one of Illinois’ two approved agencies is required. Credentials and license documentation must be in English or must be translated. Candidates whose first language is not English must pass the TOEFL or IELTS Academic Module. This requirement may be waived if the nurse took a nursing program conducted in the English language or took the licensing examination in English.
- CNAs in Illinois must renew their certificates every two years. The state sends a renewal notice prior to the due date.
- Illinois requires LPNs to renew their licenses every two years on odd-numbered years, prior to May 31. A fee is required and the applicant must complete 20 hours of approved continuing education.
- The RN process is the same, except that RNs renew in even-numbered years and the expiration date is January 1.
- APRNs must also submit proof of certification and proof of 80 hours of continuing education.
Criminal History Reports
In the interest of protecting the public, the IDFPR and IDPH receive, investigate and maintain records regarding criminal activity on the part of CNAs, LPNs, RNs, and APRNs. All of these groups are required to report criminal convictions at the time of license renewal. Among the common reasons for a license limitation or revocation are untreated substance abuse and addiction. An addicted nurse is required to complete rehab and may lose his or her license if rehab fails or the nurse does not complete the program. Drug diversion, impersonating a nurse by presenting a false license or doctoring a license, making false statements about disciplinary history, theft, abuse, arson, stalking and domestic battery may be other causes for disciplinary action in Illinois.
When disciplinary action against a nurse is contemplated against a CNA, LPN, RN or APRN, the IDFPR and the IDPH will investigate. The next step is to hold an administrative hearing and determine what action is to be taken regarding the licensee. If the situation is considered serious enough, the nurse may lose his or her license to practice. A license may be suspended temporarily for something like substance abuse as long as the nurse agrees to enter a rehabilitation program. In addition, certain actions such as theft, abuse or assault, may also result in legal prosecution. If the circumstances warrant immediate action, the IDFPR or IDPH may temporarily suspend the nurse’s license prior to completing the investigation.
Scope of Practice
Scope of practice in nursing is defined in the individual state. In Illinois, the IDPH defines the scope of practice for CNAs and the IDFPR defines the scope of practice for LPNs, RNs, and APRNs.
CNAs must always work under the supervision of a physician or licensed nurse. The CNA is considered a bedside caregiver, trained to assist with or perform direct services related to activities of daily living. These might include bathing, other hygiene activities, feeding a patient or specimen collection. Illinois also has a medication aide program that allows properly trained and certified CNAs to administer oral medications in some situations.
LPNs also require supervision by an RN, APRN, physician, dentist or podiatrist. LPNs perform the same tasks as a CNA but also administer medications, perform skin tests, manage and discontinue intravenous lines. LPNs in Illinois can administer IV antibiotics but not chemotherapy or blood.
RNs are authorized to perform all tasks of CNAs and LPNs, but they also administer blood and perform dialysis as well as other more complex tasks that require additional clinical judgment and experience. Supervision is not required for RNs as long as they work within their scope of practice.
APRNs practice at a similar level as a physician, although they cannot perform surgery. They are not required to have a supervising or consulting physician and do not need a collaborative agreement with a physician in order to practice. APRNs who prescribe are limited in prescribing certain narcotics and controlled substances. These prescriptions must be distributed in consultation with a physician. CRNAs administer anesthesia and provide pain management, while CNMs provide prenatal care and deliver babies.
Online Services Related to Nursing Licensure in Illinois
The Illinois Department of Public Health is responsible for certifying CNAs. CNAs in Illinois are required to register for the Health Care Worker Registry. The IDPH maintains the following online services:
- The Health Care Worker Registry; employers are required to verify a CNA’s registry status prior to employment, which can be done online or by phone.
- A list of approved training programs.
- Applications for foreign nurses, military personnel, nursing students and out-of-state CNAs.
- The Manual Skills Evaluator Form.
- A background check form.
- A waiver application for any disqualifying convictions.
- A list of disqualifying convictions.
The Illinois Department of Financial and Professional Regulation regulates LPNs, RNs and APRNs. Its online services include:
- License renewals.
- License look-ups.
- Complaint forms.
- LPN and RN application forms.
- APRN and APRN-Full Practice Authority applications.
- Board information.
- Laws and regulations.
Resources for more information:
- Illinois Department of Financial and Professional Regulation - Nursing License Page
- Illinois Department of Public Health - Health Care Worker Registry
- State Approved LPN Programs
- State Approved ADN Programs
- State Approved BSN Programs
- List of all Nursing Schools in Illinois