Nursing License Requirements in Louisiana
As with many states, the demand for nurses in all categories is high and expected to grow in Louisiana. The US Bureau of Labor Statistics (BLS) reports 20,690 certified nursing assistants (CNAs), 19,450 licensed practical nurses (LPNs) and 43,110 registered nurses (RNs) were employed in Louisiana in 2018. In the group known as advanced practice registered nurses (APRNs), the BLS reported 740 certified registered nurse anesthetists (CRNAs) and 2,820 nurse practitioners (NPs) for that same year. The BLS did not have data on other categories of APRN, but the College of Nurse-Midwives reports 52 certified nurse-midwives (CNMs) in 2015 – the last year for which data was available. The Louisiana Center for Nursing found there were 127 clinical nurse specialists (CNSs) in Louisiana in 2014 and reports their numbers are growing at a rate of only three percent.
The Louisiana Department of Health is responsible for licensing and oversight of CNAs in the state. The Louisiana State Board of Nursing (LSBN) handles licensing of RNs and APRNs. LPNs are licensed by the Louisiana State Board of Practical Nurse Examiners. Licensing requirements and nursing regulations are determined by the state lawmakers. Louisiana is a nursing compact state, which allows a nurse to hold a multi-state license and to practice in multiple states without being individually licensed in each state.
Certified Nursing Aides
A CNA must complete a nurse aide training and competency evaluation program (NATCEP). CNA candidates who completed at least 60 hours of training and another 15 hours of supervised training prior to July 1, 1989, or a CNA who worked as a nurse aide in one or more facilities owned by the same employer for at least 24 consecutive months before December 19, 1989, can be deemed to have met the training requirements. The applicant must also be at least 16 years old and must pass written and skills testing. CNAs in Louisiana must be listed on the Louisiana Registry System (LARS). With additional training, a CNA can also become a medication aide under the direct supervision of a licensed nurse.
Licensed Practical Nurses
Applicants for an LPN license in Louisiana must be permanent residents of the United States and be of good moral character as defined by the LSBN. The applicant must complete an accredited practical nursing training course and pass the NCLEX-PN examination. Applicants have four opportunities to attempt the NCLEX-PN or must repeat a training program. The applicant must pass the NCLEX-PN within three years of graduation. Louisiana does not have an option for a graduate nurse to practice as an LPN under a temporary permit; the individual must be fully licensed to practice.
Registered nurse applicants in Louisiana must graduate from an approved nursing diploma, associate or baccalaureate degree program. All applications must be submitted online and must include proof of residence in the form of a current, unexpired Louisiana driver’s license with a home address; a current federal income tax return with a primary state of residence declaration or a military form no. 2058 (state of legal residence certificate). In addition, the applicant must submit to fingerprinting and a criminal background check, and provide proof that he/she holds a Social Security Card.
The applicant must pass the NCLEX-RN examination within four years of graduation; four attempts are permitted. Fees are required for testing and licensure.
RNs may practice for up to 90 days under a temporary permit while awaiting NCLEX-RN results.
Advanced Practice Registered Nurses (APRN)
An APRN must first be licensed as an RN and must complete a graduate program. The program may be at the master’s or doctoral level or may offer a post-masters certificate. However, those who graduated with less than a master’s degree by December 31, 2005, maybe exempt from master’s degree requirements if the program was approved by the LSBN, accepted by a Board-approved national certifying agency or offered by an institution of higher learning and accepted by a certification agency as examination-qualifying in the desired specialty.
APRNs must be certified in one or more specialties by a national certifying organization such as the American Midwifery Certification Board (AMCB), the National Board of Certification & Recertification for Nurse Anesthetists (NBCRNA), the American Nurses Credentialing Center (ANCC) or the American Association of Critical-Care Nurses (AACN).
Fingerprinting (even if performed in the past) and a criminal background check are required. Once the applicant has been approved for licensure as an APRN, a separate application for prescriptive authority is required. To qualify for prescriptive authority, the APRN must have completed three credit hours or 45 contact hours of advanced pharmacotherapeutics, advanced health assessment, and advanced physiology/pathophysiology.
APRNs must have collaborative agreements with one or more licensed physicians to practice in Louisiana.
CNA – a CNA is eligible for renewal if he or she has worked at least eight hours in the preceding 24 months. Proof of work experience must be submitted by the employer. CNAs in Louisiana must renew certification every two years. Recertification occurs automatically once the work history is submitted.
LPN – LPNs in Louisiana renew licensure annually between November 1st and January 31st. Continuing education is not required.
RNs – RNs renew licensure annually in Louisiana. The renewal season is October 1st to January 31st. Continuing education is required to renew and is based on the number of hours worked. RNs with a minimum of 1,600 hours of practice must complete a minimum of five hours of continuing education. RNs with 160 to 1,599 hours of verified practice must complete at least 10 hours of continuing education. RNs employed 159 hours or less, or nurses who were unemployed or self-employed must complete at least 15 hours of continuing education.
APRNs – APRNs who are not nationally certified must have a minimum of 300 hours worked in advanced practice and a minimum of two college credit hours or 30 continuing education hours to renew.
Other Methods of Licensure
Sometimes called reciprocity, endorsement allows an RN licensed in another state to obtain a license in Louisiana. The applicant must:
- Hold a current unrestricted license in another US state or territory issued from the jurisdiction of last employment
- Have completed a nursing program that is approved by the LSBN or that meets/exceeds educational standards for programs in Louisiana
- Successfully pass the NCLEX-PN
- Have no grounds for pending disciplinary action by any nursing or other health regulatory board in any US state or in a country outside the US
- Have no pending civil or criminal charges in any US state or in a country outside the US
- Provide proof of a Social Security number
- Submit to a criminal background check
- Graduates of non-traditional programs such as Excelsior and Deaconess College, which do not provide a faculty-supervised clinical component, must also provide evidence of six months to one year of full-time clinical experience as an RN in a staff position under RN supervision in another US state and provide three letters of recommendation from a current/previous RN supervisor/employer attesting to ‘satisfactory clinical performance.’ The applicant must also provide verification of RN employment dates and supervisor’s contact information.
The applicant must meet all the criteria for licensure by endorsement, have no state or federal felony convictions, have no misdemeanor convictions related to the practice of nursing, not be a current participant in an alternative program and declare Louisiana as the primary state of residence.
Foreign-educated nurses must meet all of the requirements for licensure by endorsement and must also prove proficiency in English. Proof of education may be obtained through the Commission on Graduates of Foreign Nursing Schools (CGFNS).
Military personnel who completed training as a corpsman or equivalent are eligible to take the certification examination to become a CNA. Veterans must complete additional training and examinations to become an LPN or RN in Louisiana.
Criminal History Reports
Criminal background checks are required for initial licensure, whether by examination or endorsement. Applicants for renewal are also required to submit information regarding completed or pending criminal history. The burden of proof rests with the applicant in each case. Findings such as patient abuse or mistreatment, theft or sexual abuse may prevent initial licensure or renewal.
When a complaint is received or an applicant reports criminal activity, the Louisiana Department of Health or the LSBN will determine if the complaint is valid and conduct an investigation. The case is then referred to the hearings department. Each case is handled on an individual basis. The board will usually attempt to handle the case through a consent order, a document that shows the individual consents to the facts of the case. A consent order is legally binding. If the individual refuses the consent order, a hearing is required to determine whether action should be taken against the individual's license. The possible actions taken include:
- Formal Reprimand – essentially a warning; noted in the license file.
- Probation – technically the license is suspended but the individual may continue working under specific requirements.
- Suspension – the nurse cannot work for a period of one to five years. If the behavior warrants, the individual’s license may be suspended prior to a hearing (summary suspension).
- Voluntary Surrender – the individual agrees to surrender his or her license for a period of time and to fulfill certain requirements, such as mandatory continuing education or drug rehabilitation treatment, in order to have a license reinstated.
- Revocation – permanent loss of license.
Scope of Practice
Scope of practice regulations are designed to identify the tasks and authority of each class of nursing personnel. Each class of license also allows the nurse to perform tasks in the categories below it – for example, an APRN would be expected to be competent at the tasks of an RN, LPN or CNA.
CNAs have the most limited scope of practice and are bedside caregivers, providing basic hygiene and assistance with activities of daily living.
In addition to other bedside care activities, LPNs can administer medications and, if trained in their original curriculum or a post-graduate course, may administer peripheral intravenous therapy. LPNS may not manage central lines, administer blood or perform dialysis.
RNs are expected to perform higher-level functions for which additional skill and training are required. These include conducting a patient assessment, developing a nursing care plan and evaluating the care given.
APRNs provide primary care, administer anesthesia and deliver babies (according to the APRN’s specialty). They can order lab work and diagnostic tests, and prescribe medications.