Nursing License Requirements in Ohio
Like many states in the US, Ohio has more demand for nursing staff than candidates for the jobs, according to a recent article in the Dayton Daily News. The US Bureau of Labor Statistics reports Ohio employs 65,860 State Tested Nursing Assistants (STNA) – the equivalent of the certified nurse aide in other states. Licensed practical nurses (LPNs) make up a smaller group, with only 40,590 employed as of May 2018. Ohio has 125,380 RNs. This figure includes the group of advanced practice registered nurses (APRNs) known as Clinical Nurse Specialists (CNSs). In addition, 2,500 certified registered nurse anesthetists (CRNAs), 7,510 nurse practitioners (NPs) and 200 certified nurse midwives (CNMs) also practice in Ohio.
The Ohio Board of Nursing licenses LPNs, RNs, and APRNs in Ohio. The Ohio Department of Health certifies STNAs. Each group has specific requirements to become licensed or certified. Ohio is not a nursing compact state. Nurses who are licensed in other states can work in a nursing compact state without obtaining a license in the second state or passing additional examinations.
STNA: Ohio requires STNAs to complete 75 hours of training through a program known as the Nurse Aide Competency Evaluation Program (NATCEP). These programs are offered by schools, private businesses, and nursing homes. Although a criminal background check is not required for the NATCEP exam, the site that provides training may require such a check. Students who are employed by the training facility must pass a physical and have a TB test. The applicant must also pass a state-administered competency evaluation test and must obtain a passing grade of 80 percent or better. The test consists of both written and skills portions. After completing these requirements, the STNA is placed on the Ohio Nurse Aide Registry. STNAs who have paid for their training may request reimbursement for the cost of training and testing within 12 months of completing the training.
LPN: A prospective LPN in Ohio must complete a one-year course of training at an approved school and pass the NCLEX-PN examination. A valid CPR card is also required for licensure. Candidates must submit fingerprints and pass a criminal background check. Fees are required for both testing and licensure. Ohio has three categories of LPNs. Those candidates who want to administer medications or IV therapy must indicate that desire in their application. The individual’s license will reflect these categories:
- An LPN who is not authorized to administer medications or perform intravenous ((IV) therapy will have a license designation of “LPN.”
- LPNs who can administer medications but not IV therapy are designated "LPN Meds."
- LPNs who have completed the required training can administer medications and perform limited IV therapy. Their license designation is “LPN M-IV.”
An LPN who is currently licensed in another state can become licensed by endorsement in Ohio. Requirements include submission of fingerprints, a criminal background check, and completion of a two-hour course in Ohio nursing rules and laws. The applicant must also submit proof of appropriate coursework to administer medications or IV therapy. Temporary permits to practice in Ohio are possible while the submission is being processed as long as the candidate maintains an active license in another state.
RN: An RN candidate in Ohio must graduate from a program approved by the Ohio Board of Nursing (OBN) or the National Council of State Boards of Nursing. At graduation, the school will notify the OBN that the candidate has met the educational requirements. Candidates must pass the NCLEX-RN, submit fingerprints electronically and pass a criminal background check. Fees are required for the exam and license.
Candidates from another state can become licensed by endorsement. The candidate must have a current valid license as an RN, submit fingerprints, pass a criminal background check and complete a two-hour course on applicable Ohio laws and regulations. A temporary permit may be issued while the application is being processed.
Foreign-educated RNs must submit a credential evaluation from the Commission of Graduates of Foreign Nursing Schools (CGFNS). Additional coursework may be required if the CGFNS documentation does not meet Ohio requirements. Candidates must also take an English proficiency exam or the TOEFL unless they graduated from an exempt English-speaking country. Most Canadian graduates are exempted, but that does not include some schools in Quebec.
APRN: In addition to completing the requirements for an RN, an APRN candidate in Ohio must graduate from an approved master's degree or doctoral program and obtain national certification in his or her specialty. Those APRNs who want prescriptive authority must also complete an experience requirement and must have an agreement with a collaborating physician. The nurse must have completed a course in advanced pharmacology with at least 45 hours specific to the nurse's area of practice. An externship of at least 1500 hours, 500 hours under the direct supervision of a supervising professional, is also required.
In Ohio, the APRN license is called a Certificate of Authority.
Out-of-state APRNs must go through the endorsement process to become licensed in Ohio and complete an externship. The externship requirements may be reduced or waived if the candidate previously had prescriptive experience. Ohio has three different applications for endorsement APRNs, based on experience. A fee is required for all applications.
STNAs in Ohio must renew their certification every two years. The Ohio Department of Health will mail a renewal form which the licensee must complete and return. An STNA whose certificate has lapsed must complete the competency evaluation again to be reinstated.
LPNs in Ohio must renew their licenses every two years. The LPN must complete 24 hours of continuing education, including at least one hour on nursing law.
RNs and APRNs in Ohio renew every two years. Continuing education requirements are the same as for LPNs. However, the APRN must also complete additional continuing education to satisfy the requirements of the specialty certification agency or organization.
Other Methods of Licensure
STNA candidates in Ohio may be able to become certified through alternative pathways.
Foreign-trained nurses and nurse aides can request a training waiver and take the competency exam.
A current nursing student or individual who has worked as a bedside aide in a hospital or military facility for at least one year may qualify to sit for the STNA exam without completing the NATCEP.
Military personnel who can provide documentation of working 12 months in the preceding five years as a full-time employee delivering direct patient care that includes typical duties of an STNA can also request a training waiver. A Healthcare Specialist, Medical Specialist or Hospital Corpsman who has delivered 1600 qualifying -hours of direct care may also request the waiver.
Nursing students who are currently enrolled in a program may request a waiver. The student must submit documentation of basic nursing coursework that includes personal care, infection control, and safety and emergency procedures.
Military personnel may meet the requirements for LPN training in Ohio. The Level 5 Skill Level training is considered the equivalent to practical nursing training by the OBN. Other acceptable training includes the Community College of the Air Force (CCAF) Associate Degree in Practical Nursing Technology program, or for training prior to 2016, the Allied Health program.
Paramedics are not eligible to become LPNs or RNs in Ohio without additional training.
Online Services Related to Nursing Licensure in Ohio
The Ohio Department of Public Health has limited online resources for STNAs. These include:
- A list of approved training programs
- Curriculum standards and guidelines for all NATCEP programs
- Nurse aide registry
- Certification information.
The OBN maintains a number of online services for LPNs, RNs, APRNs and the public Among these are:
- Continuing education
- Discipline and compliance information
- Education programs
- Forms and applications
- Law and rules
- Licensure and renewal
- License verification
- Military and veterans
- LPN, RN and APRN practice information
- Prescribing resources
- Workforce data.
Criminal History Reports
Ohio nurses in all categories must pass a federal and civilian criminal background check. For both initial licensure and renewal, the OBN will review all relevant evidence to determine if a candidate is eligible to maintain a license as an LPN, RN or APRN. Such documents include court documents, law enforcement reports, witness statements, and other written documentation. Applicants are required to report all criminal offenses.
Disciplinary actions by the ODH and OBN occur when STNAs, LPNs, RNs or APRNs commit crimes that affect their ability to practice safely. These include a wide variety of possible infractions, from financial crimes such as theft or embezzlement, drug use or sale, abuse of people or animals, terrorism, prostitution, assault, manslaughter, homicide and patient abandonment, neglect or abuse. The ODH and OBN will investigate allegations or reports before making a decision. In some cases, a temporary stay of licensure or certification may be ordered while the investigation is completed. The ODH and OBN will also consider such factors as when the offense occurred if there are other convictions or disciplinary actions, the actual criminal act committed and whether the applicant made restitution or completed rehab and probationary terms. Depending on the circumstances, a licensee may be required to complete counseling, probation or drug rehabilitation to remain certified or licensed. Permanent revocation of a certificate or license may also occur.
In Ohio, a nursing license is automatically denied to those who have pled guilty or been convicted of murder, voluntary manslaughter, felonious assault, kidnapping, rape, aggravated robbery or burglary, sexual battery, gross sexual imposition or arson. The Board is also prohibited from issuing a license to a registered sex offender. Applicants with other types of offenses may or may not be granted a license or allowed to renew a license. Each case is individually reviewed. The board considers such factors as whether the individual has made restitution, completed a sentence or rehabilitation; when the offense occurred, facts and circumstances underlying the offense and whether multiple offenses occurred. The board may issue a conditional license barring the individual from certain work settings, such as providing care to elders or children or preventing the nurse from handling controlled substances.
Scope of Practice
STNAs in Ohio provide direct care in activities of daily living. This typically includes bathing and providing or assisting with other hygiene activities, feeding patients and assisting them to ambulate. STNAs who are also certified medication aides may administer oral, topical, rectal and vaginal medications, as well as nasal sprays, drops, and ointment to the eye, ear or nose. Supervision by a physician or licensed nurse is required for STNAs.
LPN duties are affected by the type of license the nurse holds. In addition to typical STNA duties, the LPN may administer oral, topical, inhaled and injectable medications or perform IV therapy. LPNs may also change simple dressings, insert urinary catheters and administer oxygen. In all cases, the LPN must be supervised by a physician or an RN.
RNs in Ohio are expected to perform any of the tasks of an STNA or LPN as well as what are considered higher-level nursing functions. These include supervising and directing the care given by an STNA or LPN, assessing patients, developing a plan of care and evaluation of the effects of the care. RNs perform IV therapy and administer IV medications. The RN can also perform certain higher-level functions under interpretive guidelines (often called standardized procedures in other states). These functions might include inserting an intravenous jugular central line or administering and managing medications during emergent intubation of a patient.
APRNs in Ohio have the widest scope of nursing practice. They can prescribe medications and medical equipment, order diagnostic studies, suture lacerations and provide primary medical care. The different specialties provide other more complex kinds of care. CRNAs administer anesthesia, while CNMs manage pregnancy and deliver babies.
Resources for more information:
- State Approved LPN Programs
- State Approved ADN Programs
- State Approved BSN Programs
- List of all Nursing Schools in Ohio