New York offers multiple opportunities for members of the nursing profession. Work settings range from major university medical centers in metropolitan areas to small rural clinics, doctor’s offices, skilled nursing facilities, and residential care homes. According to the US Bureau of Labor Statistics, 91,400 certified nurse aides and 46,500 licensed practical nurses (LPNs) worked in New York as of May 2018. In addition, New York employed182,490 registered nurses (RNs); this group includes the clinical nurse specialists (CNSs). Many advanced practice registered nurses (APRNs) also found employment in New York: 1,770 certified registered nurse anesthetists (CRNAs), 450 certified nurse-midwives (CNMs) and 13,700 nurse practitioners (NPs). With the exception of LPNs, New York is also one of the top-paying states for all categories of nurses.
Each state defines the requirements for licensure within the state. In New York, CNAs are certified by the Department of Health. LPNs, RNs and APRNs are licensed by the New York State Office of the Professions, commonly known as the Office of the Professions (OP).
New York is not a nursing compact state – nurses from out of state must apply for a New York license.
Initial Licensure
Certified Nurse Aide
CNA candidates in New York must complete a state-approved training course, submit fingerprints for a criminal background check and report any criminal history during the application process. In addition, candidates must pass a written examination and a clinical skills exam. Applicants must take the certification examination within 24 months of completing the training program. Successful applicants receive a certificate and are placed on the nurse aide registry. A fee is required for the examination. Employers must pay the examination fee for nurse aides who are already employed. n
CNAs may also recertify if their certification has lapsed. Those trained after July 1, 1989, must complete the written examination and skill test. Those trained prior to that date, who were deemed certified or who have reciprocity must retake a state-approved CNA program.
Licensed Practical Nurses
New York requires that LPN candidates be of good moral character and at least 17 years of age. In addition, the applicant must have completed high school or the equivalent and a state-approved nursing education program (LPN or RN) in New York, another state or US Territory. Infection control coursework that meets the standards of the NYSED is also required. The candidate must also pass the NCLEX-PN examination. Fees are required for testing and licensure.
Registered Nuse
Like LPNs, RN candidates in New York must be of good moral character. However, the minimum age requirement is 18. The candidate must have graduated from a state-approved diploma, associate, master’s or baccalaureate nursing program and pass the NCLEX-RN examination.
Completion of course work in child abuse recognition and reporting is required for RN licensure. Exemptions are available for those who graduated after 9/1/1990 or residents of nursing homes or residential care schools. RNs must also complete infection control coursework approved by the NYSED.
LPN/RN Limited Permits
Individuals who have met all requirements for licensure except the NCLEX-PN or NCLEX-RN examination may apply for a limited permit. This permit allows the individual to practice as an LPN or RN when under the immediate and personal supervision of a licensed, currently registered, professional nurse, with the endorsement of the employer. The individual must be employed by the facility in which he or she is working.
Advanced Practice Registered Nurses
APRNs provide a higher level of care and have more stringent requirements than those of an RN. A master’s degree in nursing is the minimum requirement, although some APRNs hold a doctorate in nursing. The APRN must also be certified in his or her specialty. New York does not require that midwives be RNs. However, the midwifery applicant must have a master’s degree or doctorate in midwifery or a related field such as nursing. To prescribe, the applicant must have completed a minimum of a three-credit course in pharmacology. The course must include instruction in drug management of midwifery clients and New York State and Federal laws and regulations related to record-keeping and prescriptions.
Licensure Renewal
LPNs and RNs in New York receive both a nursing license and a registration certificate. The nursing license is good for life. The registration certificate must be renewed every three years.
- CNA – The New York Nursing Assistant registry requires that CNAs renew certification every 24 months. The candidate must have worked for a minimum of eight consecutive hours as a CNA in the 24 months preceding renewal. CNAs with registry restrictions are not eligible for renewal. A fee is required.
- LPN – LPNs are required to renew their registration every three years. A minimum of three hours of training in infection control every four years is required for registration renewal. The training must be from an approved provider. A fee is also required.
- RNs – RNs must renew their registration every three years. RNs have the same requirement for infection control training as LPNs.
- APRNs – in addition to infection control training, APRNs with a DEA registration number must complete at least three hours of course work or training in pain management, palliative care and addiction. APRNs are also required to maintain certification, which requires at least 40 hours of continuing education training every two years.
Other Methods of Licensure
Certified Nurse Aide
- CNAs certified in another state pay a fee and provide proof of certification. If the previous state does not include expiration dates on the CNA certificate, the applicant must also provide proof of at least seven hours of employment for pay within the preceding 24 months.
- Graduate nurses who are eligible for the NCLEX examinations may take the examination and skills test for CNAs.
- RNs and LPNs licensed in another state need only complete an application and can work as CNA if the chose to do so.
- Nurses licensed in another country must provide copies of a Social Security card, nursing license, nursing school diploma, documentation of nursing school coursework, admission letter (if planning to take the NCLEX-RN or NCLEX-PN examination), and pass the written and clinical skills examinations for a CNA.
Endorsement
LPNs and RNs licensed in another state may submit an application for licensure, certification of professional education and verification of license in another state to become licensed in New York. Additional coursework in child abuse reporting and/or infection control may be required for licensure in New York.
Certification of Professional Education and a copy of the license issued by the previous state must be submitted to the department along with a licensing fee.
Veterans
Veterans who have completed a minimum of a nine-month education program in the US Armed Forces that is acceptable to the New York State Education Department are eligible to become LPNs.
Foreign Educated Nurses
Foreign-born or foreign-educated nurses must submit proof of credentials either from the institution that issued the credential or through the Commission on Graduates of Foreign Nursing Schools (CGFNS). This will include verification of foreign licensure. A fee is required for verification. Proof of proficiency in English is also required. LPN applicants educated in another country must have completed a nursing education program acceptable to the NYSED. Applicants must arrange for credential verification through the Commission on Graduates of Foreign Nursing Schools (CGFNS) and have the other country submit a license verification.
Paramedics must complete additional training to become LPNs or RNs in New York.
Criminal History Reports
In the interests of protecting the public from malpractice and abuse, New York requires that nursing personnel be of good moral character to practice. The nurse aide registry maintains a record of all CNAs who have criminal convictions and are no longer eligible to practice on its website.
CNAs who commit resident abuse, neglect, crimes such as assault or misappropriation of resident property are not eligible for renewal.
LPNs and RNs must complete a series of questions to become licensed or to renew a license. These include reporting of a felony or misdemeanor, whether criminal charges are pending, licensing or disciplinary actions, charges pending for professional misconduct and termination or restriction of privileges.
Disciplinary Actions
The Office of the Professions will take disciplinary action if a nurse is considered to be unfit to practice or commits a crime. The OP will investigate and if necessary prosecute if a licensed professional fails to meet expected standards of practice. Professional misconduct includes such actions as:
- Gross incompetence, gross negligence or a pattern of either negligence or incompetence over a period of time.
- Discrimination (refusing service) on the basis of race, creed, color or national origin.
- Exceeding the scope of practice.
- Conviction of a crime.
- Releasing confidential information without authorization.
- Sexual or physical abuse.
- Patient abandonment or neglect.
- Substance abuse or practicing under the influence of alcohol or drugs, including prescription medications.
After the investigation, the Board of Regents will issue a report of no findings or will invoke penalties that may include censure, probation, license revocation or monetary fines up to $10,000 for each violation. Nurses who abuse alcohol and other drugs may surrender their licenses voluntarily, providing they have not harmed a patient. Mandated rehabilitation may substitute for disciplinary action.
Scope of Practice
In the US, each state determines scope of practice in the nursing professions. Scope of practice is on a continuum, with CNAs the most limited and APRNs the least limited. Scope of practice includes those duties and tasks of the lower levels of practice.
CNAs are dependent practitioners who must work under a licensed nurse or physician. The CNA provides direct care to assist patients in activities of daily living. This might include hygiene activities such as bathing or brushing a patient’s teeth, feeding patients, specimen collection and stocking supplies.
LPNs administer medications, including injectable, oral, topical and inhaled medications. LVNs who have completed training in intravenous (IV) therapy may provide that service in acute care under the direct supervision of an RN. LPNs cannot provide IV therapy in a home care setting. The LPN may start, manage and discontinue peripheral IV lines and administer blood and blood components. Annual IV therapy training is required.
RN tasks may seem similar to those of LPNs, but the RN is responsible for higher-level functions such as patient assessment, care planning, and evaluation. RNs also insert, manage and discontinue central IV lines. They perform complex tasks such as wound management and delegate tasks to other members of the health care team based on scope of practice.
APRNs have a broad scope of practice and perform many physician-level functions. An APRN can make a medical diagnosis, prescribe medications, order medical equipment and medical devices, and order lab tests and diagnostic tests. However, CNSs in New York do not have prescription authority, cannot make medical diagnoses and cannot order lab or diagnostic tests. Their focus is on coordination and supervision of care, evaluating the quality and effectiveness of care, systems improvement, clinical research, and health care policy development. Nurse practitioners in New York must practice underwritten protocols. NPs must have a written practice agreement with a collaborating physician unless they have more than 3,600 hours of qualifying practice. In the latter case, protocols are not required. CRNAs administer anesthesia and manage pain. CNMs provide obstetrical and gynecological services. A CNM is an independent practitioner, although he or she must have collaborative agreements with a physician who practices obstetrics, an obstetrician-gynecologist or a hospital that provides obstetrics.
Online Services Related to Nursing Licensure in New York
The Department of Health and the Office of the Professions provide a variety of online services to CNAs, LPNs, RNs, APRNs and the general public. These include:
Department of Health:
- How to Use the Nurse Aide Registry
- Verify an NYS Certified Nurse Aide with the New York State Nurse Aide Registry
- How to Become a Nurse Aide in New York State
- Patient Safety Center
- Nurse Aide Registry
- Medicaid Fraud
- Laws and Regulations
- Complaints about Care
Office of the Professions:
- Laws, Rules & Regulations
- Practice Information
- Child Abuse Training (RNs)
- Infection Control Training (RNs & LPNs)
- License Verifications
- NYS Approved Nursing Programs List
- Scholarships, Grants & Loans
- Mandatory Prescriber Education
- License Statistics
- Consumer Information
- Professional Assistance Program
Resources for more information:
- https://www.health.ny.gov/health_care/consumer_information/nurse_aide_registry/
- http://www.op.nysed.gov/prof/nurse/nursing.htm
- http://www.op.nysed.gov/prof/midwife/midwifeqa.htm
- https://www.nysana.com/page/BecomingaCRNA
- http://www.op.nysed.gov/prof/nurse/np.htm
- http://www.op.nysed.gov/prof/nurse/nurse-cnscert.htm
- https://www.prometric.com/en-us/clients/nurseaide/pages/ny.aspx
- http://www.op.nysed.gov/prof/midwife/midwifelic.htm
- https://www.verywellhealth.com/which-states-allow-crnas-to-practice-independently-1736102
- http://www.op.nysed.gov/prof/nurse/nursepracticefaq.htm