Nursing License Requirements in Pennsylvania

The state of Pennsylvania offers a wide variety of work settings for all levels of nursing staff. Most registered nurses (RNs) work in hospitals, while licensed practical nurses (LPNs) and certified nurse aides (CNAs) are more likely to be found in long-term or residential care. Advanced practice registered nurses (APRNs) can be found in hospitals, primary care, and private practice, depending on the specialty. As of May 2018, the US Bureau of Labor Statistics reports Pennsylvania employed 76,260 CNAs, 38,370 LPNs, and 148,520 RNs – a figure that includes the category of APRN known as clinical nurse specialists (CNSs). In the APRN group, Pennsylvania employed 1,700 certified registered nurse anesthetists (CRNAs), 7,280 nurse practitioners (NPs) and 320 certified nurse-midwives (CNMs).

All individuals seeking certification or licensure in Pennsylvania must meet certain qualifications. These standards are designed to ensure proper education and competency as well as to protect the public. The Pennsylvania Department of Health (PDH) manages the process for CNAs and the Pennsylvania State Board of Nursing (PSBN) licenses LPNs, RNs and APRNs. Pennsylvania is a nursing compact state, which means nurses licensed in other states can also practice in Pennsylvania.

Initial Licensure

Training and licensure requirements differ for the various types of nursing personnel in Pennsylvania.

Nurse Aides – NAs in Pennsylvania must meet specific educational and competency requirements and must enroll in the Pennsylvania Nurse Aide Registry to work in a facility that receives Medicare or Medicaid reimbursement.

Employers are required to check the registry to assure a nurse aid is enrolled and is in good standing. A prospective NA must complete a nurse aide training program approved by the Pennsylvania Department of Education within 24 months of application. The applicant must pass a written examination and a skills test supervised by an authorized registered nurse. Candidates who have difficulty reading English may request an oral rather than a written examination. Applicants must provide two forms of identification, including one with a picture, and pay a fee for testing. Employers of candidates who are already employed in a Pennsylvania nursing facility must pay the examination fee for their employees. First-time applicants who do not pass both examinations within 24 months of graduation must repeat the training course. Successful applicants will receive a registry card and be placed on the registry.

Licensed Practical Nurses – Pennsylvania requires prospective LPNs to complete a course approved by the PSBN that includes a minimum of 1,500 hours of classroom, clinical and laboratory instruction. Admission into such programs is dependent on a high school diploma or equivalent, a physical examination, drug testing, immunizations, a criminal background check, and a current CPR card. The graduate must pass the NCLEX-PN licensing examination. Most programs last 12 months. A new graduate may practice with a Temporary Practice Permit (TPP) while awaiting examination results. A fee is required for the examination. Applicants must also submit proof of completing three hours of PDH-approved training in child abuse recognition and reporting.

Out-of-state LPN applicants applying for an initial license must submit a Nursing Education Verification form and official transcript; fewer than 1,500 hours of education may necessitate additional coursework. Those who are already licensed in another state may request licensure by endorsement and must complete mandated child abuse recognition and reporting training.

Foreign-educated LPNs must register with the Commission on Graduates of Foreign Nursing Schools (CGFNS), submit a fee, pass the NCLEX-PN examination and complete the three-hour training in child abuse recognition and reporting.

Registered Nurses – candidates must complete an associate or baccalaureate degree nursing program, pass the NCLEX-RN examination and apply for a temporary practice permit. Three hours of PDH-approved training in child abuse recognition and reporting is required for licensure.

Advanced Practice Registered Nurses – Pennsylvania APRNs must first become RNs and then complete a master’s or doctorate degree in nursing. The program must be approved by the Commission on Collegiate Nursing Education (CCNE), the American Nurses Credentialing Center (ANCC), or the National League for Nursing Accrediting Commission (NLNAC). APRNs must also hold national certification in their area of practice. Candidates must also apply for prescriptive authority in Pennsylvania.

Licensure Renewal

Nurse aides in Pennsylvania must renew their registry status every 24 months. Applicants must have worked for pay in a nursing home, hospital or home health setting for at least eight hours during the previous 24 months of enrollment. Self-employment and private duty employment do not qualify. A fee is required.

LPNs must renew their licenses every two years. Pennsylvania does not require continuing education or practice hours to renew, but there is a renewal fee. LPN licenses expire on June 30 of even-numbered years.

RNs in Pennsylvania must renew every two years. The RN must complete 30 hours of continuing education approved by the PSBN. The continuing education must include at least two hours of child abuse recognition and reporting. RN licenses are assigned to one of four possible expiration dates: April 30 or October 31 of even-numbered years, or April 30 or October 31 of odd-numbered years.

APRNs must meet the same renewal requirements as RNs. However, if the APRN is renewing prescriptive authority, 16 of the continuing edification hours must be in pharmacology. APRNs must also complete training in opioid prescription and management.

Other Methods of Licensure

In addition to the typical licensing or registration process for newly graduated nursing candidates in Pennsylvania, the state also has options for different situations.

Out-of-state nurse aides who are licensed, certified and/or listed on another state’s registry may apply for reciprocity in Pennsylvania.
Nurse aides whose registry status has lapsed must retake the written examination and skills test.
Out-of-state LPNs can apply for licensure by endorsement.
Out-of-state RNs and APRNs can apply for licensure by endorsement. An official transcript sent directly from the educational institution, certification of licensure from the originating state is required for both RNs and APRNs. Proof of certification is required for APRNs.
Foreign-educated RNs and APRNs can also apply for licensure by endorsement.
Paramedics: there are no options for a paramedic to become an LPN or RN in Pennsylvania without additional education.

Disciplinary Actions

The PDH and PSBN are responsible for investigating allegations of abuse, unprofessional behavior, and criminal activity. PDH investigations are focused on nurse aides and a written report must be submitted within 5 days of the initial allegation. The completed report is forwarded to the Central Office of the Division of Nursing Care Facilities. If patient abuse is deemed to have occurred the report is then forwarded to the Department of Health Nurse Aide Registry Abuse Committee for further action. Nurse aides found guilty of patient abuse are stricken from the registry and cannot work in nursing homes or similar facilities in Pennsylvania.

Most Pennsylvania nurses are competent individuals who provide safe, effective care. However, some individuals commit crimes or become addicted to various substances. They cannot practice safely and may put their patients at risk. In other cases, a nurse may act outside of his or her scope of practice. The PSBN is mandated to protect the public and to that end will investigate complaints or self-reported issues such as substance abuse or criminal activity. Theft, patient abuse, child abuse, and malpractice may all be reasons for a board investigation. The findings are presented in an administrative hearing and the board will determine the appropriate action based on the information available and the type and severity of the crime. In the case of substance abuse, mandatory substance abuse rehabilitation is a common outcome. The nurse may have his or her license temporarily or permanently rescinded. Some criminal activity may also result in a prison sentence.

LPNs, RNs and APRNs are mandated to notify the PSBN of pending criminal charges, criminal convictions (including a guilty plea) and disciplinary actions taken by other states or jurisdictions. Such reports must be made online within 30 days of the occurrence. The notification process allows the licensee to upload relevant documentation.

Scope of Practice

Scope of practice is the verbiage that delineates what nursing personnel may do. It varies from limited direct care activities up to primary care management, medical diagnosis and prescribing authority. In Pennsylvania, the various scopes of practice are as follows:

Nurse Aides perform direct bedside functions under the supervision of a licensed nurse or physician. These typically include such activities as bathing patients and performing other hygiene activities, answering patient call lights, feeding patients, cleaning rooms, changing bed linens and stocking supplies. In some work settings, such as personal care homes, assisted living facilities and child residential and day treatment, NAs may administer medications if they have received proper training.

LPNs must also work under the supervision of a physician or RN. In addition to those tasks performed by a CNA, LPNs administer oral, topical, vaginal, rectal, inhaled and injectable medications. LPNs can accept verbal orders from licensed practitioners that are within the LPN scope of practice. An LPN can administer skin tests and immunizations, initiate, maintain and discontinue intravenous therapy and withdraw blood.

RNs in Pennsylvania are expected to utilize the nursing process – assessment, planning, implementation/intervention, and evaluation – to provide nursing care. The nurse performs the tasks of both the NA and the LPN but is also responsible for planning patient care and delegating tasks as appropriate. RNs are expected to act as members of multidisciplinary care teams and to act as patient advocates. RNs administer medications in all forms including intravenously, and also administer blood and blood products. They may also defibrillate patients when appropriate.

APRNs perform functions once reserved for physicians. Among these are primary medical and pediatric care, mental health care and specialty care. The APRN can prescribe medications and medical devices, order laboratory and diagnostic testing and interpret the results of those tests. CRNAs administer anesthesia. CNMs provide gynecological and prenatal care and deliver babies. APRNs are authorized to perform procedures such as joint injections, to suture wounds or to conduct pelvic examinations, but do not perform surgery.

Online Services Related to Nursing Licensure in Pennsylvania

The PSBN provides a few online resources for nurse aides. These include:

Contact Information
Pearson Vue Pennsylvania Nurse Aide ResourcesNurse Aide Enrolling and Testing
Nurse Aide Registry.

The PSBN provides multiple online resources for LPNs, RNs, and APRNs in Pennsylvania, as well as for the general public. Among these are:

ACT 31 of 2014 Mandated Child Abuse Reporter Training
Announcements
Board Laws & Regulations
Complaints
Criminal History Reports
EppiccNURSE
General Board Information
License renewals
Mandatory Reporting
PA Guidelines: Emergency Department of Pain Treatment
PA Guidelines: Geriatric Pain Treatment
PA Guidelines: Medications in the Treatment of Pregnant Patients with Opioid Use Disorder
PA Guidelines: Obstetrics & Gynecology Pain Treatment
PA Guidelines: Opioids to Treat Chronic Non-cancer Pain
PA Guidelines: Safe Prescribing for Workers’ Compensation
PA Guidelines: Safe Prescribing of Benzodiazepines for Acute Treatment of Anxiety and Insomnia (PDF)
PA Guidelines: Safe Prescribing of Opioids in Orthopedics and Sports Medicine
PA Guidelines: Safe Prescribing of Opioids in Pediatric and Adolescent Populations
PA Prescription Drug Monitoring Program
PALS FAQs
Renewal Information.
Reporting Crimes and Disciplinary Actions
Verification of Licensure