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To recap yesterday’s post, a 24-state compact allows nurses from one state to work in any participating state. Instead of being re-certified, these nurses are allowed to use their home-state nursing license to acquire employment.
The problem with this system is that nurses suspected of negligence, nursing errors, drug abuse and other infractions are usually able to transfer freely between states. If their home-state does not do enough to stop them, or fails to warn the state they transfer to, these nurses are able to avoid punishment and do it all over again.
How does this happen?
A large part of the problem is a lack of pre-hire screening by states participating in the compact. Added to this is a huge breakdown in state-based disciplinary systems across the country. This means that bad nurses usually are not properly disciplined in their home-state, nor are they properly screened for problems before being hired in other states.
Another major problem is the incongruity of licensing laws in different states. As pointed out in USA Today, one state may require criminal background checks as part of the licensing process, while another may not. One state may have the power to immediately revoke a nurse’s license at the first sign of major problems. Other states do not have this ability, or have more lax disciplinary laws.
Under the compact, nurses can move freely (more or less) between states. So, if one state does not check criminal records, nurses from that state could make their way into a state that would have checked for criminal history.
Division in standards and breakdown in communication are two of the main factors driving this problem.