Nurse Licensure Delays in Virginia

Nurses must meet two requirements to be licensed in Virginia. New nurse graduates must pass the national licensing examination and undergo a live finger print scan. Nurses licensed in another state who wish to practice in Virginia must possess a license in good standing from another state, and they must undergo a live finger print scan. The live scan is a relatively new licensing requirement that took effect July 1, 2016. By regulation, the live scan must be sent to the Federal Bureau of Investigation (FBI) for a national background check process that takes about one month. During a six-month period after this new requirement took effect, several hospital administrators contacted VHHA about delays in the licensing of new nursing graduates and experienced nurses moving to Virginia for work. Several hypotheses about reasons for the delays were offered, including poor access to a live scan site, limited availability of testing slots and sites, and slower license processing by the state Board of Nursing. A little background on how the Board of Nursing operates in this regard: It contracts with Pearson Vue Testing Centers to conduct the national licensing examinations, and its contractor for the live scans is Fieldprint, which collects and transfers the print securely to the FBI. Questions about access to testing and Fieldprint office locations lend themselves to a geospatial analysis. The chart below is an overlay of Virginia hospital locations, Pearson Vue sites, and Fieldprint offices. An interactive version of the chart below can be accessed here. (The validity of the three aforementioned hypotheses [live scan sites, testing slot and site availability, and state license processing] become clear using the interactive map accessible through the link above.) We found there are adequate testing sites to accommodate the number of graduates. For instance, candidates in Southwest Virginia have the ability to take the licensing exam in Johnson City, TN, which appears to meet existing demand. At their own request, 11 percent of new graduates take their examinations outside of Virginia. If the Virginia Board of Nursing approves an out-of-state testing site, the nurse applicant will receive a license in Virginia. A second finding is that there are 12 hospitals located closer to a testing center than a Fieldprint site. This would suggest that a solution to scan scheduling difficulties is to have Fieldprint sites close to the testing sites, or near a hospital. The biggest effect of this change would be seen in Roanoke and Southwest Virginia. Having two of the three sites in closer proximity could improve scan timeliness by virtue of that fact that less travel would be required of applicants. The third finding is that average distance can be misleading. The average distance from a hospital to a Fieldprint site is 16.9 miles. However, the actual distance range widely varies from as close as one mile to more than 60 miles away. The practical effect of that wide range is that applicants in Roanoke, Southwest Virginia, and on the Eastern Shore have limited access to existing Fieldprint sites. VHHA and the Board of Nursing have shared this concern with Fieldprint, which is considering additional sites. (6/23)

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