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A license without borders
Health Policy Issues
APRIL 2006, VOL 83, NO 4
HEALTH
POLICY
ISSUES
A license without borders
T
he 10th Amendment to the US Constitution gives each state the power to enact measures to preserve and protect the safety, health, welfare, and morals within state borders. Included in this right is the power to regulate specific professions in a manner the state deems necessary to protect the public from incompetent professionals. The regulation and licensure of nurses varies from state to state according to the rules set forth by the board of nursing in each state. If a nurse intends to practice in more than one state, then historically that nurse must be licensed by each state and according to the state-specific requirements for education, entry into practice, competency, and scope of practice. State-specific licensure requirements are intended to protect individual state interests. In recent years, however, boundaries of nursing practice have expanded beyond state lines with the emergence of telemedicine, national nursing call centers, and increased mobility of nurses who work for hospital systems or managed care organizations that operate in several states.1 As described by the American Organization of Nurse Executives, [a]dvances in technology allow more frequent, regular communication between [nurses] and [patients] via telephone, e-mail, fax, and teleconference, contributing to the nursing profession’s ever-widening boundaries.2 In 1997, in response to a growing concern in the national nursing community regarding competing practice requirements among different states, delegates from the National Council of State Boards of Nursing (NCSBN) unanimously agreed to develop and endorse a
958 • AORN JOURNAL
Catherine Becker
mutual recognition model of nursing regulation to “remove regulatory barriers to increase access to safe nursing care.”3 The Nurse Licensure Compact (NLC) was the result of this effort. An interstate compact is an agreement between two or more states to address a problem identified by each state that can be resolved by a singular solution.4 When a state enters the NLC, nurses in the member state can practice in the other member states The Nurse without securing separate state licenses. This mutual Licensure recognition model of nurse licensure allows Compact allows nurses to secure a license in the state of their resinurses to secure dency and still practice in other states as long as a license in the they adhere to the laws and regulations of their state in which practice state.
MEMBERS OF THE COMPACT
they reside and be able to practice in other states that have enacted the compact.
In 2000, the NCSBN officially enacted the compact with these participating states: • Maryland, • Texas, • Utah, and 5 • Wisconsin. Nurses in these states are permitted to practice beyond the borders of their residency state if both their residency and practice states are members of the compact. Since the enactment of the compact, 16 additional states have joined the NLC: • Arizona, • Arkansas, • Delaware, • Idaho,
Health Policy Issues
• • • • • • • • • • • •
Iowa, Maine, Mississippi, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, South Carolina, South Dakota, Tennessee, and Virginia.6 The governor of New Jersey enacted the NLC during the 2005 legislative session, but full implementation is pending the development of regulations. Similarly, the South Carolina Legislature will vote on HB 4581 in 2006, to approve the regulations concerning the NLC, which was enacted during the 2005 legislative session. The debate on the NLC will be taken up in the 2006 legislative sessions in several states. Five states considering whether to become members of the NLC are • Colorado (SB 20); • Illinois (HB 3497, HB 3826, and SB 86); • Kentucky (HB 102); • Michigan (HB 5493); and • Missouri (HB 1150 and SB 664). Each state will weigh the benefits, risks, and costs of adopting the NLC to determine if compact membership would be beneficial for their state nursing programs. The original NLC was designed to include RNs and licensed practical nurses (LPNs) or vocational nurses (VNs) only. In 2002, however, the NCSBN approved model
APRIL 2006, VOL 83, NO 4
language for a licensure compact for advanced practice RNs (APRNs) for states that previously had adopted the NLC.5 At this time, only Utah and Iowa have passed legislation adopting the APRN Licensure Compact.6
STATE REQUIREMENTS Each state is required by the compact to enact legislation authorizing the recognition of the compact and must subsequently develop rules and regulations to incorporate the compact into their state nursing program.5 Each member state must designate an NLC administrator to participate in the exchange of information between the member states and to assist in developing model laws and regulations for enactment, implementation, and continued participation in the NLC.5
REACTION TO THE COMPACT Since its introduction, the NLC has generated significant attention in terms of whether it is truly a problem solver or whether it has created additional problems in the nursing community nationwide. The idea of a multistate compact that would permit nurses to practice across state borders initially appears to be an ideal solution to the issues created by advances in technology and increased nurse mobility. The compact, however, is not without its opponents. One of the more controversial aspects of the compact is the coordination of discipline resulting from scope-of-
practice or competency conflicts among the member states. The compact requires that the nurse’s state of residence (ie, the home state) retain the authority to discipline a nurse for actions contrary to laws and regulations governing the practice of nursing in the resident state, while permitting the state of practice (ie, the remote state) to retain its authority to regulate and discipline the manner in which the nurse conducts his or her duties in that state.1 This means that the home state can take action against the nurse’s license and practice privileges but the remote state is limited to disciplinary action only in the form of limits on practice privileges in the remote state.7 This structure requires that a nurse who is licensed by one state become familiar and comply with the laws and regulations of the remote state in which he or she is practicing. Opponents to the NLC argue that allowing both the home state and the remote state to discipline a nurse for a single infraction could result in duplicative investigations and conflicting rulings on the nurse’s behavior. A remote state, for example, could issue a disciplinary sanction against a nurse for performing a task that is outside of the remote state’s scope-of-practice requirements but is entirely consistent with the nurse’s home state’s laws and rules. “Each nurse will bear the considerable burden of determining the difference between the AORN JOURNAL •
959
Health Policy Issues
APRIL 2006, VOL 83, NO 4
scope-of-practice regulations in effect in each jurisdiction,”1(p29) and this can be both cumbersome and inefficient for a nurse practicing in several states.1 In response to the disciplinary issues regarding the compact, the NCSBN revealed that “since the implementation of the [compact], most disciplinary cases in the [member] states have been limited to single jurisdictions. . . . “8 The NCSBN, however, has tried to ease the burden of discipline by requiring that each compact member state provide licensure, discipline, and significant current investigative information to a centralized database called NURSYS.7 By sharing disciplinary information in NURSYS, states can coordinate the investigative and disciplinary actions so that a nurse is sanctioned only once for a single event.4 The NURSYS database also is promoted as a way for all state nursing boards to access timely nurse licensure and disciplinary information and be able to prevent a previously sanctioned nurse from practicing and potentially causing harm in their state. An additional criticism of the NLC is that it could have the effect of weakening statespecific standards for nursing.7 For example, many states have continuing education or practice requirements for nurses to maintain their licensure, but the standards vary greatly from state to state. Nurses in a compact state must meet only the entry-to-
960 • AORN JOURNAL
practice and licensure maintenance standards in their home state, but they would have the privilege of practicing in other compact states in which the entry-to-practice and licensure maintenance standards may be more rigorous. Provisions in the compact require party states to unconditionally accept the licensure standards of other states which could lead to a “lowest denominator” of state licensure standards.9 In response, proponents of the NLC claim that the basic goal of the compact is “harmonious cooperation among the states,”1(p29) implying that states entering into the compact should respect and recognize the standards of practice in other states rather than doubting their effectiveness.1 A third criticism of the NLC is related to the cost of implementing the compact at the individual state level. Opponents argue that the compact would decrease the revenues that a state board of nursing receives from licensure fees.10 Under the compact, nurses that are licensed in their home state would not need to pay the licensure fee of the remote state. In a recent report published by the Office of Program Policy Analysis and Government Accountability of the Florida Legislature, however, a survey of several state boards of nursing indicated that they typically experienced little to no change in licensure rev-
enues, although they did incur some expenses when implementing the compact, including a $3,000 annual fee that is paid to the NLC administrators.11 Some states would incur a greater cost than other states in the implementation process if they were forced to hire additional staff members to either administer the compact or participate in interstate disciplinary investigations. These costs would vary from state to state, however, and are therefore difficult to quantify.
ENDORSEMENTS Despite these criticisms, the NLC has garnered endorsements from a number of nationally recognized nursing organizations including the American Nephrology Nurses Association, American Telemedicine Association, American Association of Occupational Health Nurses, and American Organization of Nurse Executives.12 These organizations recognize the benefit of the compact in light of the advances in technology that have expanded the reach of nursing practice beyond state borders.13 Additionally, health care organizations view the compact as a possible solution to “the general mobility of the nursing workforce, the unpredictability of natural disasters, and the omnipresent threats of bioterrorism.”14
GOING FORWARD With all this information in mind, five state legislatures will engage in the NLC
Health Policy Issues
APRIL 2006, VOL 83, NO 4
debate in 2006. Some states may be swayed by the criticism against the compact and choose to retain absolute autonomy for the regulation of nursing in their state. Other states may embrace the benefits of cross-state licensure and readily become members of the compact. Ultimately, the practice of nursing will continue to evolve, and as advancement of the NLC continues, a workforce of “nurses without borders” will continue to emerge. ❖ CATHERINE BECKER MSPH, JD AORN LEGISLATIVE AND REGULATORY RESEARCH ANALYST
Editor’s note: NURSYS is a registered trademark of the National Council of State Boards of Nursing, Chicago.
NOTES 1. A M Sulentic, “Crossing borders: The licensure of interstate telemedicine practitioners,” Journal of Legislation 25 no 1 (1999) 29. 2. “2005 key public policy issues,” American Association of Occupational Health Nurses, http://www.aaohn.org/press_room/up
load/policy%20platform%202005.pdf (accessed 21 Feb 2006). 3. “Background information about the RN and LPN/VN Nurse Licensure Compact,” National Council of State Boards of Nursing, http://www.ncsbn.org /nlc/rnlpvncompact.asp (accessed 21 Feb 2006). 4. “Frequently asked questions regarding the National Council of State Boards of Nursing (NCSBN) Nurse Licensure Compact (NLC),” National Council of State Boards of Nursing, http://www.ncsbn.org /pdfs/FrequentlyAskedQuestions.pdf (accessed 21 Feb 2006). 5. “Nurse Licensure Compact,” National Council of State Boards of Nursing, http://www.ncsbn .org/nlc/index.asp (accessed 21 Feb 2006). 6. “Nurse Licensure Compact implementation,” National Council of State Boards of Nursing, http:// www.ncsbn.org/nlc/rnlpvncompact _mutual_recognition_state.asp (accessed 21 Feb 2006). 7. S E King, “Multistate licensure: Premature policy,” Online Journal of Issues in Nursing (May 31, 1999) http://www.nursingworld.org/ojin /topic9/topic9_3.htm (accessed 21 Feb 2006). 8. “NCSBN letter to Barbara A. Blakeney,” (Dec 4, 2003) National Council of State Boards of Nursing, http://www.ncsbn.org/pdfs /ANA7Points120503.pdf (accessed 21 Feb 2006). 9. “ANA state government relations: Background information
on interstate nurse compact,” Nursing World, http://www .nursingworld.org/gova/state /2004/interstate.htm (accessed 21 Feb 2006). 10. M A Hellinghausen, “Nurses without borders,” NurseWeek (Feb 16, 1998) http://www.nurseweek .com/features/98-2/border.html (accessed 21 Feb 2006). 11. “Nurse licensure compact would produce some benefits but not resolve the nurse shortage,” Office of Program Policy Analysis & Government Accountability, http://www.oppaga .state.fl.us/reports/pdf/0602rpt.pdf (accessed 21 Feb 2006). 12. “What organizations support the nurse licensure compact?” National Council of State Boards of Nursing, http://www.ncsbn.org /nlc/rnlpvncompact_BDED1E05DD 2F4468B2097B37E6B0D42F.htm (accessed 21 Feb 2006). 13. “CMSA letter to Kathy Apple,” (Nov 29, 2005) Case Management Society of America, http://www.ncsbn.org/pdfs/CMSA CompactLetter.pdf (accessed 21 Feb 2006). 14. “Legislative/regulatory activities: ANNA letter to Kathy Apple,” (Feb 3, 2005) American Nephrology Nurses’ Association, http://www.annanurse.org/cgi -bin/WebObjects/ANNANurse .woa/1/wa/viewSection?wosid=QTp J4vhAjPs92FU3Wgt6Zj6d4JN&tN ame=fullActivity&s_id=107374405 2&od_id=805312271 (accessed 21 Feb 2006).
AORN Member Named to Nursing Foundation’s Board
A
ORN member and former AORN Executive Director Lola M. Fehr, RN, MS, CAE, FAAN, has been appointed to the 2005-2007 board of directors of the Sigma Theta Tau International Foundation for Nursing, according to a Feb 9, 2006, news release from the Honor Society of Nursing, Sigma Theta Tau International. The mission of Sigma Theta Tau International is to improve the health of people worldwide through leadership and scholarship in practice, education, and research. The Sigma Theta Tau International Foundation for
962 • AORN JOURNAL
Nursing raises funds to support honor society programs and initiatives, including the Virginia Henderson International Nursing Library and nursing research grants. Fehr was AORN’s executive director from 1990 to 1999. She currently is the executive director for the New York State Nurses Association. Honor Society of Nursing Names Foundation Board of Directors (news release, Indianapolis: Honor Society of Nursing, Sigma Theta Tau International, Feb 9, 2006).
APRIL 2006, VOL 83, NO 4
HEALTH
POLICY
ISSUES
A license without borders
T
he 10th Amendment to the US Constitution gives each state the power to enact measures to preserve and protect the safety, health, welfare, and morals within state borders. Included in this right is the power to regulate specific professions in a manner the state deems necessary to protect the public from incompetent professionals. The regulation and licensure of nurses varies from state to state according to the rules set forth by the board of nursing in each state. If a nurse intends to practice in more than one state, then historically that nurse must be licensed by each state and according to the state-specific requirements for education, entry into practice, competency, and scope of practice. State-specific licensure requirements are intended to protect individual state interests. In recent years, however, boundaries of nursing practice have expanded beyond state lines with the emergence of telemedicine, national nursing call centers, and increased mobility of nurses who work for hospital systems or managed care organizations that operate in several states.1 As described by the American Organization of Nurse Executives, [a]dvances in technology allow more frequent, regular communication between [nurses] and [patients] via telephone, e-mail, fax, and teleconference, contributing to the nursing profession’s ever-widening boundaries.2 In 1997, in response to a growing concern in the national nursing community regarding competing practice requirements among different states, delegates from the National Council of State Boards of Nursing (NCSBN) unanimously agreed to develop and endorse a
958 • AORN JOURNAL
Catherine Becker
mutual recognition model of nursing regulation to “remove regulatory barriers to increase access to safe nursing care.”3 The Nurse Licensure Compact (NLC) was the result of this effort. An interstate compact is an agreement between two or more states to address a problem identified by each state that can be resolved by a singular solution.4 When a state enters the NLC, nurses in the member state can practice in the other member states The Nurse without securing separate state licenses. This mutual Licensure recognition model of nurse licensure allows Compact allows nurses to secure a license in the state of their resinurses to secure dency and still practice in other states as long as a license in the they adhere to the laws and regulations of their state in which practice state.
MEMBERS OF THE COMPACT
they reside and be able to practice in other states that have enacted the compact.
In 2000, the NCSBN officially enacted the compact with these participating states: • Maryland, • Texas, • Utah, and 5 • Wisconsin. Nurses in these states are permitted to practice beyond the borders of their residency state if both their residency and practice states are members of the compact. Since the enactment of the compact, 16 additional states have joined the NLC: • Arizona, • Arkansas, • Delaware, • Idaho,
Health Policy Issues
• • • • • • • • • • • •
Iowa, Maine, Mississippi, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, South Carolina, South Dakota, Tennessee, and Virginia.6 The governor of New Jersey enacted the NLC during the 2005 legislative session, but full implementation is pending the development of regulations. Similarly, the South Carolina Legislature will vote on HB 4581 in 2006, to approve the regulations concerning the NLC, which was enacted during the 2005 legislative session. The debate on the NLC will be taken up in the 2006 legislative sessions in several states. Five states considering whether to become members of the NLC are • Colorado (SB 20); • Illinois (HB 3497, HB 3826, and SB 86); • Kentucky (HB 102); • Michigan (HB 5493); and • Missouri (HB 1150 and SB 664). Each state will weigh the benefits, risks, and costs of adopting the NLC to determine if compact membership would be beneficial for their state nursing programs. The original NLC was designed to include RNs and licensed practical nurses (LPNs) or vocational nurses (VNs) only. In 2002, however, the NCSBN approved model
APRIL 2006, VOL 83, NO 4
language for a licensure compact for advanced practice RNs (APRNs) for states that previously had adopted the NLC.5 At this time, only Utah and Iowa have passed legislation adopting the APRN Licensure Compact.6
STATE REQUIREMENTS Each state is required by the compact to enact legislation authorizing the recognition of the compact and must subsequently develop rules and regulations to incorporate the compact into their state nursing program.5 Each member state must designate an NLC administrator to participate in the exchange of information between the member states and to assist in developing model laws and regulations for enactment, implementation, and continued participation in the NLC.5
REACTION TO THE COMPACT Since its introduction, the NLC has generated significant attention in terms of whether it is truly a problem solver or whether it has created additional problems in the nursing community nationwide. The idea of a multistate compact that would permit nurses to practice across state borders initially appears to be an ideal solution to the issues created by advances in technology and increased nurse mobility. The compact, however, is not without its opponents. One of the more controversial aspects of the compact is the coordination of discipline resulting from scope-of-
practice or competency conflicts among the member states. The compact requires that the nurse’s state of residence (ie, the home state) retain the authority to discipline a nurse for actions contrary to laws and regulations governing the practice of nursing in the resident state, while permitting the state of practice (ie, the remote state) to retain its authority to regulate and discipline the manner in which the nurse conducts his or her duties in that state.1 This means that the home state can take action against the nurse’s license and practice privileges but the remote state is limited to disciplinary action only in the form of limits on practice privileges in the remote state.7 This structure requires that a nurse who is licensed by one state become familiar and comply with the laws and regulations of the remote state in which he or she is practicing. Opponents to the NLC argue that allowing both the home state and the remote state to discipline a nurse for a single infraction could result in duplicative investigations and conflicting rulings on the nurse’s behavior. A remote state, for example, could issue a disciplinary sanction against a nurse for performing a task that is outside of the remote state’s scope-of-practice requirements but is entirely consistent with the nurse’s home state’s laws and rules. “Each nurse will bear the considerable burden of determining the difference between the AORN JOURNAL •
959
Health Policy Issues
APRIL 2006, VOL 83, NO 4
scope-of-practice regulations in effect in each jurisdiction,”1(p29) and this can be both cumbersome and inefficient for a nurse practicing in several states.1 In response to the disciplinary issues regarding the compact, the NCSBN revealed that “since the implementation of the [compact], most disciplinary cases in the [member] states have been limited to single jurisdictions. . . . “8 The NCSBN, however, has tried to ease the burden of discipline by requiring that each compact member state provide licensure, discipline, and significant current investigative information to a centralized database called NURSYS.7 By sharing disciplinary information in NURSYS, states can coordinate the investigative and disciplinary actions so that a nurse is sanctioned only once for a single event.4 The NURSYS database also is promoted as a way for all state nursing boards to access timely nurse licensure and disciplinary information and be able to prevent a previously sanctioned nurse from practicing and potentially causing harm in their state. An additional criticism of the NLC is that it could have the effect of weakening statespecific standards for nursing.7 For example, many states have continuing education or practice requirements for nurses to maintain their licensure, but the standards vary greatly from state to state. Nurses in a compact state must meet only the entry-to-
960 • AORN JOURNAL
practice and licensure maintenance standards in their home state, but they would have the privilege of practicing in other compact states in which the entry-to-practice and licensure maintenance standards may be more rigorous. Provisions in the compact require party states to unconditionally accept the licensure standards of other states which could lead to a “lowest denominator” of state licensure standards.9 In response, proponents of the NLC claim that the basic goal of the compact is “harmonious cooperation among the states,”1(p29) implying that states entering into the compact should respect and recognize the standards of practice in other states rather than doubting their effectiveness.1 A third criticism of the NLC is related to the cost of implementing the compact at the individual state level. Opponents argue that the compact would decrease the revenues that a state board of nursing receives from licensure fees.10 Under the compact, nurses that are licensed in their home state would not need to pay the licensure fee of the remote state. In a recent report published by the Office of Program Policy Analysis and Government Accountability of the Florida Legislature, however, a survey of several state boards of nursing indicated that they typically experienced little to no change in licensure rev-
enues, although they did incur some expenses when implementing the compact, including a $3,000 annual fee that is paid to the NLC administrators.11 Some states would incur a greater cost than other states in the implementation process if they were forced to hire additional staff members to either administer the compact or participate in interstate disciplinary investigations. These costs would vary from state to state, however, and are therefore difficult to quantify.
ENDORSEMENTS Despite these criticisms, the NLC has garnered endorsements from a number of nationally recognized nursing organizations including the American Nephrology Nurses Association, American Telemedicine Association, American Association of Occupational Health Nurses, and American Organization of Nurse Executives.12 These organizations recognize the benefit of the compact in light of the advances in technology that have expanded the reach of nursing practice beyond state borders.13 Additionally, health care organizations view the compact as a possible solution to “the general mobility of the nursing workforce, the unpredictability of natural disasters, and the omnipresent threats of bioterrorism.”14
GOING FORWARD With all this information in mind, five state legislatures will engage in the NLC
Health Policy Issues
APRIL 2006, VOL 83, NO 4
debate in 2006. Some states may be swayed by the criticism against the compact and choose to retain absolute autonomy for the regulation of nursing in their state. Other states may embrace the benefits of cross-state licensure and readily become members of the compact. Ultimately, the practice of nursing will continue to evolve, and as advancement of the NLC continues, a workforce of “nurses without borders” will continue to emerge. ❖ CATHERINE BECKER MSPH, JD AORN LEGISLATIVE AND REGULATORY RESEARCH ANALYST
Editor’s note: NURSYS is a registered trademark of the National Council of State Boards of Nursing, Chicago.
NOTES 1. A M Sulentic, “Crossing borders: The licensure of interstate telemedicine practitioners,” Journal of Legislation 25 no 1 (1999) 29. 2. “2005 key public policy issues,” American Association of Occupational Health Nurses, http://www.aaohn.org/press_room/up
load/policy%20platform%202005.pdf (accessed 21 Feb 2006). 3. “Background information about the RN and LPN/VN Nurse Licensure Compact,” National Council of State Boards of Nursing, http://www.ncsbn.org /nlc/rnlpvncompact.asp (accessed 21 Feb 2006). 4. “Frequently asked questions regarding the National Council of State Boards of Nursing (NCSBN) Nurse Licensure Compact (NLC),” National Council of State Boards of Nursing, http://www.ncsbn.org /pdfs/FrequentlyAskedQuestions.pdf (accessed 21 Feb 2006). 5. “Nurse Licensure Compact,” National Council of State Boards of Nursing, http://www.ncsbn .org/nlc/index.asp (accessed 21 Feb 2006). 6. “Nurse Licensure Compact implementation,” National Council of State Boards of Nursing, http:// www.ncsbn.org/nlc/rnlpvncompact _mutual_recognition_state.asp (accessed 21 Feb 2006). 7. S E King, “Multistate licensure: Premature policy,” Online Journal of Issues in Nursing (May 31, 1999) http://www.nursingworld.org/ojin /topic9/topic9_3.htm (accessed 21 Feb 2006). 8. “NCSBN letter to Barbara A. Blakeney,” (Dec 4, 2003) National Council of State Boards of Nursing, http://www.ncsbn.org/pdfs /ANA7Points120503.pdf (accessed 21 Feb 2006). 9. “ANA state government relations: Background information
on interstate nurse compact,” Nursing World, http://www .nursingworld.org/gova/state /2004/interstate.htm (accessed 21 Feb 2006). 10. M A Hellinghausen, “Nurses without borders,” NurseWeek (Feb 16, 1998) http://www.nurseweek .com/features/98-2/border.html (accessed 21 Feb 2006). 11. “Nurse licensure compact would produce some benefits but not resolve the nurse shortage,” Office of Program Policy Analysis & Government Accountability, http://www.oppaga .state.fl.us/reports/pdf/0602rpt.pdf (accessed 21 Feb 2006). 12. “What organizations support the nurse licensure compact?” National Council of State Boards of Nursing, http://www.ncsbn.org /nlc/rnlpvncompact_BDED1E05DD 2F4468B2097B37E6B0D42F.htm (accessed 21 Feb 2006). 13. “CMSA letter to Kathy Apple,” (Nov 29, 2005) Case Management Society of America, http://www.ncsbn.org/pdfs/CMSA CompactLetter.pdf (accessed 21 Feb 2006). 14. “Legislative/regulatory activities: ANNA letter to Kathy Apple,” (Feb 3, 2005) American Nephrology Nurses’ Association, http://www.annanurse.org/cgi -bin/WebObjects/ANNANurse .woa/1/wa/viewSection?wosid=QTp J4vhAjPs92FU3Wgt6Zj6d4JN&tN ame=fullActivity&s_id=107374405 2&od_id=805312271 (accessed 21 Feb 2006).
AORN Member Named to Nursing Foundation’s Board
A
ORN member and former AORN Executive Director Lola M. Fehr, RN, MS, CAE, FAAN, has been appointed to the 2005-2007 board of directors of the Sigma Theta Tau International Foundation for Nursing, according to a Feb 9, 2006, news release from the Honor Society of Nursing, Sigma Theta Tau International. The mission of Sigma Theta Tau International is to improve the health of people worldwide through leadership and scholarship in practice, education, and research. The Sigma Theta Tau International Foundation for
962 • AORN JOURNAL
Nursing raises funds to support honor society programs and initiatives, including the Virginia Henderson International Nursing Library and nursing research grants. Fehr was AORN’s executive director from 1990 to 1999. She currently is the executive director for the New York State Nurses Association. Honor Society of Nursing Names Foundation Board of Directors (news release, Indianapolis: Honor Society of Nursing, Sigma Theta Tau International, Feb 9, 2006).