CHAPTER 152
NURSING

Referred to in §124E.2, 125.2, 135.24, 135.61, 135B.7, 135G.1, 135J.1, 135P.1, 142C.7, 144.29A, 144D.1, 147.74, 147.76, 147.136A, 147A.12, 148F.7, 148H.1, 148H.4, 216.8C, 225C.6, 229.1, 249A.4, 261.114, 261.116, 280.16, 321.34, 321.186, 321L.2, 514.21, 514C.11, 514C.13, 514F.1, 514F.6, 622.10, 702.8, 702.17, 708.3A, 714H.4

Enforcement, §147.87, 147.92
Penalty, §147.86
Licensing board and support staff;

location, meetings, and powers; see §135.11A – 135.12, 135.31
Utilization and cost control review committee; §514F.1
Authority of advanced registered nurse practitioner

to prescribe drugs; limitations; see §147.107

  
     
152.1  Definitions.
  As used in this chapter:
  1.  “Advanced registered nurse practitioner” means a person who is currently licensed as a registered nurse under this chapter or chapter 152E who is licensed by the board of nursing as an advanced registered nurse practitioner.
  2.  “Board” means the board of nursing, created under chapter 147.
  3.  As used in this section, “nursing diagnosis” means to identify and use discriminatory judgment concerning physical and psychosocial signs and symptoms essential to determining effective nursing intervention.
  4.  “Physician” means a person licensed in this state to practice medicine and surgery, osteopathic medicine and surgery, or a person licensed in this state to practice dentistry or podiatry when acting within the scope of the license. A physician licensed to practice medicine and surgery or osteopathic medicine and surgery in a state bordering this state shall be considered a physician for purposes of this chapter unless previously determined to be ineligible for such consideration by the board of medicine.
  5.  The “practice of a licensed practical nurse” means the practice of a natural person who is licensed by the board to do all of the following:
  a.  Perform services in the provision of supportive or restorative care under the supervision of a registered nurse or a physician.
  b.  Perform additional acts under emergency or other conditions which require education and training and which are recognized by the medical and nursing professions and are approved by the board, as being proper to be performed by a licensed practical nurse.
  c.  Make the pronouncement of death for a patient whose death is anticipated if the death occurs in a licensed hospital, a licensed health care facility, a Medicare-certified home health agency, a Medicare-certified hospice program or facility, or an assisted living facility or residential care facility, with notice of the death to a physician, advanced registered nurse practitioner, or physician assistant.
  6.  The “practice of nursing” means the practice of a registered nurse, a licensed practical nurse, or an advanced registered nurse practitioner. It does not mean any of the following:
  a.  The practice of medicine and surgery and the practice of osteopathic medicine and surgery, as defined in chapter 148, or the practice of pharmacy as defined in chapter 155A, except practices which are recognized by the medical and nursing professions and approved by the board as proper to be performed by a registered nurse.
  b.  The performance of nursing services by an unlicensed student enrolled in a nursing education program if performance is part of the course of study. Individuals who have been licensed as registered nurses, licensed practical or vocational nurses, or advanced registered nurse practitioners in any state or jurisdiction of the United States are not subject to this exemption.
  c.  The performance of services by unlicensed workers employed in offices, hospitals, or health care facilities, as defined in section 135C.1, under the supervision of a physician or a nurse licensed under this chapter, or employed in the office of a psychologist, podiatric physician, optometrist, chiropractor, speech pathologist, audiologist, or physical therapist licensed to practice in this state, and when acting while within the scope of the employer’s license.
  d.  The practice of a nurse licensed in another state and employed in this state by the federal government if the practice is in discharge of official employment duties.
  e.  The care of the sick rendered in connection with the practice of the religious tenets of any church or order by the adherents thereof which is not performed for hire, or if performed for hire by those who depend upon prayer or spiritual means for healing in the practice of the religion of their church or denomination, so long as they do not otherwise engage in the practice of nursing as practical nurses.
  7.  The “practice of the profession of a registered nurse” means the practice of a natural person who is licensed by the board to do all of the following:
  a.  Formulate nursing diagnosis and conduct nursing treatment of human responses to actual or potential health problems through services, such as case finding, referral, health teaching, health counseling, and care provision which is supportive to or restorative of life and well-being.
  b.  Execute regimen prescribed by a physician, an advanced registered nurse practitioner, or a physician assistant.
  c.  Supervise and teach other personnel in the performance of activities relating to nursing care.
  d.  Perform additional acts or nursing specialties which require education and training under emergency or other conditions which are recognized by the medical and nursing professions and are approved by the board as being proper to be performed by a registered nurse.
  e.  Make the pronouncement of death for a patient whose death is anticipated if the death occurs in a licensed hospital, a licensed health care facility, a correctional institution listed in section 904.102, a Medicare-certified home health agency, a Medicare-certified hospice program or facility, an assisted living facility, or a residential care facility, with notice of the death to a physician, advanced registered nurse practitioner, or physician assistant.
  f.  Apply to the abilities enumerated in paragraphs “a” through “e” of this subsection scientific principles, including the principles of nursing skills and of biological, physical, and psychosocial sciences.
[S13, §2575-a28, -a31, -a32; C24, 27, 31, 35, 39, §2561, 2562; C46, 50, 54, 58, 62, 66, 71, 73, 75, §152.1, 152.2; C77, 79, 81, §152.1]
87 Acts, ch 215, §41; 91 Acts, ch 100, §1; 95 Acts, ch 108, §12; 2001 Acts, ch 113, §2 – 4; 2003 Acts, ch 78, §4, 5; 2004 Acts, ch 1168, §8; 2007 Acts, ch 10, §126; 2007 Acts, ch 159, §29, 30; 2008 Acts, ch 1088, §101, 102; 2015 Acts, ch 56, §4 – 8; 2017 Acts, ch 96, §1
Referred to in §509.3, 514.7, 514B.1

  
     
152.2  Executive director.
  The board shall retain a full-time executive director, who shall be appointed pursuant to section 135B.11.* The executive director shall be a registered nurse. The governor, with the approval of the executive council pursuant to section 8A.413, subsection 3, under the pay plan for exempt positions in the executive branch of government, shall set the salary of the executive director.
[C35, §2537-g1; C39, §2537.1; C46, 50, 54, 58, 62, 66, 71, 73, 75, §147.105; C77, 79, 81, §152.2]
2003 Acts, ch 145, §197; 2008 Acts, ch 1031, §106; 2019 Acts, ch 85, §61
Referred to in §152E.2
*Reference to section 135.11B probably intended; corrective legislation is pending
Section amended

     
152.3  Director’s duties.
  The duties of the executive director shall be as follows:
  1.  To receive all applications to be licensed for the practice of nursing.
  2.  To collect and receive all fees.
  3.  To keep all records pertaining to the licensing of nurses, including a record of all board proceedings.
  4.  To perform such other duties as may be prescribed by the board.
  5.  To appoint assistants to the director and persons necessary to administer this chapter. Any appointments shall be merit appointments made pursuant to chapter 8A, subchapter IV.
[C35, §2537-g2, -g3; C39, §2537.2, 2537.3; C46, 50, 54, 58, 62, 66, 71, 73, 75, §147.106, 147.107; C77, 79, 81, §152.3]
88 Acts, ch 1134, §31; 2003 Acts, ch 145, §198, 286; 2006 Acts, ch 1155, §8, 9, 15

     
152.4  Appropriations.
  The board may apply appropriated funds to:
  1.  The administration and enforcement of the provisions of this chapter and  chapters 147, 152E, and 272C.
  2.  The elevation of the standards of the schools of nursing.
  3.  The promotion of educational and professional standards of nurses in this state.
  4.  The collection, analysis, and dissemination of nursing workforce data.
[C35, §2537-g3; C39, §2537.3; C46, 50, 54, 58, 62, 66, 71, 73, 75, §147.107; C77, 79, 81, §152.4]
2015 Acts, ch 56, §9

  
     
152.5  Education programs.
  1.  All programs preparing a person to be a registered nurse or a licensed practical nurse shall be approved by the board. The board shall not recognize a program unless it:
  a.  Is of recognized standing.
  b.  Has provisions for adequate physical and clinical facilities and other resources with which to conduct a sound education program.
  c.  Requires, for graduation of a registered nurse applicant, the completion of at least a two academic year course of study.
  d.  Requires, for graduation of a licensed practical nurse applicant, the completion of at least a one academic year course of study as prescribed by the board.
  2.  All postlicense formal academic nursing education programs shall also be approved by the board.
[S13, §2575-a29; C24, 27, 31, 35, 39, §2564; C46, 50, 54, 58, 62, 66, 71, 73, 75, §152.4; C77, 79, 81, §152.5]
95 Acts, ch 79, §1; 2006 Acts, ch 1008, §1; 2015 Acts, ch 56, §10
Referred to in §152.5A, 152.7, 235A.15, 235B.6, 261.116

     
152.5A  Student record checks.
  1.  For the purposes of this section:
  a.  “Nursing program” means a nursing program that is approved by the board pursuant to section 152.5.
  b.  “Student” means a person applying for, enrolled in, or returning to the clinical education component of a nursing program.
  2.  A nursing program may access the single contact repository established pursuant to section 135C.33 as necessary for the nursing program to initiate record checks of students.
  3.  A nursing program shall request that the department of public safety perform a criminal history check and the department of human services perform child and dependent adult abuse record checks in this state on the nursing program’s students.
  4.  If a student has a criminal record or a record of founded child or dependent adult abuse, upon request of the nursing program, the department of human services shall perform an evaluation to determine whether the record warrants prohibition of the person’s involvement in a clinical education component of a nursing program involving children or dependent adults. The department of human services shall utilize the criteria provided in section 135C.33 in performing the evaluation and shall report the results of the evaluation to the nursing program. The department of human services has final authority in determining whether prohibition of the person’s involvement in a clinical education component is warranted.
2015 Acts, ch 56, §11
Referred to in §235A.15, 235B.6

     
152.6  Licenses — professional abbreviations.
  The board may license a natural person to practice as a registered nurse, as a licensed practical nurse, or as an advanced registered nurse practitioner. However, only a person currently licensed as a registered nurse in this state may use that title and the letters “R.N.” after the person’s name; only a person currently licensed as a licensed practical nurse in this state may use that title and the letters “L.P.N.” after the person’s name; and only a person currently licensed as an advanced registered nurse practitioner may use that title and the letters “A.R.N.P.” after the person’s name. For purposes of this section, “currently licensed” includes persons licensed in another state and recognized for licensure in this state pursuant to the nurse licensure compact contained in section 152E.1 or pursuant to the advanced practice registered nurse compact contained in section 152E.3.
[C50, 54, 58, 62, 66, 71, 73, 75, §152.5; C77, 79, 81, §152.6]
2000 Acts, ch 1008, §4; 2005 Acts, ch 53, §4; 2014 Acts, ch 1019, §2; 2015 Acts, ch 56, §12
Referred to in §272C.2C

  
     
152.7  Applicant qualifications.
  1.  In addition to the provisions of section 147.3, an applicant to be licensed for the practice of nursing shall have the following qualifications:
  a.  Be a graduate of an accredited high school or the equivalent.
  b.  Pass an examination as prescribed by the board.
  c.  Complete a course of study approved by the board pursuant to section 152.5.
  2.  An applicant to be licensed as an advanced registered nurse practitioner shall have the following qualifications:
  a.  Hold a current license as a registered nurse.
  b.  Satisfactory completion of a formal advanced practice educational program of study in a nursing specialty area approved by the board.
  c.  Hold an advanced level certification by a recognized national certifying body.
  3.  For purposes of licensure pursuant to the nurse licensure compact contained in section 152E.1, the compact administrator may refuse to accept a change in the qualifications for licensure as a registered nurse or as a licensed practical or vocational nurse by a licensing authority in another state which is a party to the compact which substantially modifies that state’s qualifications for licensure in effect on July 1, 2000. For purposes of licensure pursuant to the advanced practice registered nurse compact contained in section 152E.3, the compact administrator may refuse to accept a change in the qualifications for licensure as an advanced practice registered nurse by a licensing authority in another state which is a party to the compact which substantially modifies that state’s qualifications for licensure in effect on July 1, 2005. A refusal to accept a change in a party state’s qualifications for licensure may result in submitting the issue to an arbitration panel or in withdrawal from the respective compact, at the discretion of the compact administrator.
[S13, §2575-a29, -a30; C24, 27, 31, 35, 39, §2563; C46, 50, 54, 58, 62, 66, 71, 73, 75, §152.3; C77, 79, 81, §152.7]
95 Acts, ch 79, §2; 2000 Acts, ch 1008, §5; 2000 Acts, ch 1140, §37; 2000 Acts, ch 1232, §50; 2005 Acts, ch 53, §5; 2006 Acts, ch 1030, §15; 2007 Acts, ch 22, §37; 2015 Acts, ch 56, §13
Referred to in §152.8

     
152.8  Reciprocity.
  Notwithstanding the provisions of sections 147.44, 147.48, 147.49, and 147.53, the following shall apply regarding applicants for nurse licensure possessing a license from another state:
  1.  A license possessed by an applicant from a state which has not adopted the nurse licensure compact contained in section 152E.1 or the advanced practice registered nurse compact contained in section 152E.3 shall be recognized by the board under conditions specified which indicate that the licensee meets all the qualifications required under section 152.7. If a foreign license is recognized, the board may issue a license by endorsement without an examination being required. Recognition shall be based on whether the foreign licensee is qualified to practice nursing. The board may issue a temporary license to a natural person who has completed the requirements of and applied for licensure by endorsement. The board shall determine the length of time a temporary license shall remain effective.
  2.  A license possessed by an applicant and issued by a state which has adopted the nurse licensure compact contained in section 152E.1 or the advanced practice registered nurse compact contained in section 152E.3 shall be recognized pursuant to the provisions of that section.
[C35, §2537-g3; C39, §2537.3; C46, 50, 54, 58, 62, §147.107; C66, 71, 73, 75, §147.107, 152.7; C77, 79, 81, §152.8]
2000 Acts, ch 1008, §6; 2005 Acts, ch 53, §6; 2008 Acts, ch 1088, §103

     
152.9  Temporary license.
  The board may issue a temporary license to a natural person who has completed the requirements of and applied for licensure by endorsement. The board shall determine the length of time a temporary license shall remain effective.
[C77, 79, 81, §152.9]
94 Acts, ch 1123, §1

     
152.9A  Limited nursing authorization.
  The board may issue a limited authorization to a nurse to complete the clinical component of a nurse refresher course. The board shall determine the length of time a limited nursing authorization shall remain effective.
2018 Acts, ch 1092, §1

     
152.10  License revocation or suspension.
  1.  Notwithstanding sections 147.87 to 147.89, the board may restrict, suspend, or revoke a license to practice nursing or place the licensee on probation. The board may also prescribe by rule conditions of license reinstatement. The board shall prescribe rules of procedure by which to restrict, suspend, or revoke a license. These procedures shall conform to the provisions of chapter 17A.
  2.  In addition to the grounds stated in section 147.55, the following are grounds for suspension or revocation under subsection 1 of this section:
  a.  Willful violation of the rules of the board.
  b.  Continued practice while knowingly having an infectious or contagious disease which could be harmful to a patient’s welfare.
  c.  Conviction for a felony in the courts of this state or another state, territory, or country if the felony relates to the practice of nursing. Conviction shall include only a conviction for an offense which if committed in this state would be deemed a felony without regard to its designation elsewhere. A certified copy of the final order or judgment of conviction or plea of guilty in this state or in another jurisdiction shall be conclusive evidence of conviction.
  d.  (1)  Having a license to practice nursing as a registered nurse or licensed practical nurse revoked or suspended, or having other disciplinary action taken by a licensing authority of another state, territory, or country. A certified copy of the record or order of suspension, revocation, or disciplinary action is prima facie evidence of such fact.
  (2)  Having a license to practice nursing as a registered nurse or licensed practical nurse revoked or suspended, or having other disciplinary action taken, by a licensing authority in another state which has adopted the nurse licensure compact contained in section 152E.1 or the advanced practice registered nurse compact contained in section 152E.3 and which has communicated information relating to such action pursuant to the coordinated licensure information system established by the compact. If the action taken by the licensing authority occurs in a jurisdiction which does not afford the procedural protections of chapter 17A, the licensee may object to the communicated information and shall be afforded the procedural protections of chapter 17A.
  e.  Knowingly aiding, assisting, procuring, advising, or allowing a person to unlawfully practice nursing.
  f.  Being adjudicated mentally incompetent by a court of competent jurisdiction. Such adjudication shall automatically suspend a license for the duration of the license, unless the board orders otherwise.
  g.  Being guilty of willful or repeated departure from or the failure to conform to the minimum standard of acceptable and prevailing practice of nursing; however, actual injury to a patient need not be established.
  h.  (1)  Inability to practice nursing with reasonable skill and safety by reason of illness, excessive use of alcohol, drugs, narcotics, chemicals, or other type of material or as a result of a mental or physical condition.
  (2)  The board may, upon probable cause, request a licensee to submit to an appropriate medical evaluation by a designated health care provider. If requested by the licensee, the licensee may also designate a health care provider for an independent medical evaluation. Refusal or failure of a licensee to complete such evaluations shall constitute an admission of any allegations relating to such condition. All objections shall be waived as to the admissibility of the examining health care provider’s testimony or evaluation reports on the grounds that they constitute privileged communication. The medical testimony or evaluation reports shall not be used against a registered nurse, licensed practical nurse, or advanced registered nurse practitioner in another proceeding and shall be confidential. At reasonable intervals, a registered nurse, licensed practical nurse, or advanced registered nurse practitioner shall be afforded an opportunity to demonstrate that the registered nurse, licensed practical nurse, or advanced registered nurse practitioner can resume the competent practice of nursing with reasonable skill and safety to patients.
[C77, 79, 81, §152.10]
2000 Acts, ch 1008, §7; 2005 Acts, ch 53, §7; 2008 Acts, ch 1088, §104; 2015 Acts, ch 56, §14
Referred to in §272C.3, 272C.4, 272C.5

  
     
152.11  Investigators for nurses.
  The board of nursing may appoint investigators, who shall not be members of the board, to administer and aid in the enforcement of the provisions of law related to those licensed to practice nursing. The amount of compensation for the investigators shall be determined pursuant to chapter 8A, subchapter IV. Investigators authorized by the board of nursing have the powers and status of peace officers when enforcing this chapter and chapters 147, 152E, and 272C.
93 Acts, ch 41, §1; 2003 Acts, ch 145, §199; 2018 Acts, ch 1026, §53
Referred to in §272C.5

     
152.12  Examination information.
  Notwithstanding section 147.21, individual pass or fail examination results made available from the authorized national testing agency may be disclosed to the appropriate licensing authority in another state, the District of Columbia, or a territory or country, and the board-approved education program, for purposes of verifying accuracy of national data and determining program approval.
97 Acts, ch 159, §22; 2008 Acts, ch 1088, §105; 2012 Acts, ch 1021, §47