Orientation of Graduate Nurses

Application for Licensure by Examination Filed AFTER January 1, 2006 - Clinical Internship and Provisional License:  A person who files an application for licensure by examination with KBN after January 1, 2006 is issued a provisional license and must complete the clinical internship prior to taking the licensure examination.  For additional information on the clinical internship, provisional license, and requirements for the "RN Applicant/LPN Applicant," see Clinical Internship. 

Application for Licensure by Examination Filed BEFORE January 1, 2006:  A person who filed an application for licensure by examination with KBN before January 1, 2006 will not be issued a provisional license and will not be required to complete the clinical internship.  The graduate will not be issued a temporary work permit, or any form of licensure, and will not be eligible to be classified as a registered nurse applicant or licensed practical nurse applicant.  Technically, the graduate is considered unlicensed assistive personnel.  Pearson/VUE will issue the graduate an "Authorization to Test" (ATT) document (as referenced below), and he/she may orient to a licensed position as a graduate nurse.  To differentiate these individuals from nurse aides, it is recommended that they be referred to as "graduate nurses" (GNs).  Graduate nurses may not refer to themselves as RNs or LPNs and may not practice as RNs or LPNs.

See Licensure by Examination for additional information about the application process.

The administrative regulation on delegation (201 KAR 20:400) applies and allows an RN or LPN to delegate certain nursing tasks to graduate nurses consistent with the standards set forth in the regulation.

To ensure public health and safety, employers who orient new graduate nurses based on the issuance of an Authorization to Test (ATT) letter should follow this procedure:

Graduates Applying to KBN for Licensure by Examination:  The GN shall have submitted an application for licensure to KBN and have been declared eligible by the Board to take the licensure examination prior to beginning orientation.  Once declared eligible to test by KBN, the applicant is mailed an Authorization to Test (ATT) letter by the test service.  The GN must provide a copy of the ATT to the employer to show evidence of having applied to KBN for licensure.

Graduates Applying to Another Board of Nursing for Initial Licensure by Examination and to KBN for Licensure by Endorsement Prior to January 1, 2006:  If an individual who has been authorized to test by a board of nursing in a state other than Kentucky provides a copy of the ATT, the employer must contact KBN to verify that the individual has submitted an application for licensure in Kentucky.  The individual may not be designated a graduate nurse or oriented under these guidelines without filing an application for licensure by endorsement in Kentucky.

Supervision:  An RN must be designated as the responsible individual to provide continuous, direct, on-site supervision for the GN.  An RN may designate an LPN to participate in the orientation for the graduate of a practical nursing program. A GN may NOT engage in independent nursing responsibilities.

A GN not licensed by the end of orientation or who has failed the first attempt at NCLEX may function only as an unlicensed assistive person.  The employer should monitor the GNs progress toward licensure, being mindful that the GN has 90 days after receiving the ATT to schedule the examination (after which time the ATT expires) and will receive examination test results from KBN within 3 weeks of the test date.