Telenursing is also being practiced across state lines. The nurse on the hotline may be in Virginia but advising a client in Texas. The faculty member may be teaching in New York but her students may be anywhere in the United States. For nursing regulation, the challenges are many. First and most significantly, the current model of licensure does not permit practice in this manner.
States require nurses to be licensed where they are providing care.
This model allows states to set and enforce standards to protect their citizens. These are some of the questions with which nursing regulation is struggling at the national level. Although the supremacy clause of the 10th amendment has not affected health care professional regulation yet, recent federal legislation has affected standards of care across state lines. Examples include lengths of hospital stay for women following labor and delivery and nursing home reform. If the Secretary determines that insufficient progress is being made by the states, the bill requires that she make recommendations for federal remedies to licensure as a barrier to interstate telehealth practice.