The need for nurses is growing, especially for advanced practice nurses, such as nurse practitioners (NPs), and Hawai‘i is one of the highest-paying states for registered nurses (RNs).

The U.S. Bureau of Labor Statistics (BLS) predicts 45% job growth for advanced practice registered nurses (APRNs) between 2019 and 2029, much faster than the projected average for all occupations. An aging population, increased emphasis on preventive care, and the burden that COVID-19 has placed on the profession are contributing to the increase in demand.

For those who want to help meet this growing need in Hawai‘i, pursuing education and licensing are among the steps to become a nurse. For advanced practice nurses, that education often includes a master’s in nursing degree. The process of obtaining a Hawai‘i nurse license includes meeting requirements, from exams or endorsements to background checks.

Although Hawai‘i did allow exceptions in response to the COVID-19 pandemic, it typically requires practicing nurses to hold a current state nursing license. State licensing helps protect the public by ensuring that nurses meet established competency standards for providing care. Hawai‘i offers licenses for the following types of nursing roles:

• Licensed practical nurses. LPNs work under the supervision of RNs and physicians to provide basic medical care.
• RNs. Providing and coordinating care, RNs also educate patients and communities about health issues and guide and support patients and their loved ones.
• APRNs. APRNs coordinate patient care and provide primary and specialty health care, with many also permitted to write prescriptions. In Hawai‘i, they work in the following professions:
  • Certified nurse practitioner (CNP), delivering advanced nursing services to patients and families
  • Certified nurse specialist (CNS), researching and developing best practices in nursing
  • Certified registered nurse anesthetist (CRNA), providing anesthesia and caring for patients undergoing procedures that require anesthesia
  • Certified nurse-midwife (CNM), delivering babies and providing other health care for women

The state’s board of nursing governs nurse licensing in Hawai‘i. State boards of nursing are typically responsible for evaluating licensing applications and issuing and renewing licenses. They also can take disciplinary action against nurses who violate laws or guidelines.

Hawai‘i’s Nurse Practice Act, which outlines regulations for nurses, calls for the state’s board of nursing to include the following:

• Six RNs, one of whom must be an APRN
• One LPN
• Two members of the public

For those seeking a nurse license without holding a license in another state, the state’s board of nursing offers licenses by exam. The National Council of State Boards of Nursing (NCSBN) offers year-round exams required for LPN and RN licensing; the organization also has a test center on Oahu. For those with a nurse license in another state, the board may grant a Hawai‘i license by endorsement. Following are requirements for earning a Hawai‘i license to practice as an LPN, RN, or APRN:

Those seeking a Hawai‘i LPN license must complete an application in person or online; pay any licensing, exam, or other fees; submit proof of completion of an LPN program; and provide their fingerprints electronically for a background search. They must pass the National Council Licensure Examination (NCLEX), securing approval of the board before taking the test. Applicants who don’t pass the exam within three tries must take a remediation course.

Applicants who already hold a nursing license in another state may submit information showing they’re licensed in good standing in that state and meet Hawai‘i’s standards for providing care as an LPN. Applicants for licensure by endorsement may receive a temporary license to work as an LPN in Hawai‘i while they await approval from the state.

To receive an RN license in Hawai‘i, applicants must complete an application in person or online, pay any applicable fees, and provide fingerprints for a background check. They must also show that they graduated from an RN program, or that they earned a bachelor’s degree and completed the prelicensure portion of a master’s entry program in nursing.

Additionally, they must either pass an exam or show that they’re licensed in another state and meet standards to hold that license in Hawai‘i. Those taking the NCLEX must get approval from the state’s board of nursing before doing so. Applicants have three tries to pass the exam before being required to undergo remedial training.

Those who hold an RN license in another state may receive a temporary Hawai‘i nurse license, allowing them to work in an RN role in the state as they await approval for a Hawai‘i license.

RNs who want to progress to APRN licensing must prove they hold an RN license and have completed advanced nursing education for a state-recognized APRN role (CNP, for example). They must show they hold national certification for specializing in a particular population, such as family nurse practitioner (FNP), psychiatric-mental health nurse practitioner (PMHNP), or adult-gerontology acute care nurse practitioner (AGACNP). Along with providing any required fees and fingerprinting for a background check, Hawai‘i APRN applicants must meet requirements for clinical experience and competency for directing patient care.

APRNs may also apply for approval from the state’s board of nursing to prescribe medication to patients. They must hold a Hawai‘i APRN license, complete a background check, and meet state standards in advanced pharmacology.

Hawai‘i-licensed nurses must renew their license by June 30 of every odd-numbered year; the state sends postcard reminders a few months before the upcoming renewal deadline. APRNs must renew their APRN and RN licenses together. Nurses who don’t renew their Hawai‘i license by the deadline must restore their license before practicing nursing again.

State officials may randomly select nurses who received a license in Hawai‘i before July 1, 2017, for a background check to complete the renewal process.

Renewing a Hawai‘i nurse license also includes a continuing competency requirement, although in many cases nurses with national certification are exempt from this requirement. Those who aren’t exempt must have completed one of the following learning activities within the past two years to meet the standard:

• Completing 30 hours of continuing education courses approved in Hawai‘i, California, or Florida
• Taking a 120-hour refresher course
• Earning two semester credits of post-licensure academic education for nurses
• Spending 120 hours guiding a nursing student or employee moving into a new area of practice
• Leading a nursing research study
• Writing a peer-reviewed, published nursing or health article, book, or book chapter
• Developing and presenting five hours of nursing continuing education
• Completing a nurse residency program

Nurses applying for renewal may also seek approval from the board of nursing for other types of continuing competency activities to fulfill the requirement. Additionally, recent nursing school graduates can renew their license with fewer hours of continuing competency credits.

A strong nursing education is another step in pursuing — and advancing in — a nursing career in Hawai‘i. The Hawai‘i Pacific University (HPU) online MSN program can provide that high-quality education, offering fully online learning, small classes, dedicated support, and the flexibility of three start times throughout the year.

Discover how HPU’s online MSN program can help you work to advance in one of the nation’s most in-demand professions.