Licensure for advance practice nurses in Illinois became a reality in 2001, following decades of arduous and dedicated political action performed by nurse midwives, nurse practitioners, nurse anesthetists, and clinical nurse specialists, with the invaluable assistance of a lobbyist, Susan Clark, a registered nurse.  This legislative maneuvering surged in 1997 when the Illinois Nursing Act, as it was then titled, was scheduled to sunset (expire).  For complicated political reasons, changes in the Nursing Act were not achieved until the following year when SB 1585 became Public Act 90-742 on August 13, 1998 by Governor Jim Edgar. The Governor’s signature gave our practice act a new name, the "Illinois Nursing and Advanced Practice Nursing Act,” and finally recognized the existence of and the services rendered by advanced practice nurses in Illinois.

However, a governor’s signing a bill into law is only the first step to its becoming reality and actual licensure would not be achieved for nearly three more years.  The reason for this delay had to do with the transition of political leadership, as well as a bureaucratic process. Many laws are actually comprised of two components: the statute and its rules for administration.  A practice act statute is a compilation of numerous laws passed over the years by the Illinois General Assembly.  Rules, on the other hand, are written by state agencies.  In the case of the Nursing Act, writing the Rules for Administration of the Nursing and Advanced Practice Nursing Act (Rules) is the responsibility of the Illinois Department of Financial and Professional Regulation (IDFPR) staff and/or its advisory boards, which involves a convoluted process called promulgation. Promulgation entails a governmental labyrinth that includes intervention by IDFPR, the Secretary of State’s Office, and the Joint Committee on Administrative Rules (JCAR), which is a bipartisan committee of Illinois legislators.

The first step in implementing the newly-named Illinois Nursing and Advanced Practice Nursing required that an entirely new advisory group, the Advanced Practice Nursing Board (APN Board), had to be created, and that required that each member of the Board be appointed by the governor of Illinois. It would then be the task of the APN board to help generate the Rules. The new APN Board was not appointed during Governor Edgar’s tenure; as a result, the task fell to his successor, George Ryan, who was inaugurated in January, 1999.  Governor Ryan had numerous other advisory boards to appoint, as well as many other duties to accomplish as he assumed his new position.  APNs in Illinois became frustrated as months passed without the APN Board being created. Thanks to some gentle reminders from certain Illinois legislators, Governor Ryan eventually made the necessary appointments, and in December, 1999, the APN Board met for the first time. The Board’s complement at that time was four APNs (representing each of the four APN specialties), three physicians (an anesthesiologist and two obstetrician/gynecologists), and one public member. A second public member joined the board some months later.

Although most advisory boards within IDFPR meet only quarterly, the APN Board was allowed to meet monthly in order to accelerate the process of writing the Rules. Remuneration for members serving on advisory boards for IDFPR is meager; for the most part is it simply reimbursement of travel expenses. Therefore, it is remarkable that eight people could be found who were keenly committed to spending several hours for many months to accomplish their first assignment of writing the Rules for newly-revised Nursing Act.  The Board issued its first draft of the Rules by December, 2000, launching the previously-mentioned bureaucratic labyrinth.  In April, 2001, APNs "became real” in Illinois as they were finally able to obtain licenses that accorded them the title "Advanced Practice Nurse” and their specialty-specific title of either "Certified Nurse Midwife,” "Certified Nurse Practitioner,” "Certified Registered Nurse Anesthetist,” or "Clinical Nurse Specialist.”

All APNs in Illinois owe a debt of gratitude to the many nurses over several decades, as well as the first APN Board, all of whom worked tirelessly to make APN licensure a reality. 

Fast forward to 2005; the Illinois Nursing and Advanced Practice Nursing Act was due to sunset (expire) in two years. Mary Ann Alexander, PhD, RN, CNS, an IDFPR employee who at the time held the title of Coordinator of the Nursing Act, took on task unusual for someone in her position.  Rather than sit on the sidelines waiting for nursing colleagues to explore strategies for dealing with sunset, Dr. Alexander put out a call to numerous nursing organizations to recruit nursing leaders throughout the state to create a grassroots Nurse Practice Act Task Force. Soon one hundred fifty-five licensed practical nurses (LPNs), registered nurses (RNs), and advanced practice nurses, gathered together in one room to assume their marching orders. It was Dr. Alexander’s vision that an entirely new Nursing Act be created, one that would serve the public and nurses for the next decade and beyond. To that end, those attending that meeting were assigned to various work groups based on their interests and experience.  These work groups included the topics of education, introduction/definitions, licensing violations/discipline, continued competency, scope of practice, and structure of the nursing boards.  On October 5, 2007, SB 360 became Public Act 95-639, thus launching a new era for nursing practice in Illinois.