Nursing student Carolyn Patchett felt called to rural healthcare after growing up in a remote Alaska town where the nearest hospital was a four-hour plane ride away. Her path wasn’t traditional: She left college after a family emergency and then met her husband, who served as military police in the Air Force, and had three children. When she returned to school, she needed a program that would allow her to raise her kids and accommodate a military schedule, which brought her family to Washington, then Georgia, and finally Colorado.
Carolyn eventually discovered Nightingale College, a private, accredited nursing school based in Utah that offered a range of nursing degrees in a distance-learning format. The program’s flexibility allowed her to enroll despite her responsibilities at home, and it put her on a path toward pursuing her lifelong goal: expanding healthcare access in rural communities.
“It’s such a special place because it makes a nursing education possible for almost anybody who wants to do it,” she says.
Clinical placements are a cornerstone of the program, which Nightingale arranges locally in each student’s area through partnerships with in-state facilities. The collaboration is mutually beneficial; students earn their degrees, and rural or remote communities retain trained healthcare professionals.
Unfortunately, the state of Montana has hindered this arrangement through protectionist regulations that unlawfully discriminate against out-of-state programs. Montana law requires out-of-state programs to submit detailed written requests for placement, student and setting details, credentials of preceptors and faculty, and—perhaps most egregiously—confirmation from in-state programs (i.e., Nightingale’s competitors) that no Montana student will be displaced because of the clinical placement. It also requires the Montana Board of Nursing’s unconditional approval—something that in-state programs need not obtain.
In effect, it constrains the ability of any nursing student enrolled in an online or out-of-state program to complete their clinicals in Montana. As a result, those students can only obtain their needed clinical training outside of the state.
Represented free of charge by Pacific Legal Foundation, Carolyn and Nightingale College filed a complaint in the U.S. District Court for the District of Montana alleging that the state’s protectionist regulations violate the Dormant Commerce Clause, which is supposed to limit the state’s authority to burden interstate commerce. By imposing requirements on out-of-state programs that in-state programs do not face, Montana is playing favorites rather than allowing programs to compete on an even playing field—and allowing students the freedom to choose a program that best suits their needs.
The state also violates the Equal Protection Clause through its protectionism, which restricts access to training for nursing students and lacks any rational relation to public health.
A victory for Carolyn and Nightingale would protect the rights of nursing students to pursue their degrees without discriminatory state regulations getting in the way. For a nation facing a nursing shortage—especially in rural regions of Montana—policymakers should be expanding access to a nursing education, not restricting it.
What’s At Stake?
- Americans have a right to pursue their calling without burdensome regulations that arbitrarily favor in-state competitors over out-of-state programs providing equivalent education.
- Students pursuing nursing careers deserve equal access to clinical placements regardless of which accredited program they choose.
