Nurse Licensure Compact: A Response to the Crisis of Nursing Shortage

January 22, 2024

There is a critical nursing shortage in the United States, which has an effect on healthcare quality and strains the system. To solve this problem, the idea of a Nurse Licensure Compact (NLC) also known as an Enhanced Nurse Licensure Compact (eNLC) has been adopted by various states. Nurse Licensure Compact is an agreement that allows registered nurses who are legal residents of one of the enhanced compact states to practice nursing in any of the other enhanced compact states without even having a license in that state.

The NLC program was initially introduced in 2000, and as of now, 39 states are members of compact states. Nurses with a multistate license have greater opportunities for career advancement and job flexibility. As a result, fewer difficulties, application fees, and barriers exist.

What are the Nursing Compact States?

Nurses who presently practice in states where legislation is pending are not required to do anything until the bill(s) is enacted. When the state joins the eNLC, the state board will contact all registered nurses in the state. Nurses will subsequently be needed to verify that their permanent address is up to date with the state board for compact license eligibility to be determined.

Nurses not due for license renewal will not be charged a fee to migrate to the eNLC. All nurses who fulfill the eNLC standards will be granted a new license.

You must declare a domicile in an eNLC state to apply for a compact license. As a non-resident of an eNLC state, you can apply for state licensure through endorsement, but you will only be given a single-state license rather than the compact license. Nurses are permitted to have multiple single-state licenses.

Here is the list of compact nursing states:

Vermont enacted the NLC on June 7, 2021. The implementation date is Feb. 1, 2022.
Pennsylvania enacted the NLC on July 1, 2021. The implementation date is to be determined.
Ohio enacted the NLC on July 1, 2021. The implementation date is Jan. 1, 2023.
New Jersey allows nurses who hold active, unencumbered multistate licenses issued by NLC member states to practice in New Jersey under their multistate licenses.

Benefits of Nurse Licensure Compact

Despite some states' reluctance to adopt the eNLC, the NCSBN asserts that more than 2 million nurses now reside in eNLC states and can practice in other compact states. Knowing more about the NLC gives you these benefits:

Increases mobility and flexibility for nurses. This allows them to work in areas where there is a high demand for nurses, reducing the impact of the nursing shortage crisis. Nurses can take advantage of job opportunities in other states, or they can temporarily work in another state if they are unable to find work in their home state. This increased mobility can also benefit patients, as it ensures that they have access to qualified and competent healthcare professionals, regardless of where they live.
The NLC program helps to improve the quality of care the patients receive. By allowing nurses to work across state borders, healthcare facilities have access to a larger pool of qualified nurses. This can lead to better patient outcomes, as healthcare facilities are able to select the best-suited nurse for a specific patient.
In addition to the benefits for nurses and patients, the NLC program also has economic benefits. By reducing the need for additional licensure, it saves time and money for both nurses and healthcare facilities. Nurses are able to start working in another state more quickly, and healthcare facilities can fill positions faster, which saves them time and money on the recruitment process. This can also help to reduce the overall cost of healthcare, as patients receive the best possible care in a timely and efficient manner.

Challenges Associated with the Nurse Licensure Compact

There are some challenges associated with the NLC program that must be addressed. One of the biggest challenges is the potential for inconsistent standards of care across different states. This can be addressed through effective communication and collaboration between states to ensure that all NLC states are adhering to the same standards of care.

Another challenge is ensuring that all NLC states have access to the same resources, such as continuing education and professional development opportunities. To address this, the NLC program must be accompanied by a comprehensive system of support that provides access to the resources that nurses need, to maintain their competence and continue their professional development.

In conclusion, the nursing shortage crisis is a complex issue. On the other hand, the Nurse Licensure Compact program is just one piece of the puzzle that is a promising solution to the nursing shortage crisis in the United States. Nevertheless, it is a positive step towards ensuring all patients have access to high-quality healthcare.

Now, let’s go over the process on how to get a multistate license and your options if you currently have one.

How to obtain a multistate license?

If the state board of nursing in your Primary State of Residence (PSOR) is a member of the nurse licensure compact, you may be eligible for a multistate license. To successfully apply for a multistate license, you must meet the uniform licensure requirements indicated below:

Meets the requirements for licensing in their home state
Graduate from a board-approved education program or an international education program (recognized by the appropriate country's authorized accrediting body and confirmed by an independent credentials review agency).
Pass an English proficiency exam (applicable to graduates of an international education program that does not teach English or if English is not the individual's native language).
Pass an NCLEX RN or NCLEX PN Examination or predecessor exam
Holds or be eligible for a valid, unrestricted license
Submit to state and federal fingerprint-based criminal background checks
Have no state or federal felony convictions
Have no misdemeanor convictions related to nursing practice.
Not presently participating in an alternative program
Self-disclose your present participation in an alternative program.
Possess a valid Social Security number.

Understanding the NLC could open up the possibility of various employment as a registered nurse in nursing compact states. Leverage your USRN Dream by learning the most common myths about the NLC.

5 Common Myths About the NLC: Debunks!

In this article, we'll debunk and dispel the top 5 NLC-related myths and misconceptions you should be aware of!

Myth #1: A nurse who relocates to another compact state intending to establish a new primary state of residence (PSOR) is not required to declare the new state residence until the license from the previous state is about to expire.

Fact: Based on NCSBN, upon issuance of a new multistate license, the former primary state of residence shall deactivate its multistate license held by the nurse and provide notice to the nurse.

Myth #2: A registered nurse having a license in one state can work in another. It is one of the most widespread misconceptions. However, simply because a nurse is licensed in their home state does not entitle them to work in a neighboring state.

Fact: A nurse from Illinois, for example, could not work in Missouri using the Illinois license since it is not a compact state.

But if the nurse maintains a legal residency in the state of Arkansas and has been issued a multistate license that remains in good standing to work in Missouri, then the licensee can practice her profession since Missouri is a compact state.

As per NCSBN, the nurse can only practice in any state that has enacted the compact.

Myth #3: If the employer is in a compact state, a nurse who transfers from a compact state to the employer must get an in-state license within 30 days of starting work.

Fact: A nurse must apply for licensure by endorsement and complete the declaration of Primary State of Residence form within the application when relocating permanently to another compact state.

A nurse may start the application process before or after the move and should not delay applying once you have moved because there is no grace period. Suppose you are moving from a noncompact state, applying to a compact state before the move. In that case, you may be issued a single-state license, or your application may be held until you move and have proof of legal residency, at which time you may be issued a multistate license.

Myth #4: You'll need to retake the NCLEX if you apply for a license in a compact state.

Fact: The National Council Licensure Examination (NCLEX) is the national exam that all states recognize, and once passed, states do not require retaking unless there is an uncommon scenario.

Myth #5: As a compact state nurse, I will be required to monitor and maintain continuing education credits (CE) in each state where I practice.

Fact: According to the compact legislation, a nurse is only required to retain CE when the home state requires it.

Leverage your USRN dream by practicing in nursing compact states. As a multi-state licensed nurse, you may advance professionally while gaining job flexibility.

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