The idea of nurses working across state lines was thrust into the national dialogue during the COVID-19 pandemic, but regulations that allow nurses to do that with ease have been in place for more than two decades.
The Nurse Licensure Compact, established in 1999, is the structure under which nurses are qualified to treat patients outside of their primary state of residence. And it’s a vital component in the travel nurse landscape.
Nurses can work in any NLC member state “pretty easily,” according to Luminous Travel Staffing Co-Founder Alysia Adams, DNP, APRN, AGACNP-BC, CCRN, NE-BC. A single license makes that possible.
What is the Nurse Licensure Compact?
The NLC allows RNs and LPNs to maintain one, multi-state license to practice in states that are part of the compact without securing licenses for each state they intend to work in.
Practitioners can provide both in-person and telehealth services under the compact but must maintain residency in the state that issued their compact license, in addition to several other requirements. Among those are:
- Graduate from a board-approved education program or an international education program that’s approved by the accrediting body in the country it was obtained;
- Pass an English proficiency exam;
- Pass the NCLEX-RN, NCLEX-PN, or predecessor exam; and
- Have a valid United States Social Security Number.
(Tip: A full list of requirements is available on the NLC website.)
Forty-three states have enacted the NLC. Of those, Pennsylvania is the only one with partial implementation. Rhode Island and Connecticut have enacted the NLC but have not yet implemented it, according to the most recently available NLC data.
Multi-state licenses are not available in NLC states until the compact has been fully implemented.
In November, Massachusetts became the latest state to join the NLC, which was met with elation by the Massachusetts Health & Hospital Association.
“This is a pivotal moment for nursing and healthcare delivery in Massachusetts,” Amanda Stefancyk Oberlies, PhD, MBA, RN, FAAN, CEO & Chief Nursing Officer of The Organization of Nurse Leaders – MA, RI, NH, CT, VT, said in a news release. “With the adoption of the NLC, we’re taking a critical step forward in supporting our nurses and addressing workforce shortages that are having a very real impact on wait times and timely patient care. We commend the Massachusetts legislature for recognizing the urgency of this issue and taking action to ease the burdens on our dedicated nurses. By joining the Compact, Massachusetts is creating immediate, meaningful change and providing relief for both caregivers and patients alike.”
A separate compact exists for APRNs.
What About Non-NLC States?
Only the following states are the only ones with no NLC agreement on the books:
- Hawaii
- California
- Nevada
- Oregon
- Minnesota
- Illinois
- New York
Adams said that if you know you want to work in a state that’s not part of the NLC, be proactive in securing that licensure.
“I will tell you from an agency perspective, you cannot submit a person [for a travel staffing job] that doesn’t already have a license in those states that specifically are not part of the compact,” Adams said.
Luminous Travel Staffing recruiters can help nurses determine what steps need to be taken to acquire licensure in non-compact states.
“The recruiters are very knowledgeable,” Adams said. “They keep a good profile, especially here at Luminous, we keep a good profile. And [we are aware of] all the state requirements and we can send you exactly where to go to apply, get your license started.”
The Bottom Line
The Nurse Licensure Compact is an arrangement that gives RNs and LPNs the flexibility to work in multiple states without securing a license from each state’s board of nursing. This makes choosing new assignments easier by removing the burden of learning licensure requirements for new states. As of publication, only seven states were not a part of the NLC. Nurses interested in working in those states should be proactive in obtaining licensure.
