What is the Nursing License Compact and How Does it Impact Nursing?
As of January 2019, there are 34 states participating in, or have legislation pending to participate in, the Nursing Licensure Compact. A compact is defined by Black’s Law Dictionary as being “an interstate agreement between two or more states for the purpose of remedying a particular problem of multi-state concern.”
The National Council of State Boards of Nursing (NCSBN) governs the NLC. The NLC was recently enhanced by legislation which took effect January 19, 2018. The eNLC now simplifies the process and allows nurses to hold a multi-state license in their home (residence) state and practice in multiple (NLC) states. Under the new eNLC, a multi-state license is granted to qualified nurses, eliminating the need to give up one multistate license to accept another all the while also being licensed in your home state.
This is particularly useful for travel nurses as well as for nurses living in smaller states or in areas bordering another state allowing nurses to work across state lines. It aids in reducing the shortage of nurses and provides for a more standardized health care system. The eNLC opens up many avenues and opportunities for employment for all nurses; not just travel nurses, especially as the number of states participating in the eNLC expands.
- Graduate form a BON approved nursing program (RN or LV/PN)
- Pass the NCLEX-RN or NCLEX-PN(VN) exam (Can be taken in any state)
- Reside in a NLC state
- Possess an active, unencumbered license in the state of residency (if renewal is required, all CEUs must be met)
- Have a valid Social Security number
- Pass an English proficiency exam (for international graduates)
- Undergo state and federal fingerprint-based criminal background check
- May not be participating in an alternative program
- Not have any state or federal felony convictions
- Not have any misdemeanor convictions related to practice of nursing
Application for an eNLC can be made online through the state BON website. Click on apply for a new license and the option to apply for a multistate license option should appear. If all of the above requirements are met there should not be an issue with the application. There will be additional fees for this licensure. Some states require proof of residency which can be done by providing a physical mailing address or showing a valid driver’s license, voter registration or at that address. Nurses who hold a single-license in a compact state will renew with the eNLC provided they meet all criteria.
The fingerprint requirement is new and even if fingerprints were submitted to renew a nursing license previously, they must be repeated. This needs to be done at a specified Live Scan location in their state of residency. There will be additional fees for this process. Once the application has been submitted, it will take about 2 weeks to process. Nurses already possessing an NLC license will be grandfathered in to the eNLC, but they have to complete the application as it won’t be an automatic process.
With an eNLC, nurses can practice in any NLC state without any further license process. Previously, the nurse had to effectively exchange the NLC license for another NLC license. They must keep their state of residency license up to date and compete all required CEUs. If the nurse moves from one state to another there are rules governing how to complete the process of establishing a new state of residency in the NCSBN’s Final Rules for January 2019.
The NLC has allowed nurses far more mobility and improved career path options in a widening national health care system. It also means states have been forced to work together and coordinate licensing and continuing education rules more than ever before. Having this compact has afforded nurses an opportunity to practice nursing without being burdened with applying and paying for multiple nursing licenses and dealing with confusing renewal requirements. As more states apply to the compact, the more the healthcare system grows and expands. And now with the multistate license, many more doors open to nurses.
Nurses are still responsible to fulfill the CE requirements (if any) to renew their resident state’s license, but they are held to the standards as established by the BON and Nurse Practice Act of the state where they are practicing. More than ever nurses need to be aware of the scope of practice and expected standards of practice as they can vary widely across state lines. Florida for instance requires nurses to take 2 CEUs in the laws and rules for nurses in the state of Florida as part of its CEU requirements. They also require CEUs in domestic violence, impairment in the workplace, and avoiding medication errors in addition to the 24 CEUs required every 2 years.
Other states have specific requirements that often pertain to the demographics of their state such as courses in dementia, HIV/AIDS, human trafficking, workplace violence, and conflict resolution. Continuing education is meant to meet the continuum for lifelong learning. Nurses practicing in these states need to be alert to these requirements and encouraged to seek out the information and knowledge to improve their practice.
Nurses never learn everything they need to know in nursing school. In this age of emerging and growing technology, the aging patient population demands more sophisticated and up to date levels of care. Nurses are expected to perform most of the patient education to help patients improve their outcomes and prevent complications from chronic illness. Continuing education, whether required or not is an essential part of a nurse’s career.
Some states allow CEUs for courses that are required to practice such as CPR, PALS, and ALCS; others only allow the CEUs for initial certification courses, but not to renew. Continuing education is designed to enhance and supplement the nurse’s education; not to repeat basic nursing courses. Nurses should find continuing education courses that inspire them to grow professionally.
As the Nursing License Compact grows, perhaps individual state licenses and continuing education requirements will become more standardized and the nursing workforce strengthened by it.
Here is list of all states currently impacted by multi-state compact licensing (as of 2/24/18):
Current states within the eNLC:
- Kansas (will join the eNLC on July 1, 2019)
- Louisiana (will join the eNLC on July 1, 2019)
- New Hampshire
- New Mexico
- North Carolina
- North Dakota
- Rhode Island
- South Carolina
- South Dakota
- West Virginia
States with Pending Legislation for the eNLC:
- New Jersey
States without Legislation for the eNLC:
- New Hampshire
- New York
- Rhode Island (is part of original NLC)