The Future of the Nurse Licensure Compact


Illinois is set to become the 26th state to join the Nurse Licensure Compact (NLC) after Senate Bill 2214 successfully passed the Senate. “I am very excited that this legislation has moved forward and I encourage my colleagues in the Illinois House to pass this bill in order to expand the opportunities for Illinois’ licensed nurses,” bill sponsor Senator Pamela Althoff (R-McHenry) said.

The Nurse Licensure Compact allows nurses to get a multistate license and practice in any other state that is also a part of the NLC. Nurses currently have to get a license for every state they wish to practice in. This can become expensive and cumbersome. It can keep nurses from helping with disaster recovery efforts and create barriers to new forms of healthcare such as telehealth, or telemedicine.

Nurse smiling using an iPad

Telemedicine is the use of telecommunication and information technologies to provide clinical healthcare at a distance.

According to the American Telemedicine Association, telehealth, or telemedicine, is “the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status”. Healthcare providers can use two-way video, email, smartphones and other forms of telecommunications technology to be able to help patients. The telemedicine industry is estimated to reach $1.9B in revenue by 2018, up from $240M in 2013.

To Join, Or Not To Join

States began to join the NLC in 1999. By 2010, there were 23 states that were a part of the Compact. Since then, only 2 states have joined. To try and get more states interested in joining, the NLC has recently undergone some revisions that now include requiring states to do a fingerprint-based state and federal background check. Nurses that have been convicted of a felony will not be able to get multistate licenses, however, they can still practice in their home state with a license.

Many people think that the NLC is a great idea, and in fact, doctors, psychologists, physical therapists, emergency service personnel, and dieticians are considering adopting an interstate licensing model. It makes it easier for nurses to help in other states in case of natural disasters, can help to fill nursing shortages in other states, and can help to lower costs for patients using telemedicine services.

The Nurse Licensure Compact is beneficial for travel nurses looking to save some time and money between assignments.

The Nurse Licensure Compact is beneficial for travel nurses looking to save some time and money between assignments.

Not everyone thinks that the Compact is a good idea. Some nurses and unions are against it because licensing standards vary from state to state and feel it may negatively impact patient care. David Schildmeier, a spokesperson for the Massachusetts Nurses Association, a union and professional group voiced his concerns, “Massachusetts has higher requirements than other states. This would allow nurses from other states to work here. We don’t want their problems.”

However, as stated by Maureen Swick, the senior vice president and chief nurse executive for Inova Health System in Falls Church, VA, “That’s absolutely crazy. We all take the same test. The curriculum from nursing school is all the same.”

The hope is that with the new standards for membership, other states might want to join the Compact. It seems to be working as six states have enacted legislation to adopt a licensure compact to allow nurses to practice telemedicine across state lines. Those states include Wyoming, Virginia, South Dakota, Idaho, Florida, and Tennessee. Seven more states have bills pending. Visit the National Council of State Boards of Nursing website for more information regarding the Nurse Licensure Compact.

A map showing the 25 states that are part of the NLC.

Map showing which states participate in the Nurse Licensure Compact.
Courtesy of National Council of State Boards of Nursing.

Author: Travel Nurse Source

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