Registered Nurses (RNs) should pay close attention to the Nurse Licensure Compact (NLC), especially if they’re looking for the edge that comes with the ability to practice across state lines.
This article covers everything you need to consider about the NLC and the implications of multistate licensing.
What Is the Nurse Licensure Compact?
The Nurse Licensure Compact (NLC) is an agreement among U.S. states and territories that allows mutual nursing license recognition. While nursing licenses are state-based, the NLC currently allows nurses in more than 40 states and territories to practice across state lines. Several other states and territories are pending NLC participation or legislation.
Nurses living in an NLC state can practice in any NLC member jurisdiction without obtaining additional licenses. The National Council of State Boards of Nursing created the NLC in 2008 to improve patient access to care. The NLC also protects patient safety by setting high standards of care and facilitating communication among member states.
In 2018, the NLC officially became the Enhanced Nursing Licensure Compact (eNLC) to recognize its heightened safety measures. Key among these measures is the capacity to conduct a federal criminal background check on nursing employees.
What Is the Enhanced Nurse Licensure Compact (eNLC)?
As previously mentioned, the Enhanced Nurse Licensure Compact officially replaced the NLC in 2015. However, people still generally refer to the “eNLC” as the “NLC” both inside and outside the nursing industry.
An updated version of the NLC, the eNLC contains a number of supplementary operating requirements for participating states and nurses. Most significantly, the eNLC added uniform licensure requirements that include universal criminal background checks.
How Does the Nurse Licensure Compact Work?
The Nurse Licensure Compact offers a clear and concise explanation of how it works: “Nurses holding a multistate license can practice in other NLC states/territories, without obtaining additional licenses, while maintaining their primary state of residence (PSOR). The multistate license is issued in a nurse’s PSOR, but is recognized across state lines, like a driver’s license.”
Multistate License vs. Single-State License
Before the advent of the Nurse Licensure Compact in 2008, nurses could practice within their specific states of licensure and no others. If they wanted to practice outside their license-issuing state, they had to apply for new licensure in a new state. For nurses in states outside the NLC, this is still the way things operate.
However, the NLC created the first multistate nursing license in the United States. Any nurse with an NLC license can practice in any NLC state.
The NLC benefits nurses by broadening their professional horizons as well as patients by increasing their access to quality nursing care. Although some states cite safety concerns as their primary reason for remaining out of the NLC, these concerns appear to be largely unfounded. A 2022 study in the Journal of Nursing Regulation concluded that “multistate license holders’ consistently low discipline rates hold across all available demographic categories, suggesting the overall safety of the NLC.”
What States Are in the Nurse Licensure Compact?
According to the latest available resources, there are currently 42 jurisdictions in the NLC. This includes the full participation of the following 39 states:
- Alabama
- Arizona
- Arkansas
- Colorado
- Connecticut
- Delaware
- Florida
- Georgia
- Idaho
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Mississippi
- Missouri
- Montana
- Nebraska
- New Hampshire
- New Jersey
- New Mexico
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
In addition, the U.S. territory of Guam welcomes nurses with NLC licenses, and Pennsylvania has partially implemented NLC measures. Seven states and the District of Columbia are pending legislation in advance of NLC approval. The full list of pending NLC states and districts includes:
- Alaska
- District of Columbia
- Hawaii
- Illinois
- Massachusetts
- Michigan
- Minnesota
- New York
Because its participating states may change, you should check the official NLC website to get the most up-to-date information. State governments must pass laws through their official legislative bodies before they can join the NLC.
Professional Nurse Licensure Compact Benefits
By greatly expanding their geographical practice range, the NLC offers more job opportunities and increased career flexibility to all kinds of nurses. It also makes life far easier from an administrative point of view, streamlining license processing and saving money on fees.
Increased Job Opportunities and Career Flexibility
Some of the most financially and personally rewarding positions in the nursing field are immediate hires. After all, regions in the throes of a healthcare emergency will inevitably have the highest demand for nurses. The NLC opens a wider range of job opportunities for nurses by allowing them to practice in multiple states without the need for additional licenses.
Streamlined Licensure and Reduced Costs
Without the NLC, nurses who want to practice in a new state must go through all the hassle and expense of securing licensure in that state. This makes regular cross-state practice impractical, requiring more time and resources to get a license.. The simplified licensure process for nurses in compact states eliminates the need to apply and pay for multiple state licenses. This can save nurses considerable time and money, allowing them to focus on their careers and patient care. According to the travel nursing employment company TRS Healthcare, “Most NLC states have a very easy process to transfer from state to state, with some offering temporary licenses within 24 hours.”
Enhanced Mobility and Disaster Response
Because nurses are most needed wherever medical care is most needed, immediate disaster response is a core component of the profession. The NLC facilitates nurse mobility, which enables them to quickly respond to healthcare needs in other states. This enhanced mobility can greatly improve access to care and contribute to a more effective healthcare system, especially during public health emergencies.
Benefits of the Nurse Licensure Compact for Employers and the Healthcare System
The advantages of the NLC are both numerous and significant for nurses and their patients. Not to mention, it also offers substantial value to healthcare employers and the community at large. As just three examples, the NLC has proven effective when it comes to addressing nurse shortages, increasing access to care, and enhancing the overall efficiency of the healthcare workforce.
Addressing Nursing Shortages
The NLC routinely mitigates nursing shortages by increasing the pool of available nurses who can practice in a given state. This is particularly valuable to hospitals and other healthcare facilities in rural or underserved areas, which traditionally have trouble attracting highly qualified nurses. Practice area restriction is just one among various factors contributing to the severe nursing shortage that has long plagued the U.S. and will likely continue through 2030, according to the American Association of Colleges of Nursing (AACN).
Improved Access to Care
The NLC can greatly expand access to quality healthcare, especially for patients in remote or underserved areas with a severe lack of local providers. In addition to allowing nurses to easily travel or relocate to these remote or underserved areas, the NLC allows them to work across state borders as telehealth nurses. Because nurses must be officially licensed to treat patients in each state they service, licensing issues can be a headache for cross-state telemedicine providers. Fortunately, any nurse with an NLC license can serve telemedicine patients in multiple states. In fact, furthering the outreach potential of telehealth in nursing is one of the primary objectives of the NLC.
Enhanced Efficiency and Cost Savings
The NLC can improve the efficiency of the healthcare workforce by reducing the administrative burdens commonly associated with multi-state licensure. This can lead to substantial financial savings for healthcare organizations and ultimately improve patient care. TRS Healthcare points out that NLC licensure can prove quite cost-effective for nurses, too, specifically when compared with individually securing and renewing several different state nursing licenses.
Considerations for the Nurse Licensure Compact
It is crucial to consider the various limitations of the NLC as well as its many benefits. For example, it may prove difficult for NLC licensees to secure licensure in a non-compact state because those states often have radically different requirements. Below are just a few common questions and nuanced concerns that nurses might have about obtaining and maintaining multistate licensure.
State-Specific Laws and Regulations
While the NLC allows nurses to practice in multiple states, those nurses must adhere to all relevant laws and regulations in the state where the patient is located at the time of care. This can be tricky to sort out, particularly for travel nurses and telemedicine nurses. However, it is imperative that nurses fully understand the advisable nursing practice acts and established scope of practice regulations that affect them in different states.
Disciplinary Actions and Reporting Requirements
The NLC is firmly committed to facilitating seamless communication among government agencies and healthcare organizations in all its member states. This allows nurses in good standing to begin working in a new state almost immediately.
With this in mind, nurses with a spotty professional history might find it difficult to hide their poor work record by moving to another state. In fact, disciplinary actions in one state are likely to impact a nurse’s licensure in all NLC states; therefore, it is critical to faithfully adhere to NLC reporting requirements and stay free of all professional reprimands and demerits.
Continuing Education and License Renewal
Reporting regularly and keeping a clean record isn’t all nurses must do to maintain their licenses. Each state has its own continuing education (CE) requirements and license renewal processes. Additionally, NLC licensees must meet these requirements and follow these processes like any other nurse who practices in the state. Nurses practicing in more than one state should carefully research relevant CE matters and remain well-prepared for all renewal deadlines.
Telehealth and Remote Practice
Given the profound implications of the NLC for nursing telehealth and remote practice outlined above, it is essential to successfully navigate the regulations that govern the telehealth practices of each state in which you intend to provide care.
Learn About the NLC in the Comprehensive Nevada State University RN to BSN Program
A better understanding of the NLC is just one of countless benefits of the RN to BSN online program at Nevada State University. To request more information about earning your online bachelor’s degree in nursing, contact us through our program page today.