Nurses with multistate licenses welcome to practice in participating states

As of this morning, the Enhanced Nurse Licensure Compact (eNLC) goes into effect in 29 participating member states, allowing RNs and LPNs with a multistate license to practice in eNLC states.

The applicable license grants these nurses the ability to treat patients in not only their home state, but in others participating in the program. (A full list of eligible and participating states appears at the bottom of this article.)

Nurses residing in a participating state (commonly referred to as “compact states”) are grandfathered into the eNLC, as long as they held a multistate license as of six months ago (July 20, 2017 to be precise) under the original Nurse Licensure Compact (NLC).

Of the 29 compact states, Florida, Georgia, Oklahoma, West Virginia, and Wyoming are requiring nurses who wish to obtain a multistate license to complete an application on their respective websites.

With the measure going into effect today, initially only 27 states ratified their participation. However, the governors of both Colorado and New Mexico signed off on the measure Friday morning, bringing the total to 29.

The eNLC’s widespread implementation gives compact states the ability to align their licensure requirements and assimilate all application prerequisites. This includes a full background and criminal check for applicants, regardless of their state of residence.

From a perspective of continuing education (CE) requirements, a nurse holding a multistate license must meet the CE requirements of his or her home state. For example, a nurse with primary state of residence in Florida holding a Florida multistate license would meet the CE requirements of Florida. Since a nurse may only hold one multistate license among compact states, renewal requirements are only related to the state that issued the multistate license. Should the nurse additionally hold licenses issued by non-compact states, each such state has renewal requirements which may also include CE.

(This ruling is in flux in many areas, and it is recommended that any interested nurse consult with the appropriate State Board of Nursing.)

“This opens a new and exciting era for nursing licensure,” said Sue Tedford, MNSc, APRN, RN, executive director, Arkansas State Board of Nursing, and Interstate Commission of Nurse Licensure Compact Administrators Chair. “The eNLC not only benefits nurses with increased mobility to practice, it also increases access to care for patients. Additionally, new provisions in the eNLC enhance patient safety.”

James Puente is the Director of the Nurse Licensure Compact, National Council of State Boards of Nursing (NCSBN). Mr. Puente told ADVANCE that the transition from the original NLC to the eNLC has been more than smooth. 24 of the 25 states in the original NLC have made the transition, with an additional five states joining in the meantime.

“That shows significant growth,” Puente said, “but more importantly, the revisions within the compact are removing the barriers that some states had to joining.”

As a result, Puente said eight more states are ‘pending’ or prospective members of the compact, with potential to come on board in the near future. If this comes to fruition, 37 of 50 states would be members—placing some pressure upon those states that continue to resist.

“I don’t think anyone would debate that we will have reached a tipping point, where more states are compact than not,” said Puente. “Consequently, the nurses of those states will begin to question why they aren’t in the compact.”

The goal, of course, is to make all 50 states compact. While it’s hard to put a timeline on such an achievement, Puente did express optimism that the trend will continue, and he looks forward to hopefully seeing at least 42-43 states on board within the next five years.

“But these things are unpredictable, as to when they will happen. We’re often surprised as to when these initiatives are introduced.” Puente admitted. “Just today, we learned about two more states that have taken up legislation. We weren’t expecting that.”

Statistically, the overwhelming majority of the profession favors the compact. Puente cited statistics derived from NCSBN surveys indicating that 96 percent of hospitals nationwide want their states to be in the compact, while 88 percent of nurses favor membership in their states.

“In any given state, there’s significant support for the compact,” he summarized. “If you see close to 90 percent of the states shaded as compact states, and the others aren’t… I think it will cause the nurses of those states to take a stand against why their state can’t join. It’s already happening in a number of states.”

For today, however, the widespread ratification is a victory—for Puente and NCSBN, for nurses in 29 states, but most of all for the millions of patients impacted in the present and future by this decision.

“With one license, nurses can now practice throughout much of the country,” Puente concluded. “This means greater access to care for patients, whether at staffing levels in a hospital, telehealth, or remote and rural healthcare. Nurses no longer have that barrier of applying for a license in each state in order to practice.”

Compact states include:

Arizona,

Arkansas,

Colorado,

Delaware,

Florida,

Georgia,

Idaho,

Iowa,

Kentucky,

Maine,

Maryland,

Mississippi,

Missouri,

Montana,

Nebraska,

New Hampshire,

New Mexico,

North Carolina,

North Dakota,

Oklahoma,

South Carolina,

South Dakota,

Tennessee,

Texas,

Utah,

Virginia,

West Virginia,

Wisconsin,

and Wyoming.

For more information on eNLC implementation, visit the National Council of State Boards of Nursing (NCSBN) website.