The nursing profession continues to expand, giving clinicians even more choices to grow their careers. One of the ways nurses have been able to find new career opportunities is with the Nurse Licensure Compact (NLC), an agreement between participating U.S. states that provides a more rapid, streamlined process for nurse licensing. Through the NLC, nurses can get licensed to work in states outside of their home base, allowing them to discover and apply for travel nursing jobs across the country.
First enacted in 2000, the Nurse Licensure Compact gives nurses opportunities to practice across state lines. The compact has revolutionized the nursing profession, providing much-needed personnel during times of high need. By allowing nurses to practice across state lines, healthcare facilities of all kinds can choose from a much larger pool of qualified professionals to ensure patient access to quality care.
In 2018, the NLC amended the original agreement, adding a more uniform licensing process and background checks for all nurses. This further secured the importance of the compact and encouraged more states to join.
The NLC’s main goal is to simplify the licensing process, helping nurses better navigate what used to be a complex and time-consuming process for obtaining multiple state licenses. Now, nurses can apply for a single multistate nursing license in their home state. Once approved, they have the privilege to practice nursing in all participating compact states.
Though the compact has yet to be implemented in all 50 states, the idea of a nationwide compact is more than feasible, with 70% of nurses supporting their state joining the NLC.
The NLC has removed barriers and created what many call “borderless” practice, and the compact has become widely supported by state hospital associations and healthcare facilities in every state where the NLC has been enacted. In addition, the nursing compact is supported by the U.S. Chamber of Commerce, the National Military Family Association, the American Telemedicine Association (ATA), and many other prominent agencies and organizations across the country.
As of now, there are 41 states and U.S. territories that are part of the Nurse Licensure Compact, including:
*Only has partial implementation. Nurses with a multistate license who reside outside of the state or territory can practice nursing in-person or via telehealth within the state or territory. Nurses who reside in the state or territory, however, will not be able to obtain multistate licensure until full implementation.
Currently, the states that are not part of the NLC are:
Several states that do not participate in the NLC are in different levels of approval in their respective state legislatures:
The NLC is currently available to registered nurses (RNs), licensed practical nurses (LPNs), and licensed vocational nurses (LVNs). While the agreement does not specifically cover advanced practice licenses, it still provides benefits for advanced practice registered nurses (APRNs), certified registered nurse anesthetists (CRNAs), and certified nurse midwives (CNMs) who have RN degrees.
To begin the process for compact state nursing licensure, nurses must meet certain eligibility requirements, including a degree from an accredited nursing school/program and a passing score on the NCLEX-RN (National Council for Licensure Examination for Registered Nurses)—or the NCLEX-PN for licensed practical nurses.
Once an NLC application is complete and the necessary fees* have been paid, the state’s nursing board will review the application. Keep in mind that processing times vary, with applicants typically receiving a decision within a few weeks to several months.
Once an application is approved, qualified nurses receive their compact nursing license. However, it’s important to note that while the compact license grants nurses the ability to practice in multiple states, they must still adhere to the laws and regulations of each individual state where nursing care is being administered.
*Fees can vary depending on the state, so it’s important to check the specific requirements for the state you are applying to.
Each compact state may have other requirements that must be met, such as specific continuing education units (CEUs) or proof of competency. It's always best to check in with the nursing board or licensing authority in the state to get the most accurate, up-to-date information on specific processes and requirements.
Not only does obtaining a multistate license open doors to new opportunities for travel nurses, but it can also create the kind of lifestyle travel nurses want to live. Some of the major benefits of a compact nursing license include:
Nurses who are interested in working with different patient populations or facilities can use the NLC as a stepping stone to new career opportunities across the country. With a multistate nursing license, travel nurses can find jobs in participating states and start working without delays or additional paperwork.
By obtaining an NLC license, nurses can move between participating states with ease, making a travel nursing career more attainable. Most NLC states have a very easy process to transfer from state to state, with some offering temporary licenses within 24 hours.
The cost to join the NLC is currently a one-time fee of $375 for a permanent license, or $475 if the applicant also wants an accompanying temporary license. In addition, there are no annual licensing renewal charges in the nurse’s home state. When compared to applying for individual state nursing licenses—which range from as little as $10 for a temporary license to as much as $375, plus renewal fees—the savings associated with joining the compact really add up.
By simplifying the process for qualifications and background checks, the compact greatly reduces administrative overhead. Processing times for individual states can vary dramatically, with some states offering temporary licenses in 48 hours to a matter of days. However, there are longer processing times in other locations that can span weeks and even months. By choosing to join the NLC, travel nurses can save considerable time, especially compared to the time it would take to apply separately to each state.
The COVID-19 pandemic dramatically accelerated legislation for telehealth services. By allowing nurses to practice across state lines with a compact license, access to much-needed care can happen via telehealth services. While many saw this as a one-time expansion of healthcare, the trend is moving toward even greater access to these kinds of services.
The future of the NLC holds several potential developments and considerations as the healthcare landscape and nursing profession continue to evolve. Many experts see a bright future for the compact, with continued expansion to more states and territories, as well as additional areas of focus, such as:
To address emerging needs across the healthcare spectrum, a streamlining of administrative process, enhanced data-sharing mechanisms, and accommodations for further outreach to rural areas will likely precipitate increased measures and advances for practicing telehealth across the states that are part of the NLC.
Currently, many states have different levels of continuing education that multistate nursing license holders must be aware of. One opportunity the compact presents is room for an educational system that allows nurses to complete courses that will apply to all NLC member states. The NLC realizes that keeping up with individual state mandates for CEUs is cumbersome for clinicians, which is why one of their future goals is to have a more streamlined approach to educational requirements.
The scope of practice regulations varies from state to state, but the future of healthcare can benefit dramatically from uniformity in standards, which is what the compact seeks to address. This could also help simplify the process for nurses who travel across state lines to work.
Ensuring consistent quality of care and patient safety will remain a top priority for all compact states. Future developments with NLC requirements and regulations could involve enhanced oversight and quality assurance mechanisms to maintain the integrity of the compact.
As nursing shortages continue to occur every year, the importance of a flexible nurse workforce is integral to addressing not only disparities in care, but also equity and inclusion. Increased mobility through multistate licensure will help address these challenges across the spectrum of healthcare.
Addressing legal and ethical concerns, such as differing state laws and regulations, will remain important as nurses continue to practice across state lines. In the future, the NLC may establish clearer guidelines and resources for nurses to navigate these complexities.
The Nurse Licensure Compact is a great way for any nurse to achieve career goals. With an ongoing nursing shortage and continued expansion of compact states, the NLC is helping to make travel nursing a worthwhile solution for nurses looking for new opportunities and better work-life balance.
As a healthcare staffing agency with over 25 years in the travel nursing industry, TRS Healthcare can help you create an amazing career as a travel nurse. No matter what stage of your nursing career you’re in, our travel nursing recruiters can connect you with the kinds of opportunities that will help you achieve your something bigger. We have opportunities across the country, including great locations in Nurse Licensure Compact states.