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Pros and Cons of Nursing Licensure Compact

In the United States, the Nursing Licensure Compact (NLC) lets nurses work across multiple states without the impediments of having to register and gain licensing in each state. This Licensure eradicates the need for renewal and fees in each state you wish to practice in.

If you are a registered nurse or an LVN/LPN, you might not want to stay in one place for work. If your state is a compact state you will be able to work in other states that have also enacted the compact state Licensure.

However, when applying for a license in your home state you can acquire a multi – state license which gives you the benefits of working in compact states. Have it in mind there are certain criteria you are expected to meet in order to apply for a multistate license.

First, you have to be a resident in a multi – state license state with an NLC state as your primary residence.  You will also need an active license as a registered nurse or LPN/LVN. Do not forget that you will have to meet any licensing requirements by your home state and when practicing in another compact state you need to adhere to the standards set out by that state.

In July 2018, the NLC was officially changed to eNLC and all states except Rhode Island joined the new program and adhered to the guidelines.

One of the underlying reasons why the NLC was changed to eNLC was that there were provisions in the original compact that some states didn’t like or weren’t there that some states wanted. Most of the states in the NLC are expected to adopt the eNLC.

Also note that the ability to work across state lines only applies to RN’s and LPN’s or LVN’s. At present there are no guidelines or legislation in place for APRN’s. The NCSBN have been striving to get a compact agreement in place but presently only three states have signed up for this and for it to become a legislation there needs to be 10 states signed up.

Howbeit, if your state has pending legislation or has recently joined eNLC, your State Board of Nursing will get in contact with you.

You will need to show proof of state residency for them to decide if you have compact state eligibility. In addition, if you are not due to renew your nursing license you don’t need to do anything as you will be issued with a new license if you meet the requirements for eNLC without any further cost to you.

The enhanced Nurse Licensure Compact (eNLC) has been in the news since its inception for so many reasons. However, what most people haven’t spent much time on are the reasons why the eNLC makes sense to some and is less than ideal for others. Here is a brief look at the Pros and Cons of having a National Nurse Licensing Compact.

Pros of Nursing Licensure Compact

State boards of nursing are known to issue nursing licenses in terms of state legislation, and a nurse may only provide nursing services to patients located within that state. Here are the Pros of the nurse licensure compact.

  1. Flexibility

Whether it is getting married or family circumstances that necessitate a move, the nurse licensure compact (eNLC) offers you the ability to speed up that process. A multi – state license afforded by the eNLC opens those doors. If the process turns out to be as seamless as it is supposed to be, having a multi – state license could become the unofficial standard.

  1. Streamlines licensure to employment

Note that before the nurse licensure compact was introduced, nurses were expected to apply for a license in each state where they wanted to work.

This was also the case in non – compact states, which is costly and time – consuming. There are fees for the license application, license verification, and a criminal background check. Then weeks or even months could pass before the license is issued.

  1. Employers can fill positions quickly

Have it in mind that under the NLC agreement, nurses can start work in any compact state right away. Employers and nurses can leverage advantage of this NLC provision and can get the right qualifications to fill a vacant position quickly.

  1. Rapid deployment of nurses

Without doubt, the NLC has been particularly beneficial for travel nurses who no longer need to obtain multiple licenses. It also allows for the rapid deployment of additional healthcare providers in the event of a disaster.

  1. Addresses nursing shortage

Under the NLC, nurses can also work in areas right across the border from where they live without having to apply for another license in the neighbouring state. Ideally, this can contribute to improved service delivery, especially in community health services in rural areas where there is often a shortage of nurses.

  1. Greater earning potential

The increased flexibility coupled with the increase in options and opportunities can only mean good things for your wallet. You will have more ways to leverage yourself and your skill set.

Cons of Nursing Licensure Compact

Above we talked about how awesome the Nurse Licensure Compact (NLC) is and how it could positively impact your career. The main concern among critics is that a national compact interferes with the oversight purposes of the state nursing boards regarding vetting licensees, tracking them, and coordinating disciplinary actions.

  1. It requires different state regulations and requirements

Have it in mind that every state has their board of Nursing. While the Enhanced Nurse Licensure Compact (eNLC) starts bridging that gap, it still doesn’t change the fact that there are some scopes of practices for nurses that can vary from state to state.

Note that as the compact is currently constructed, you’re legally held accountable to the practice laws of the state you’re practicing within, not necessarily your home state.

  1. eNLC vs. NLC

Just like it was mention above, before the eNLC there was the nurse licensure compact (NLC) which was started in 2000. Most of the states from the original NLC have enacted legislation to adopt the new eNLC standards. At some point, three states Colorado, New Mexico and Rhode Island failed to do so.

It simply entails that when the Enhanced Nurse Licensure Compact (eNLC) went live on January 19, 2018 nurses with a multi – state NLC license from those three states were expected to only practice within themselves and will be excluded from practicing in the Enhanced Nurse Licensure Compact (eNLC) States.

While these aren’t necessarily deterrents from attaining a multi – state license it is something nurses should keep in mind.

  1. eNLC raises questions about what defines practice location

In the United States, there is some confusion when it comes to telemedicine. If the patient and the nurse are in two different states, then what is the practice location?

Depends on who you ask! The American Nurses Association (ANA) and others believe it is the state where the nurse has their primary license while the National Council of State Boards of Nursing (NCSBN) believes it is the state where the patient is.

Conclusion

For now the eNLC seems to be a step in the right direction, and as hesitant states express concerns, it is clear that additional changes will be implemented.

Each of the states that are yet to take action regarding eNLC have their own reasons internal to their state legislatures. Presently, more than 2 million nurses in the US have multiple state licenses which allow them to practice in other NLC states.

NLC staff is actively working with non-compact state boards of nursing to achieve the goal of one state-based license, enforced locally and recognized nationally, in all US states and territories.