Nurse licensure is an idiosyncratic beast, and many American nurses struggle with the fact that obtaining a license in another state can be a laborious process.
Innumerable nurses are unaware of the fact that the Nurse Licensure Compact (NLC) has been in existence for years. The NLC allows registered and practical/vocational nurses living and working in 24 member states to move among those jurisdictions without having to apply for a new license. Those who are lucky enough to live within the NLC system enjoy much greater freedom of professional movement than those living in the other 26 states that have yet to join.
In terms of advanced practice nurses, the Compact expects APRNs to be brought into the NLC some time in 2016.
With continued shortages of nurses in certain regions of the country, it would behoove our healthcare system to be more flexible, allowing nurses to have the greatest possible freedom to go where their help is needed most. Thus, this begs the question if the NLC should be aggressively expanded.
The structure of the NLC
As of this writing, 24 states belong to the NLC. According to the NLC website, another four states have pending legislation regarding the NLC (all bills currently inactive):
National Council of State Boards of Nursing
If a nurse with license in an NLC member state permanently relocates to another NLC member state, he or she is still required to apply for licensure in the new state. However, such nurses face no obstacles to immediate employment in their new state of residence.
How do we benefit?
The Nurse Licensure Compact creates an environment in which nurses can move among member states without the need for licensure issues that hinder timely, gainful employment. Thus, nurses in NLC states are allowed the latitude to pursue work as they see fit, released from statutory limitations that are unnecessarily restrictive for nurses in non-NLC states.
Patients benefit from the NLC due to the fact that nurses are able to pursue work in areas of the country in the greatest need of qualified healthcare workers. Benefits for healthcare facilities include the greater availability of qualified licensed nurses. Meanwhile, one can only assume that patient outcomes are positively impacted by such increased flexibility of nurse employment.
A nimble, mobile workforce for the 21st Century
With the rapid aging of the American population and regional demographic shifts occurring throughout the country, the need for a nimble, mobile healthcare workforce has never been more important, and the NLC contributes to the fulfillment of that need.
Additionally, economic shifts can occur at any given time in various regions, and nurses' ability to follow those shifts is paramount, both for their personal finances and for the healthcare needs of specific states or cities.
And when it comes to disasters, emergencies and other urgent demands for medical personnel, it is in the interest of the healthcare industry to allow nurses the greatest possible mobility with the least possible licensure restrictions.
To Compact or not Compact: Is that the question?
As noted above, the NLC offers many advantages to patients, nurses and healthcare facilities, as well as the overall healthcare industry.
With a growing shortage of primary care physicians, this type of licensure flexibility for advanced practice nurses is paramount. The addition of APRNs to the Compact will contribute powerfully to the alleviation of such physician shortages, in both the long and short term.
For nurses in non-NLC states, it would be advisable to consider beginning a conversation with state boards of nursing, as well as legislators who have the ability to influence the potential adoption of the Compact.
If we imagine a country wherein all 50 states have joined the Compact, we can foresee a healthcare climate within which nurses, physicians and other healthcare professionals are allowed broad latitude of movement in pursuit of employment. That latitude of movement holds great benefit for all concerned.
The time has come for an enlarged NLC, not to mention similar compacts for other healthcare professionals who are key to the robust performance of the American healthcare system.
