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Nursing Compact States: What Every Nurse Needs to Know

Learn what you need to know about the Enhanced Nursing Licensure Compact. Discover the advantages and drawbacks, along with licensure requirements, process, and eligibility.

A diverse group of medical professionals in a seminar, including a black female nurse with a stethoscope around her neck, smiling and engaged in a discussion with colleagues about the nurse licensure compact.

The US nursing shortage is a major concern in healthcare. As we’ve witnessed during the COVID-19 pandemic, the need for skilled nurses is absolutely imperative. But with state licensing laws and regulations, what happens in these critical times of need? Whether it’s pandemic hotspots or a natural disaster, emergency health situations often occur in specified geographical locations. Luckily, when there aren’t enough nurses to meet the need in one location, nurses from out-of-state can be called upon thanks to the nursing compact.

In the past, nurses who wanted to begin work in a state other than the one they were licenses in would have to jump through quite a few inconvenient hoops. However, with the help of the Enhanced Nursing Licensure Compact, moving across state lines no longer means having to obtain additional licensure. This not only helps nurses who want or need to travel, but it means that short-staffed facilities can make use of out-of-state nurses to help meet patient needs when faced with a critical situation. And being part of the compact isn’t just good for patients, it’s also great for nurses. Learn about the other benefits of compact nursing states, find out about the potential drawbacks, and see if your state is currently part of the compact.

What Are Nursing Compact States?

The Nursing Licensure Compact (NLC) was created in 2000 as an agreement between states to allow licensed registered nurses and licensed practical nurses to practice in multiple member states without having to complete the licensure process in each state.

By 2015, the NLC included 25 states but was replaced in 2018 by the Enhanced Nursing Licensure Compact (eNLC), which is more rigorous and includes additional standardization of rules and requirements. For instance, it wasn’t until the eNLC was enacted that applicants had to submit fingerprints for federal and state criminal background checks.

As of 2021, 33 states and several U.S. territories have enacted the eNLC. Numerous other states and territories are in different stages of implementation or have pending legislation.

Nursing Compact States: Official Members of the eNLC

As of July 1, 2021, 33 states have implemented the Enhanced Nursing Licensure Compact. This means that nurses working in these states can use their single multistate license to practice in both their home state and other states participating in the compact.

  • Alabama
  • Arizona
  • Arkansas
  • Colorado
  • Delaware
  • Florida
  • Georgia
  • Idaho
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Missouri
  • Montana
  • Nebraska
  • New Hampshire
  • New Jersey*
  • New Mexico
  • North Carolina
  • North Dakota
  • Oklahoma
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Virginia
  • West Virginia
  • Wisconsin
  • Wyoming

*New Jersey has partial implementation as of 3/24/20 in response to the COVID-19 pandemic.

States that have enacted the eNLC but have not yet implemented

  • Guam: This US territory will have implementation in 2022
  • Vermont: Implementation on February 1, 2022

States and territories with pending eNLC legislation

  • California
  • Illinois
  • Massachusetts
  • Michigan
  • Ohio
  • Oregon
  • Pennsylvania
  • Rhode Island
  • US Virgin Islands

The Advantages of Nursing in a Compact State

Living in a nursing compact state offers many benefits to nurses, their employers, and the patients they serve. The advantages of a streamlined process along with the flexibility a multistate license not only gives nurses more options but also increases the availability of healthcare and allows for easier sharing of medical expertise and information. Here are some of the major benefits you can expect as a nurse working within the compact agreement.

Ability to travel

Individuals working as travel nurses often face substantial challenges if they want to work in a non-compact state. Because nursing licensure requirements vary between compact and non-compact states, meeting all the requirements for an additional license can take months. Conversely, travel nurses working in compact states can easily transfer to a new location using their multistate licenses.

Help ease the nursing shortage

According to the American Association of Colleges of Nursing, a perpetual shortage of nurses is expected over the next decade. Some states will experience more acute shortages than others, creating opportunities for nurses to travel to states with critical shortages to provide care. States that have not implemented the compact may struggle filling gaps in a timely manner, which may dissuade some nurses from going through the additional paperwork and waiting.

Cross-state telehealth

As COVID-19 demonstrated, access to telehealth is critical in addressing health issues when in-person care isn’t possible or recommended. Nurses in states that enacted the eNLC can provide telehealth services to any of the 32 other compact states. In addition to creating much-needed access to care, cross-state telehealth also provides greater nurse mobility and helps address issues related to staffing shortages.

Uniform licensing requirements

The eNLC sets uniform licensing requirements. This set of standards means consistent nursing requirements that ensure patients receive the same levels of care regardless of the state they’re in. These uniform requirements simplify the process for bringing a nurse across state lines without sacrificing quality of care since nurses moving from one compact state to another can easily prove they are practicing within their scope of expertise.

Critical care services

Natural disasters such as wildfires, hurricanes, and flooding wreak havoc on communities with little warning. States participating in the eNLC can quickly and seamlessly welcome nurses from other compact states to help disaster victims. Whether providing wound care or ensuring displaced residents can access essential services like dialysis, the nursing compact provides an easy way for individuals to receive critical care quickly.

The Drawbacks of Nursing in a Compact State

Despite the many benefits of working in a nursing compact state, opponents of the program have legitimate concerns about the drawbacks. The differences and potential confusion arising from how each state uniquely approaches nursing need addressed if you want to work as a nurse in a compact state.

Differing state regulations

While the nursing licensure compact aims to make bridging the gap between patient care and location easier, regulations around scope of practice can still vary from state to state. According to the current rules of the compact, nurses are held to the laws laid out by the state in which they practice rather than their primary state of residence. This presents challenges for both nurses and healthcare facilities when determining regulatory requirements.

Confusion with practice location

If a nurse holds licensure in one compact state but provides telehealth services in another, questions arise around which state regulations should be followed. Should a nurse observe the statutes and regulations set out by their own state’s board of nursing or by the board in which their telehealth patient is located? This issue can become confusing, especially for nurses practicing telehealth in multiple states.

Different professional development standards

While the national compact addresses standards of education, patient care, and licensure requirements, it does have any mandates regarding continuing education. Each state currently sets its own requirements for how many hours nurses must complete before renewing their licenses. Some states have rigorous requirements, while others give little or no direction related to professional development.

Potential disciplinary issues

If a registered nurse or licensed professional nurse faces disciplinary action, this can sometimes be confusing for those whose work spans more than one state. If a nurse originally received his or her license in one state but faces a disciplinary issue in another, which nursing board has jurisdiction over the nurse? Questions such as these worry opponents of the nursing compact since no official answer currently exists.

Applying for Multi-State Nursing Licensure

Applying for a multistate license is typically quite straightforward if you meet all eligibility requirements. If you are unsure whether your current state and/or the state you plan to move to is part of the nursing compact, check with the National Council of State Boards of Nursing. Regardless of where you live, go through your state’s board of nursing to gain licensure. We review the eligibility requirements and application steps in detail below.

Eligibility requirements

To receive a multistate license and practice in compact states, nurses must meet a variety of eligibility requirements. Those include:

  • Reside in one of the compact states and claim it as your legal residence
  • Graduate from a board-approved nursing education program or international education program that has been approved by an authorized accrediting body and verified by an independent credentials review agency
  • Take and pass an English proficiency exam if from an international education program not taught in English
  • Hold an active, unencumbered nursing license
  • Submit both state and federal criminal background checks
  • Have no state or federal felony convictions
  • Have no misdemeanor convictions related to the practice of nursing
  • Self-disclose current participation in an alternative program
  • Have a valid United States Social Security Number

Navigating the application

After meeting all the eligibility requirements, you can apply for your multistate license. Begin by visiting your primary resident state’s board of nursing and select the application for a multistate license. Depending on your state, you may need to provide a mailing address or copy of your driver’s license, voter ID, or federal income tax returns showing proof of residency.

After applying, you must supply fingerprints and pass a background check. Fees for this process are in addition to your multistate license application fee. Your application should be approved and your multistate license sent to you after several weeks.

How to Get Moving: Relocating to or From a Compact State

Nurses often move states throughout their careers. Licensing rules vary based on whether you are moving to and/or leaving a compact state. A relocation is seen as an indefinite move where you will live in a new, permanent residence. It does not apply to travel nurses with short-term assignments. Applicants need a permanent address reflected on their driver’s license when applying and to apply for licensure by endorsement. Common moving scenarios and how to handle them are addressed in the next section.

Common moving scenarios for nurses

The scenarios below are the most common for nurses entering the compact. Use them to develop a game plan for your potential move.

  1. Moving from a non-compact state to a compact state

Because your single-state license from a non-compact state cannot transfer to your new place of residence, you need to apply for licensure by endorsement. This involves the state board of nursing assessing whether you meet the academic and experiential requirements set by that state, so plan for it to take a few weeks. You cannot receive your new license until you officially move to the new state, so you might be out of work temporarily while waiting.

  1. Moving from a compact state to a non-compact state

Nurses who currently live in a compact state but plan to move to a non-compact state must apply for licensure by endorsement. While this can be done before you move or after you arrive, prepare to wait a few weeks before your new license arrives. Your previous compact license will revert to a single-state license issued by your previous state’s board of nursing.

  1. Moving from one compact state to another compact state

While you will still need to apply for licensure and endorsement when moving from one compact state to another, you can practice with the license issued in your previous state until you receive your multistate license. The application requires legally declaring yourself a resident of the new state by updating your driver’s license and vehicle tags, changing your voter registration, and updating your mailing address.

  1. Moving from one compact state to another compact state

While you will still need to apply for licensure and endorsement when moving from one compact state to another, you can practice with the license issued in your previous state until you receive your multistate license. The application requires legally declaring yourself a resident of the new state by updating your driver’s license and vehicle tags, changing your voter registration, and updating your mailing address.

Less common moving scenarios

Some nurses looking to take advantage of the compact have more unique situations to navigate. While these scenarios are less common than those described above, they are still important to be aware of.

  1. Nurses who commute across state lines for work

If you live close to a state line, you may live in one state and work in another. If this is the case, you’ll need a nursing license from the state in which you live since it is considered your primary residence.

  1. Military spouses participating in the nursing compact

Military spouses who are nurses may need to change jobs more frequently since members of the military often move during their service tenure. If you previously lived and worked in a compact state and move to another compact state, you can continue practicing for as long as your spouse is stationed in the new state without applying for a multistate license. If you register to vote or get a driver’s license in the second state, however, you need to apply for a multistate license.