New Law Frees Some Nurses to Work Across State Lines

A sweeping change to nurse licensure rules implemented on Jan. 19, 2018 makes it easier in some states for nurses to transfer to other states and to practice telehealth across state lines.

As of the implementation date, 29 states (see list below) had approved the Enhanced Nurse Licensure Compact (eNLC). In states where this new rule applies, nurses who obtain licenses also can apply for multistate licenses, which would give them the freedom to practice in any A list of the states allowing nurses to practice across state lines.participating state.

An additional eight states had pending legislation to approve multistate licensing as of the implementation date. Pending states were Illinois, Indiana, Kansas, Massachusetts, Michigan, New Jersey, Rhode Island and Vermont.

According to the National Council of State Boards of Nursing (NCSBN), registered nurses (RNs) and licensed practical/vocational nurses (LPN/VNs) can now have one multistate license that permits them to practice in their home state, and also opens up doors to practice telehealth within the 29 states in the Compact.

The eNLC applies only to RNs and LPNs/LVNs, so advanced practice nurses (APRNs) are not yet eligible. However, an APRN Compact will go into effect once 10 states have joined – so far, only three are members.

In an interview with the Tallahassee Democrat, Florida Surgeon General Dr. Celeste Philip said multistate nurse licensing will reduce “regulatory burdens on nurses with the goal of increasing patient access to quality nursing care.”

An ongoing nationwide shortage of nurses contributed to this decision. The United States Bureau of Labor Statistics projects that the country must produce 1.1 million new RNs by 2022 in order to make up for increased demand and an estimated 500,000 nurse retirements by then.

Now that nurses can be licensed in multiple states, they will be able to assist with natural disasters in other states and provide telehealth consultations for patients in Compact states. The new rule also removes a potential procedural obstacle for nurses who choose to relocate to Compact states – the multistate license is transferable from one Compact state to another.

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

Nurses who already hold an original NLC license have been grandfathered into the eNLC program if they had that license as of July 20, 2017. Any nurse living in the states that just joined the eNLC – Florida, Georgia, Oklahoma, West Virginia and Wyoming – who wish to get a new eNLC license must submit the application on their state board of nursing sites.

According to a 2014 NCSBN survey, 80 to 90% of nurses want their state to join the compact, and more than 90% of employers support it as well. Standards apply to all participating states, and all nurses are required to get a federal and state criminal background check.

The main opposition to this compact came from nurse union organizations, according to the NCSBN.

The original NLC compact, formed in 2000, consisted of 24 member states as of 2010 but it did not have a uniform requirement for background checks. The eNLC improves on that, giving states who had objections to joining a way to remove those barriers. The eventual goal is to have all states join this compact.

Nurses who wish to apply for this license should note that all applicants are required to have passed the NCLEX RN or NCLEX LPN exams, or the state board test pool exam. Nurses must also declare primary residence in one of the compact states.

Additional info on the eNLC can be found on the NCSBN site.

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