Nurse Licensure Compact: Pros and Cons for Nurses

• It is important for nurses to understand the advantages and disadvantages of practicing in a nurse licensure compact.
  
• There are certain states that participate in the nurse licensure compact and there are others that do not and it is important to be knowledgeable of this information. 
  
• Pros and cons of the nurse licensure compact are present and must be recognized in order to examine the benefits and negative aspects. 

The process of becoming a licensed registered nurse (RN) in the United States comes with a variety of advantages and disadvantages, depending on the state in which one practices.  One of the greatest factors that can affect a nurse’s experience is the compact state in which he/she is licensed. 

Compact states are those that have joined the Nurse Licensure Compact (NLC), which allows nurses who are licensed in one compact state to practice in any other compact state without having to obtain additional licensure.  

Advantages and Disadvantages of the Nurse Licensure Compact

Advantages  

One of the main advantages of being a nurse in a compact state is the ability to practice in multiple states without additional licensure.  This idea can be especially beneficial for nurses who are looking for travel nursing opportunities or who may want to relocate to a different state in the future.  It can also be beneficial for nurses who live near the border of a non-compact state and want to work in that state. 

Another advantage of being a nurse in a compact state is the potential for increased job opportunities.  As a nurse that has the capability to practice in multiple states, there may be greater demand for nurses in compact states, leading to a wider variety of job opportunities. 

Disadvantages  

There are also some disadvantages to being a nurse in a compact state, and one of the main disadvantages is that compact states may have less stringent licensing requirements than non-compact states.  Unfortunately, this could potentially lead to a lower quality of care for patients, as nurses in compact states may not have to meet the same standards as nurses in non-compact states. 

Another disadvantage of being a nurse in a compact state is that it may be more difficult to obtain licensure in a non-compact state if the nurse decides to relocate in the future.  The reason for this is because non-compact states may have different licensing requirements than compact states and nurses may have to go through the licensure process again if they want to practice in a non-compact state. 

If a nurse is not licensed in a participating state of the Nurse Licensure Compact (NLC), they will not be able to practice nursing in any of the other participating states without obtaining additional licensure in those states; unfortunately, this can limit job opportunities and make it more difficult to travel or work remotely.   

Additionally, not being licensed in a participating state may make it harder to obtain liability insurance or to be reimbursed for telehealth services.

Participating States in the Nurse Licensure Compact

Currently, there are several states participating in the Nurse Licensure Compact (NLC) in the United States. 

These states include the following: 

• Alabama 
• Arizona 
• Arkansas 
• Colorado 
• Delaware 
• Florida 
• Georgia 
• Guam 
• Idaho 
• Indiana 
• Iowa 
• Kansas 
• Kentucky 
• Louisiana  
• Maine 
• Maryland 
• Mississippi  
• Missouri 
• Montana 
• Nebraska 
• New Hampshire 
• New Jersey 
• New Mexico 
• North Carolina 
• North Dakota 
• Ohio 
• Oklahoma 
• Pennsylvania 
• South Carolina 
• South Dakota 
• Tennessee 
• Texas 
• Utah 
• Vermont 
• Virginia 
• Virgin Islands 
• West Virginia 
• Wisconsin 
• Wyoming 

The following states are not a part of the agreement of the compact states: 

• California 
• Connecticut 
• Nevada 
• Oregon  

Participating States in the Nurse Licensure Compact

Being licensed as a nurse in a participating state of the Nurse Licensure Compact (NLC) can have both pros/cons.

The pros include the following:

• Increased job opportunities:  Nurses who are licensed in a participating state of the NLC can practice nursing in any of the other participating states without obtaining additional licensure which can open more job opportunities and make it easier to travel or work remotely.
  

• Improved liability insurance:  Nurses who are licensed in a participating state of the NLC may be more likely to be able to obtain liability insurance at a lower cost.
  

• Telehealth reimbursement:  Nurses who are licensed in a participating state of the NLC may be more likely to be reimbursed for telehealth services.
  

• Convenience:  Nurses who are licensed in a participating state of the NLC may find it more convenient to renew their licensure or report changes to their information through their primary state of residence rather than through each individual state in which they practice. 

The cons include the following: 

• Poor oversight of the state nursing boards:  The issues of verifying licenses, tracking licenses, and coordinating disciplinary actions can be very limited due to the NLC.  
  

• Differing Professional Development Standards:  There is no uniform policy regarding continuing education which means that in some states, there may little to no professional development.  
  

• Differing Licensure and Disciplinary Standards:  There are enough differences between state standards that cannot be managed effectively.  If a dispute arises regarding a skill or judgment, which nursing board is going to manage the investigation and take action?   

The Bottom Line

It is important to note that the NLC is not available in all states and not all employers accept the multistate license so one must weigh the pros and cons based on one’s career goals, location, and employer’s preference.  It is also important to note that individual states can opt out at any time regarding participation in the Nurse Licensure Compact. 

The licensed nurse that works in a compact state can have both advantages and disadvantages, but it is imperative to be mindful that compact states may have less stringent licensing requirements and it may be more difficult to obtain licensure in a non-compact state in the future. Nurses should weigh the pros and cons carefully before deciding to become licensed in a compact state.

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