What Are the Nursing Compact States?

• Nursing compact nursing states is a term that refers to the Nursing Licensure Compact (NLC) and is known as an agreement among states that allows Registered Nurses (RN’s) and Licensed Practical Nurses (LPN’s) to have one license but the ability to practice in several states if the states participate.  
• There are currently 39 states that participate in the Nursing Licensure Compact agreement. 
• Various benefits of the Nursing Licensure Compact include career advancement, flexible job opportunities, less licensure fees, and telehealth capabilities. 

Nursing is an incredibly rewarding profession and can offer many opportunities in various geographical areas due to the Nursing Licensure Compact states (NLC) since in the past some nurses have been limited to a specific location or state due to their nursing license only being valid in one state.   

With the Nursing Licensure Compact, it allows a nurse to relocate to another state and practice without the extra hassle of receiving a new RN license for that specific location.  This idea serves as the principle behind nursing compact states and is worthy of closer consideration.   

The following are important to consider when discussing compact states: 

• What are the nursing compact states? 
• Why are compact states important for nurses?  
• How does the nursing compact benefit the healthcare system? 
• What are the drawbacks of nursing in compact states?  

Nursing Compact States

Nursing compact nursing states is a term that refers to the Nursing Licensure Compact (NLC) and is known as an agreement among states that allows Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) to have one license but the ability to practice in several states as long as the states participate.   

 If a nurse is a legal resident in a compact state, the nurse can practice nursing in any of the other enhanced nursing compact states without having to get a new license to practice in other states.   

The following is a list of the current states participating in multi-state compact licensing as of February 2022.   

There is a total of 39 and they are listed below: 

• 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 *awaiting implementation 
• Oklahoma  
• Pennsylvania  *awaiting implementation 
• South Carolina  
• South Dakota  
• Tennessee  
• Texas  
• Utah  
• Vermont 
• Virginia  
• Virgin Islands  
• West Virginia  
• Wisconsin   
• Wyoming  

The following states are currently not a part of the agreement regarding compact states, nor do they have any legislation that is currently working on the agreement: 

• California 
• Nevada 
• Oregon 
• Connecticut 

Some states may be hesitant due to different professional development standards such as continuing nursing education, different licensure and disciplinary standards, interference with oversight of state nursing boards regarding verification of licenses, tracking licenses, and coordinating disciplinary actions.  

Some states argue that losses from state revenue may be a factor to not be a part of the compact states.

Benefits to the Healthcare System

Nurses definitely reap the benefits of compact states, but the healthcare system does as well due to the professional mobility that is typically afforded since more nurses are able to work in various environments in various states. 

With the healthcare system having professional mobility, nurses should be able to have the advantage of not experiencing excess stress over being on the frontlines when tragedy, emergencies, and pandemics occur.   In situations such as these, nurses that have the capability to work in multiple states can be a huge assistance to those in other states undergoing tragedies, emergencies, or pandemics. 

Also, many have heard the importance of telehealth and the nurses that are able to use cross-state nursing licenses due to the Nursing Licensure Compact can actually serve as a telehealth nurse without having to obtain additional licenses. 

Drawbacks of Nursing Compact States

While there are many advantages of implementing nursing in various compact states, there are some drawbacks that must be considered.  The first drawback involves differing state regulations which focus around the scope of practice.   

According to certain rules of the compact, nurse are held to laws that are made by each state in which they practice rather than their primary state of residence.  As one can imagine, this presents challenges for both nurses and healthcare facilities when determining regulatory requirements.   

Another drawback involves confusion with practice location.  If a nurse holds licensure in one compact state but provides telehealth services in another, oftentimes questions arise around which state regulations need to be followed.  Should a nurse observe the regulations set forth by his/her own state’s board of nursing or by the board in which the telehealth patient is located?  The concept can become confusing, especially for nurses practicing in various states.  

The problem of different professional development standards can also be an issue since the compact does not have any mandates regarding continuing education.  Each state currently sets its own requirements regarding the number of hours that nurses must complete before renewing their licenses.  Some states have very rigid requirements while others have little or no direction related to professional development.   

The other drawback to compact states involves potential disciplinary issues as this can sometimes be confusing for a nurse whose work spans more than one state.  For example, if a nurse obtained his/her license in one state but faces a disciplinary issue in another state, which nursing board has the right to deem the necessary discipline to the nurse?  This scenario can be difficult and confusing without much guidance or official answers that exist for this potential drawback.   

The Bottom Line on Nursing Compact States

While it is evident that compact nursing states can have various advantages for nursing and healthcare in general, there are still some potential disadvantages that concern the states that have chosen to not be a part of the compact states yet.   

It is important for nurses to be mindful of the states that are a part of the Nursing Licensure Compact and those who are not in order to fully understand what nursing responsibilities they are able to participate in and perform based on each state.   

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