Exhaustive Guide to Nurse Compact States & RN License Reciprocity

This nurse travels and works in compact statesObtaining your license as a nurse can be complex. 

For good reason, there are many verifications, testing, and certifications you need to complete before you are allowed to practice as a nurse. 
 
But once you’re verified by your home state, you should be allowed to practice all throughout the United States, right? 
 
According to the system we have now, no. 
 
If you are licensed as a nurse and you move to another state, you actually have to go through the complexities (and expenses) of licensing all over again.
 
Unless both states are members of the Nursing Licensure Compact, also called the NLC. 
 

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What is the Nursing Licensure Compact?

The NLC is a multi-state agreement that allows nurses to practice in any participating state. The public can receive care that is overseen by guidelines developed by all participating states. With advanced regulatory oversight, patients have access to safe nursing care, either in-person or electronically, as long as they are in any of the participating compact states. 
 
Think of it this way: when you earn your driver’s license, the privilege to drive a motor vehicle is honored in all states. You still have to drive within the laws of each state, but you don’t have to verify your skills as a driver every time you cross state lines. Within nursing compact states, the NLC is very similar to this principle. 
 

Benefits of the NLC

The NLC is one of the most popular and widely supported compacts in the country. In fact, there are dozens of organizations that officially endorse the compact, including the National Patient Safety Foundation, the National Military Family Association, the American Organization of Nurse Executives, and the National League for Nursing. 
 
The benefits of this compact are widespread. It enables nurses to move across the country and remain in their profession without obtaining additional licenses, but it also allows nurses to quickly move across the states to provide critical disaster care and other emergency services on a short notice. 
 
It also helps in facilitating nursing education, and makes practicing across state borders more affordable and convenient. It removes expenses for organizations that employ nurses, which can in turn result in less expensive care for patients. 
 

How the NLC Works

Nursing licensure is organized by two categories: single state licenses and multi-state licenses. States participating in the NLC are often called “compact states.” Nurses residing and licensed in a compact state are eligible to acquire a multi-state license, which allows them to practice in any other compact state, without the hassle of additional licenses or fees. 
 
Once a multi-state license is issued, a nurse’s home state license is accepted in any participating compact states. If a nurse’s primary state of residence is not a compact state, that nurse must apply for a single-state license and pay any required fees and application costs. Essentially, the NLC helps nurses practice their important skills with less paperwork and more mobility, creating greater efficiencies while maintaining the high standards of American care. 
 
After earning your first license, following licenses are obtained by completing an application for license by endorsement. Sometimes new nursing graduates are told this is called “transferring,” but the term “endorsing,” is more accurate. 
 
The NCLEX, (National Council Licensure Examination) is a standard test that is used nationally for testing, including RN licensure. Because it is a national exam and not a state exam, you can take the test at any convenient location. The results of this test are sent to the board of nursing where you applied for your initial licensing. 
 
There are 25 current NLC member states:

  1. Idaho
  2. Montana
  3. Utah 
  4. Arizona
  5. New Mexico 
  6. Colorado
  7. North Dakota
  8. South Dakota
  9. Nebraska
  10. Texas
  11. Iowa
  12. Missouri
  13. Arkansas
  14. Wisconsin
  15. Kentucky
  16. Tennessee
  17. Mississippi
  18. Maine
  19. New Hampshire
  20. Rhode Island
  21. Delaware 
  22. Maryland
  23. Virginia
  24. North Carolina
  25. South Carolina
     

How to Apply for a Multi-State License

If you are qualified, getting your multi-state license is practically as easy as acquiring a driver’s license. The first step is to doublecheck that your state is a current member of the Nursing Licensure Compact. You can do this by first visiting the NCSBN website and scrolling down to see the list of current compact states.
 
If your state is a compact state and you are eligible, you can apply and become licensed with a multi-state license. You’ll be issued a multi-state license, which allows you to practice your skills in any of the compact states.
 
If your home state is an NLC state and you have a RN state license, or another form of nursing license, you can start the process for application for a multi-state license. If you’ve moved a lot and you’re not sure what state is your home state, it’s most often the state where you hold your driver’s license. 
 
Many students are trained and earn their nursing degrees in states that are different from the state where they will practice their careers. This is perfectly fine, but it’s important to research the licensing requirements for a state registered nurse in your home state, not the state where you earned your degree. Both may be compact states, but the individual licensing requirements are probably different. 
 
If your state is one of the compact states, you may be eligible for a multi-state license. However, you will need to meet at least three requirements: 
  • Apply for licensure by examination
  • Receive authorization to test, also known as ATT, in that state
  • Pass the NCLEX
  • Meet state licensure requirements
     
If you meet all of the above steps, you should be able to apply for a multi-state license. Applying for the compact license will not require additional application for licensure because the license in your home state is valid among all compact states. As long as your PSOR does not change, you are eligible to practice in all compact states.
 
However, if you reside outside of the compact, you will have to apply for single-state licenses wherever you go, using the appropriate board of nursing to receive licensing in each state. 
 
But what happens if you are applying for licensure while waiting on a pending job offer? In this case, the initial application for your license should be to only one state. If you need additional licensing in a non-compact state, you can apply for licensure by endorsement in another state after receiving your initial license. 
 

Moving Between Compact States: The NLC in Action

Here’s a perfect example of how the multi-state license is designed to work. Suppose you are a practicing nurse with full licensure in Raleigh, North Carolina. In the coming year, you will be moving to Richmond, Virginia. In this case, you’re in luck, because both states are members of the Nursing Licensure Compact, making your transition virtually seamless. 
 
However, there are a few changes you need to make before your move. Because you are moving to a new state, you need to learn the process of applying for licensure for endorsement in your new state, in this case, Virginia. Start the application in Virginia as soon as possible. The North Carolina nursing license will only be eligible for a short period, usually about a month after you move, and the new state licensing can take longer. Therefore, it’s important to get started as soon as possible.
 

Moving from a Compact to a Non-Compact State

If you currently live in a compact state but plan on moving to a non-compact state, you will unfortunately lose your privilege to practice in multiple states. You will lose your multi-state license. 
 

What if I Live in a Non-Compact State But Plan on Moving?

 Let’s say you live in a non-compact state such as Indiana, but you plan on moving south across the Ohio River to Kentucky, which is a nurse compact state. Are you eligible for a multi-state license? 
 
In this case, you’ll want to start the application process as soon as possible so you can become licensed in your new state of Kentucky. However, you will not be issued a multi-state license within the Nursing Licensure Compact until you establish residency in the Bluegrass State. Basically, because you are currently not licensed in a compact state, you need to move to Kentucky, establish a Kentucky nursing license, then apply for the multi-state license. 
 

The Enhanced Nursing Licensure Compact

In 2015, the Nursing Licensure Compact was updated into the Enhanced Nursing Licensure Compact, or eNLC. This new addition to the NLC is designed to further enhance access to quality care while maintaining convenience and simplicity for nurses. 
 
With the new eNLC, nurses are able to provide care to patients in all the participating states, once again without having to obtain additional licensing. Nurses who already have a multi-state license within the NLC will be grandfathered in, but new applicants in compact states will need to meet specific requirements to stay eligible. These requirements include test like an English-proficiency examination.
 

Key Provisions of the Enhanced NLC 

The eNLC provided some additional changes to the overall program. While many of the rules and guidelines of the existing NLC were kept the same, the new version added key provisions that address issues such as eligibility requirements and future rule making. 
 
Minor changes to the NLC included adjustments to the eligibility and uniform licensure requirements for the multi-state license. It also added a grandfathering provision to enhance efficiencies and allow some nurses to continue practicing uninterrupted. It also allows the party state licensing board to obtain and submit criminal background checks, which was previously not a part of the compact. 
 
One of the biggest changes came in Article VII, which establishes a governing body as a public agency. This agency, known as the “Interstate Commission,” now holds much of the responsibility for overseeing the compact moving forward. 
 
Perhaps the most important changes and provisions for the eNLC came to Article VIII, which addresses rule-making. The new provisions allow rules to be adopted directly by the Interstate Commission. These rules are legally binding in all compact states. There is no requirement that rules be ratified or adopted by individual states, which should increase efficiencies. The provision allows for many different requirements, such as notification to the public for any rule changes. It requires the opportunity for comment, public hearing, and consideration. It also requires voting upon proposed rules, and requires responses to comments that are received. 
 
To make the NLC more effective, the new provisions also improved the dispute resolution process. In the event that no resolutions are possible, the eNLC set up means of termination from the NLC. It also clearly defines the method through which a state can enter into the compact, or withdraw if desired. 
 
So what does all of this mean to nurses working the floor? It means that the NLC has been improved and made more efficient and less cumbersome. It also means that regions that are not compact states may soon be more enticed to join. If you’re not in one of the compact states, it may be only a matter of time until your state adopts the NLC. 
 

Common Myths About the NLC

Unfortunately, there are a few common misconceptions about the NLC. But with the right information, you can be fully informed on this important legislation. 
 
One of the most common myths is that a nurse holding a license in a neighboring state can work in a bordering state. However, just because the nurse is licensed in their state does not automatically qualify them to work in a bordering state. It’s not the borders that matter, it’s participation as a nursing compact state. For example, a nurse in Illinois could not move one to Missouri and work under their license, as Illinois is not a participating state. However, a nurse in Arkansas, which also borders Missouri, is an NLC state and therefore nurses would qualify if they move between these bordering states. 
 
Another misconception is that if a facility is located in a compact state, a nurse who moves from a compact state to this facility must obtain an in-state license within 30 days of their employment. The truth, according to the NLC’s “What Nurses Need to Know” fact sheet, is “the nurse can practice on the former license for up to 90 days, which starts when the new state determines that the nurse is a resident of the state.” Some states, however, are in the process of implementing an amendment that allows a nurse to practice with their old license for either 30 or 90 days, depending on the current status of the rules. 
 
You may also hear that as a grad, you are required to apply for your initial license in the state where your nursing program is located. This is not true either. The location of your school or training program is not what matters, it’s the location of your work. So if you train in Arizona but will practice nursing in New Mexico, you need to become licensed in New Mexico. In this case, New Mexico is the state where you apply for licensure by exam and the ATT. By the way, this same principle applies for non-compact states; you need to become licensed in your state of residence, regardless of where you were educated. 
 

Important Definitions in the NLC

Let’s face it, the NLC is a government legislation, so it tends to include complex legalese and wording that people rarely use in regular conversation. Because of some of the wording and phrases, misunderstanding the NLC’s rules can be common. To make understanding the rules of the NLC easier, we’d like to elaborate on a few important definitions: 
 
Compact: This is an agreement between two or more governments, which in this case are state governments. In most cases, the goal of the compact is to address a particular concern, enhance efficiencies, or establish a strong partnership. 
 
Compact State: Any state that participates in the Nursing Licensure Compact.
 
Home State: The state that serves as your primary residence, usually the one in which you have your driver's license. 
 
Remote State: Essentially, this is a compact state that is not your home state. In the case of a nursing, this is a state where you practice nursing services that is not your home state. 
 
Primary State of Residence: This is the state where you declare your primary residency. To verify your primary state of residency, you will have to use sources such as a driver’s license, federal income tax return, or voter registration forms. 
 
Nursys: You will see this term used often in the Nursing Licensure Compact. This is the database used by the compact to provide licensing and disciplinary information on all RNs and LPN/VNs . The information is contributed by participating states. The public has access to information on Nursys and can look up a nurse’s licensing and discipline status for free. 
 

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