By: Kathleen Frisbie, MSN, RN, Faculty
In order to practice as a nurse, one must obtain licensure. The governing bodies which grant licensure are individual State Boards of Nursing. Licensure is the process by which boards of nursing grant permission to an individual to engage in nursing practice after determining that the applicant has attained the competency necessary to perform a unique scope of practice (More at: NCSBN – About Nursing Licensure). Each State Board of Nursing determines if an individual meets the criteria for licensure. Once eligibility for initial licensure is verified, the individual may seek licensure in their state of residence through testing. Across all U.S. jurisdictions, the national nursing licensure examination is the NCLEX (National Council Licensure Examination). This is a psychometrically valid examination designed to test minimal competency as a nurse. Passage of this exam indicates that the individual has the minimal competency needed to practice nursing safely. If the individual currently holds a nursing license and is seeking licensure in a new state, they may seek licensure by endorsement. Policies regarding licensure by endorsement vary from state to state. Those seeking licensure by endorsement must contact the appropriate state board for regulations.
Licensure by endorsement requires the individual to complete an application to the state board of nursing in which they are seeking licensure. The individual must possess equivalent credentials and qualifications as those seeking the same licensure by examination. The individual must have graduated from a nursing program approved by the state board of nursing and hold a license with no restrictions. Some states require specific continuing education requirements as well as holding an unencumbered license. Most states also require the individual to pass a criminal background check.
Another consideration in determining whether you need to seek licensure in another state is the Nurse Licensure Compact. The Nurse Licensure Compact allows nurses to hold licensure in their home state but practice in other states without obtaining another license. Not all states belong to the compact so it is important to determine if the state you want to work in belongs to the compact. Currently there are 24 states in the Nurse Licensure Compact. The list of states can be found at NCSBN – Nurse Licensure Compact (NLC) States.
Licensed nurses are eligible for a multistate (compact) license if: 1. they legally reside in a compact state; 2. hold a current RN or LPN license in good standing; 3. declare a compact state as their primary residence. It is important to note that licensees must abide by the practice act in each state. Therefore, it is imperative to review the practice act for whatever state work is done. To assist individuals in determining the process for seeking multistate licensing a flowchart demonstrating the process can be found at NCSBN – Navigating the Nurse Licensure Compact: Licensure by Endorsement.
What happens when a nurse moves to another state? If the current primary state of residency is a compact state and the new state is also a compact state, then the nurse can practice on the former residency license for up to 30 days. After the 30 days, the nurse is required to apply for licensure by endorsement, pay any applicable fees and complete a declaration of primary state of residency in the new home state, whereby a new multistate license is issued and the former license is inactivated. Proof of residency may be required. If the move is to a non-compact state, then the nurse must seek licensure by endorsement, pay any applicable fees and will be issued a single state license. The nurse is required to notify the former state board of nursing they are moving out of state.
There are definite advantages of the Nurse Licensure Compact. The most obvious advantage is that it provides greater mobility for nurses. Improvement in mobility of nurses can have a direct impact on improving access to quality healthcare services and addresses workforce needs. Another advantage is that the compact licensure can provide improved access during times of a disaster. In today’s fast paced technological world, the concept of telemedicine and telenursing is becoming a reality. The compact licensure has provided clarification of the authority to practice for nurses engaged in telenursing.
The processes for obtaining licensure in different states are relatively straight forward and simple. Individuals seeking licensure in a different state should carefully read the policies located on the State Board of Nursing websites. It is also imperative that nurses understand the Nurse Practice Acts in whatever state they are licensed to practice in. If the individual has any questions, they should contact the State Board of Nursing for clarification.