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Nurse licensure compact offers practice flexibility

Jim Puente

The Nurse Licensure Compact provides nurses with the opportunity to hold one license in their home state and practice in person or remotely in other states within the compact without obtaining another license. Twenty-four states participate in the compact. That saves time and money for nurses who want to accept temporary travel assignments, assist in disaster recovery, telephonically case manage or provide telehealth services.

“More and more treatment modalities involve telecommunications, and there is an increased focus on remote patient monitoring,” said Jim Puente, MS, director of the Nurse Licensure Compact at the National Council of State Boards of Nursing. “It’s possible a nurse in any given state is contacting a patient in another state. The nurse needs to be licensed in the state where the patient is located.”

The NCSBN endorsed the compact model in 1997 to facilitate interstate practice and promote nurse mobility. It follows a driver’s license model. Maryland was the first state to implement a nursing licensure compact, in 1999, and Missouri the most recent in 2010.

Nurses must adhere to the nurse practice act for the state they are practicing in and meet licensure requirements, such as continuing education, in the home state.

Disciplinary action results in the restriction of multistate privileges. Compact states must report disciplinary action to the NCSBN’s national nurse licensure database, Nursys. The system posts an alert to boards of nursing about any investigation or pending disciplinary action. It also provides online licensure verification, with discipline status.

If a nurse’s primary residence is not in a compact state and he or she wants to travel or practice through telecommunication, the nurse needs to apply for licensure through endorsement in the state where the hands-on or electronic care takes place.

“That is burdensome, expensive and inefficient as far as regulatory processes because of the duplications,” Puente said. “The goal is to have all states in the compact, so it is universal.”

For more on compacts, visit

By | 2020-04-15T09:28:24-04:00 January 31st, 2015|Categories: National|1 Comment

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    Kathy campbell October 22, 2015 at 11:56 pm - Reply

    Can you provide a list of states with compact with California?

    Editor’s note: Kathy, here’s a map from the National Council of State Boards of Nursing with the Nurse Licensure Compact states.

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