Troubled nurses cross state boundaries

The multi-state Nurse Licensure Compact (NLC) make it easier for troubled nurses to work in other states, warns Propublica and USA Today.

While the compact is designed to address the nursing shortage and ease barriers to practice, some wonder if a multi-state license inadvertently allows impaired or incompetent nurses to continue practicing nursing. According to Propublica and USA Today, four dozen nurses who were barred from practice in a compact state maintained a clean nursing license in their home state — enabling them to work — for a number of months.

Under the compact, nurses who are licensed in a compact state are legally free to work in any compact state. If a disciplinary issue arises, it is handled in the state in which the issue occurred. The incident is also reported to the nurse’s home state. Problems may arise, however, when there’s a delay between the incident and notification. A coordinated licensure information system, Nursys (R), helps disseminate important disciplinary information.

What do you think? Do you think the multi-state nursing compact inadvertently puts patients at risk? Or do you think the Propublica/USA Today article incited a lot of unnecessary worry?


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Jennifer Fink, RN, BSN

Jennifer is a professional freelance writer with over eight years experience as a hospital nurse. She has clinical experience in adult health, including med-surg, geriatrics and transplant; she also has a particular interest in women’s health and cancer care. Jennifer has written a variety of health and parenting articles for national publications.

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3 Responses to Troubled nurses cross state boundaries

  1. If credentials are verified by the employer and spot check with BCII..then how can the freedom to move state to state be compromised?..I relocated to Hawaii anticpating a quick verification of license due to current status in california,..but had to return to the mainland becuz hawaii took 9months to verify a clean license.If I had had NLC in hand..that whole fiasco would have been avoided..and I’d be living in Hawaii now. its a racket by the powerful state boards of nursing to generate money for nurses to move state to state. I actually wish now for federalization of nurses..and strip the states of licensing duties. Another reason to work for the V.A…they recognize “any” license from any state without that nurse having to get a state license…federal law recognizes any license as long as it is kept in good standing and this should be a federal law!!

  2. We are on the verge of implementing EMR for the whole country and the State Boards can not keep up and transfer information from state to state?Hospitals in Louisiana can check the status of a nurse (Agency) on arrival to the hospital. It should be easy to set up a national database so any license can be checked from any state at any time.You would think that the compact states would be integrated at least!
    I’m sure there are some nurses who abuse the compact. You would also think the State Boards would be speaking up and doing something about it instead of letting the Profession get so much bad press over such a small number of patients – When they should have made sure up-to-date information was readily available to all states to start with..
    Vernon Dutton, R.N..

  3. Glen Quinn

    Australia has just gone national registration, that is, one registration to allow practice in all 7 states and territories. We have endorsements and limitations applied to our registration.
    Surely your NLC could have limitations applied to nurses with issues over practice. It then becomes the employers responsibility to check the registration / licence for limitations on practice.