The National Council of State Boards of Nursing (NCSBN) created the Nurse Licensure Compact (NLC) to expand nursing job opportunities across all state lines especially in rural, over populated nursing homes, and other areas limited in healthcare access.
The aim is to have competent nursing care provided by licensed nurses nationwide and have them closely monitored on the national database called “Nursys”. The database enables the states to collect, track, report, and verify nursing candidate information, see disciplinary actions, and license verification fees.
Another advantage in joining NLC is to enable nurses to work across state lines to conduct telemedicine and telenursing. Nurses need to be able to use technologies such as telemonitoring tools to serve many more people in the U.S.
However, using telemedicine can become an issue when states have not joined the NLC. The nurses in states that have joined the NLC, are allowed to practice medicine across state lines, whereas as nurses in non-compact states cannot.
Some states are concerned that nurses that use telemedicine in other states will take nursing positions away from nurses living in local areas. However, telemedicine could open up more job opportunities along with more training and collaborative experiences.
A solution needs to be found for the high patient to nurse ratio that is causing infections and illnesses that could possibly be prevented if medical facilities were properly staffed. The result is that the states not in the NLC, are losing millions since they are faced with many more preventable illnesses due to staff shortages.
Twenty-six states have not joined the compact but not all of the states that have not joined are completely against joining. For example, Florida wants to join the NLC but is waiting to implement compact legislation in Florida.
However, other states such as Massachusetts are completely against joining partly based on what they think may be the possible loss of privacy to patients. The leaders in the state feel that by joining a national database, personal information will be exposed for not only nurses but also for patients.
Some non-compact states are also worried about how disciplinary actions will be handled under NLC. These states think that it would be difficult to locate and follow-up with nurses after they have been involved in a difficult medical situation since they could be working in many areas all over the U.S.