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Lauren Bond, a touring nurse, has held licenses in 5 states and Washington, D.C. She maintains an in depth spreadsheet to maintain monitor of license charges, expiration dates and the completely different programs every state requires.
The 27-year-old received into journey nursing as a result of she needed to work and reside in different states earlier than settling down. She mentioned she wished extra states accepted the multistate license, which minimizes the hassles nurses face after they need to observe throughout state traces.
“It would make things a lot easier — one license for the country and you are good to go,” mentioned Bond, who just lately began a job in California, which doesn’t acknowledge the multistate license.
The license, generally known as the Nurse Licensure Compact (NLC), was launched in 2000 to deal with nursing shortages and allow extra nurses to observe telehealth. Under the settlement, registered nurses licensed in a taking part state can observe in different NLC states while not having a separate license. They should nonetheless abide by the legal guidelines that govern nursing wherever their sufferers are positioned.
About half of the states joined the original compact, which was modeled on the portability of a driver’s license. Some states that declined to signal on cited a serious flaw: The settlement didn’t require nurses to endure federal fingerprint criminal background checks.
Last month, the National Council of State Boards of Nursing launched a new version of the NLC that requires these checks. Twenty-nine states have handed laws to hitch the brand new settlement.
Jim Puente, who oversees the compact for the council, mentioned he expects much more states to signal the settlement now that legal background checks are required. He famous that 9 states have laws pending to hitch.
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Among states taking part within the new nurse licensing compact are Iowa, Kentucky, Tennessee, Delaware, Idaho and Arizona.
California doesn’t plan to hitch the brand new compact, largely due to concern about sustaining state coaching and high quality requirements. The state, like many others, already requires nurses to endure background checks. Washington, Oregon and Nevada are among the many different states that don’t settle for the multistate license.
Proponents of the nurse licensing settlement — each the previous and new variations — argue that it helps fill jobs in locations the place there aren’t sufficient nurses and permits nurses to reply rapidly to pure disasters throughout state traces.
“The nurse shortage tends to wax and wane regionally, so being able to move nurses where the needs are is really, really important,” mentioned Marcia Faller, chief medical officer at AMN Healthcare, a San Diego-based medical staffing firm that employs Bond. The multistate license “really helps with that mobility … to deliver care to patients across state lines.”
Similar cross-state agreements exist for physicians, psychologists, emergency medical technicians and bodily therapists.
In some states, the multistate nursing license is useful as a result of it streamlines the method for nurses doing case administration or telehealth, mentioned Sandra Evans, govt director of the Idaho Board of Nursing. Getting nurses to work within the rural areas of Idaho is a problem, and hospitals typically depend on telemedicine in locations the place the closest well being care facility is likely to be in Montana, she mentioned.
Before Idaho joined the unique NLC in 2001, nurses doing telehealth or case administration wanted quite a few licenses to work throughout state traces, however now they “can travel virtually — electronically or telephonically — to help their clients,” she mentioned.
Joey Ridenour, govt director of the Arizona State Board of Nursing, mentioned one of many greatest benefits of the compact for her state is that it permits authorities to share info and collaborate with different states to research and self-discipline downside nurses. “We are able to take action faster,” she mentioned.
Opponents of the compact argue that states have completely different requirements, course necessities and pointers and that nurses licensed in a single state could lack the mandatory information or expertise to observe in one other one.
“The ability to control the standards of training and quality are of some concern to us,” mentioned Linda McDonald, president of United Nurses and Allied Professionals union in Rhode Island, which participated within the unique NLC however hasn’t signed on to the brand new one. “We want them trained in Rhode Island. We want them licensed in Rhode Island.”
Nurses in California have related considerations. “We really want to make sure that nurses who are entering our state and taking care of our patients are competent and qualified,” mentioned Catherine Kennedy, a Sacramento-area nurse who’s secretary of the California Nurses Association. Some touring nurses haven’t been, she added.
Kennedy mentioned California doesn’t have issue recruiting nurses, even with out the compact, due to the state’s comparatively high salaries and strict nurse-to-patient ratios in hospitals.
Research has proven that California’s minimum nurse staffing requirements, which had been the primary within the nation, can scale back workloads and burnout, enhance the standard of care and make it easier for hospitals to retain their nurses.
Lauren Bond, a touring nurse who has a short lived place at UCLA Medical Center, Santa Monica, has held licenses in 5 states and the District of Columbia. She maintains an in depth spreadsheet to maintain monitor of license charges, expiration dates and the completely different programs every state requires. (Courtesy of Robert Hernandez/UCLA Health)
Massachusetts, which has by no means participated within the nurse licensing compact, requires nurses licensed there to take programs on treating victims of home violence and sexual assault, mentioned Judith Pare, director of the division of nurses for the Massachusetts Nurses Association. If the state allowed out-of-state nurses to observe in Massachusetts with out getting a license there, they wouldn’t essentially have that coaching, she famous.
Bond, the touring nurse, mentioned extra programs don’t make her extra certified to do her job. “Across the board, wherever you go to nursing school, everybody comes out with a similar experience,” mentioned Bond, who works at UCLA Medical Center in Santa Monica. “Then most of the training you are going to do is on the job.”
Jenn Stormes works as a nurse and formally cares for her 18-year-old son, who has a extreme seizure dysfunction and developmental disabilities. Stormes is licensed in Colorado, which participates within the multistate compact.
She has been ready to make use of that license in some states. But she has additionally needed to get a number of particular person licenses so she will proceed serving as her son’s nurse in different states the place the household travels for medical care. Stormes estimated she has spent about $2,000 on licenses.
“It took me over a year to get all these licenses,” she mentioned. “I had to prove to every state the same education, the same experience, the same fingerprints. I think it is a duplication of efforts and is a waste of everybody’s time and money.”
KHN’s protection in California is supported partially by Blue Shield of California Foundation.
Anna Gorman: agorman@kff.org”>agorman@kff.org, @AnnaGorman
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