Guide to NLC for Nurse Employers

Welcome to this brief educational video
that will serve as a guide to the Nurse Licensure Compact
for Nurse Employers. The objectives of this video are to
provide an overview of the Nurse Licensure Compact, to explain Privilege to Practice, to very briefly explain
Primary State of Residence, to share some valuable
employer resources and to answer some key questions. So what is the Nurse Licensure Compact? The NLC is an interstate agreement that
allows nurses, RNs, and LPNs to practice in all compact states
with a Multistate License issued from their primary
state of residence. They can practice physically,
via telehealth, or via other electronic means with their one Multistate License. Now, which states are part of the NLC? You can see from the map that there are 33
blue states. This means that 33 states
have enacted the NLC. Thirty-one of those states
have implemented. You can also see that Alabama and Indiana
are light blue because they have yet to implement the NLC. Alabama will implement the NLC
on January 1st of 2020. Indiana implementation date
is still to be decided. Once the NLC is implemented in those newer
states that were mentioned, nurses with legal residents in those
states will then be able to apply for a Multistate License. Nurses from other NLC states who already
have a Multistate License will then be able to practice in those
newer states as well. Now that we explained all that,
let’s take a look at exactly who is eligible for a Multistate License. To be eligible, a nurse’s primary state of
legal residence must be a state that is part of the NLC. That nurse will also have to meet the 11
Uniform Licensure Requirements for a Multistate License. These are included in the
licensure application. So, who besides travel nurses benefits
from the NLC? On the screen, you can see the extensive
list of job positions that benefit. As stated before, any nurse that may deal
with a patient in another state time of practice, benefits. It also benefits military and VA nurses
who move a lot. Although they can have a license anywhere
in the country, when practicing in a civilian facility, they aren’t covered
under federal supremacy, thus, they need a license in the state
where the civilian facility is located. Finally, you, the employer,
benefits as well. When a nurse has a Multistate License,
the nurse can be available in a compact state immediately because they have
authority to practice in that state. This is obviously to your advantage when
it comes to staffing. As employers, you should also know a nurse
can only hold one Multistate License that is issued by his or her home state. A Multistate License is a state-based
license and it is not a national license. This means that a nurse with a multistate
license, who maintains PSOR in a compact state, can work in any state
within the compact without taking any additional steps. But when a nurse changes their state of
legal residency, they will need to obtain a new license from their new primary state
of legal residence. For more information regarding changing
legal residence, we suggest that you watch the video, NLC and PSOR requirements. What if a nurse is practicing in a state
that is not an NLC state, such as California or Nevada? They will need a single-state license
valid in that noncompact state. They can apply by completing the
appropriate application on the Board of Nursing website. A nurse can only have one Multistate
Cicense, but as many single-state licenses in noncompact states as he or she needs. As an employer, how can you ensure that
nurses hired from NLC states are appropriately licensed? Let’s take a look at some situations to
help explain this. First, is the nurse relocating to your
state on a permanent basis and changing their PSOR to your state? Yes. Then the nurse should immediately apply
for License by Endorsement in their new state of residence. There is no grace period. Many employers implement a policy where a
nurse must provide proof of application for licensure within a
certain number of days. However, if you hire a nurse from an NLC
state, that nurse will be able to practice on his or her former Multistate License
until the new Multistate until the new
Multistate License is issued. An exception to this is when a nurse
accepts a job in Kansas City, Missouri, but intends on making Kansas City, Kansas,
her new PSOR, and commuting to Missouri. In this case, the nurse should obtain her
Multistate License from Kansas, her PSOR. Now, what happens when a nurse is
temporarily practicing in your state and has no intention on changing
their PSOR to your state? That nurse can practice in your state with
their Multistate License issued from their primary state of legal residence. There is no time limit. Military spouses fall into the category of
nurses who may practice in your state for a prolonged period of time,
as they may work in a civilian facility and be stationed in your state for years. Sometimes, employers have a policy
requiring a nurse to be licensed in the state where the employer is. They should consider amending such a
policy to allow for nurses holding compact licenses from different primary
states of legal residence. As an employer, how can you confirm
whether a nurse has the authority to practice in your state? You can do so via A quick confirm report allows you to
search for the nurse by name, license number, or NCSBN ID. When you click “View Report,” you see an
Individualized Authority to Practice map that displays the states where the nurse
can legally practice. is a national database. All boards of nursing upload their
licensure database into Nursys daily. We’ve been using the term practice a lot,
but what exactly does it mean? Practice is when a nurse utilizes
knowledge, education, training or decision-making skills. So with each job function a nurse has,
practice is in play. Lawful practice requires a nurse be
licensed in the state where the patient is located at the time nursing
service is provided. This is where the Multistate
License comes in handy. If the patient is located in a compact
state, and the nurse has a Multistate License, the nurse is covered
to practice in the patient’s state. However, if the nurse only has a
single-state license from a noncompact state, she will need to make
sure she is licensed in the state where the patient is. Which Nurse Practice Act should a nurse
follow when practicing with a patient in another state? Follow the Nurse Practice Act from the
state of practice or the state where the patient is located. You can find the Nurse Practice Act for
each state at this website. Another great resource is E-Notify. It’s free and provides reminders about
license expiration dates and notifies of any discipline. By registering your nursing workforce
here, you can receive a notice of disciplinary action taken on any
license a nurse holds in the U.S. If there is a discipline on a license,
a Multistate License may be converted to a single-state and practice would be limited
only to the home state. This often happens when the level of
discipline restricts or limits the nurse’s practice. As we start wrapping up,
let’s take a quick look at some other common questions that
nurse employers often have. Are APRN nurses included in the compact? No. APRNs must apply for license by
endorsement in each state where they practice, unless
exempted in a federal facility. What about continuing
education requirements? In terms of the compact,
the nurse’s PSOR that issued the Multistate License is the state to which
the nurse owes the CEs. If a nurse holds a license in noncompact
states, each of those states might have their own requirements. What if the licensee only wants a
single-state license? In that case, a compact party state may
issue a single-state license upon request. But why would a nurse request a
single-state license? Let’s take a look at some examples. In the first example,
you have a nurse who has PSOR in Florida. That nurse has always maintained her
single-state license even upon implementation of the NLC because she
only plans to practice in Florida. The nurse may elect to maintain their
single-state license. If a nurse does not qualify for a
Multistate License, the home state may iissue them
a single-state license, subject to the
state licensure requirements. Another example is that a nurse may be a
legal resident of a compact state such as Arizona, but that nurse may have an
unencumbered single-state license. Upon completion of the conditions,
the nurse may still elect to maintain his or her single-state license. Finally, a nurse’s primary legal
residence in Arizona, for example, may not have met the
grand-fathering criteria. That nurse may also elect to maintain
their single-state license. Those were just a few examples we’ve
encountered, where a nurse may choose to maintain his or her
single-state license. However, a licensee who has PSOR in a
compact state, and wishes to practice in other compact states,
should obtain a Multistate License from their home state. Thank you for watching this video. We hope that you enjoyed the information. And if you have any questions,
don’t hesitate to contact us. We have a variety of other videos and
resources available. You can find those on our Toolkit page.

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