Nursing is licensed at the state level in the United States, traditionally limiting practice by geographic borders. This structure has historically presented a barrier to nurses seeking to relocate, accept travel assignments, or provide telehealth services across state lines. Specific legal mechanisms have been developed to address the challenge of maintaining a valid license in multiple jurisdictions and support workforce mobility. Understanding these options is the first step for any nurse looking to expand their practice.
The Primary Solution: Nurse Licensure Compact (NLC)
The Nurse Licensure Compact (NLC) is an agreement among participating states allowing registered nurses (RNs) and licensed practical/vocational nurses (LPN/VNs) to practice in any other compact state using a single multi-state license (MSL). This mutual recognition model streamlines the process for nurses who reside in a compact state and wish to practice physically or electronically elsewhere. The NLC eliminates the need to apply for separate, single-state licenses in every jurisdiction.
The MSL is issued by the nurse’s primary state of residence (PSOR). The PSOR is defined as the state where the nurse holds a valid driver’s license, voter registration, or federal tax return address. While the MSL is granted and maintained through the PSOR’s Board of Nursing, the nurse is held to the standards of the state where the patient is located. A nurse can only hold one MSL at a time, and changing PSOR requires transferring the license quickly.
Qualifying for a Multi-State License
To obtain a multi-state license, a nurse must satisfy the uniform licensure requirements (ULRs) set forth by the NLC, along with the licensing criteria of their PSOR. The nurse must legally reside in a state that has enacted the NLC legislation. Proof of residency is required through documentation such as a driver’s license or federal income tax return.
The nurse must hold an active and unencumbered RN or LPN/VN license, meaning there are no current disciplinary actions against it. Applicants must have successfully completed a board-approved nursing education program and passed the National Council Licensure Examination (NCLEX). The application involves submitting to a federal fingerprint-based criminal background check.
The Alternative: Licensure by Endorsement
Licensure by Endorsement (LE) is the traditional mechanism used when the NLC cannot be utilized. This process is necessary if a nurse is moving to or wishes to practice in a state that is not an NLC member, or if their PSOR is a non-compact state. Endorsement allows a state’s Board of Nursing to recognize an existing license from another jurisdiction as proof of competence, without requiring the nurse to retake the NCLEX examination.
The outcome is the issuance of a new, single-state license specific to that jurisdiction. Unlike the MSL, this license only permits practice within the issuing state’s borders. The nurse must meet all of that state’s unique requirements, which can vary widely. Endorsement grants a nurse a separate license for each non-compact state where they intend to practice.
Essential Steps for Endorsement Applications
The process for Licensure by Endorsement begins with the nurse applying directly to the new state’s Board of Nursing and submitting the required forms and fees. A standardized step involves verifying the nurse’s original and current licenses through the Nursys system, the national database for verification of nurse licensure. If the former state does not participate in Nursys, the nurse must request that the state board complete and send a paper verification form to the new licensing board.
All endorsement applicants must undergo a criminal background check, often involving submitting fingerprints for state and FBI-level review. The nurse may also be required to provide official transcripts from their nursing education program. Some states require demonstration of completion of state-specific continuing education or jurisprudence examinations. The timeline for receiving an endorsed license can range from a few weeks to several months, depending on the state board’s processing backlog.
Temporary Practice and Special Considerations
A nurse may be able to begin practice before their permanent Licensure by Endorsement application is fully processed by using a temporary permit. Many state boards issue these non-renewable permits, typically valid for 60 to 90 days, allowing the nurse to work while documentation review and background checks are finalized. Issuance of a temporary permit is often contingent on the nurse holding at least one active, unencumbered license in another state.
Nurses employed in federal facilities, such as Veterans Affairs (VA) hospitals or military installations, operate under different rules. A federal nurse is authorized to practice in any state or territory regardless of their location, provided they hold a current, active, and unrestricted license from any U.S. jurisdiction. This federal exemption bypasses the need for NLC participation or state-by-state endorsement for practice within federal facilities.