Highlights of the Nurse Licensure Compact Survey Findings: Nurses’ Needs, Experiences, and Views

Abstract

Background

The Nurse Licensure Compact (NLC), developed by the National Council of State Boards of Nursing (NCSBN), is designed to promote nurse mobility, increase access to care, and enhance public protection through uniform licensure requirements. The value of the NLC has been made evident during healthcare crises, especially during the recent COVID-19 pandemic. However, the NLC has not yet been adopted nationwide in the United States.

Purpose

To gather empirical data on nurses’ views, concerns, and work experience related to the NLC.

Methods

This study is an aggregate summary of state-based online surveys conducted by NCSBN in partnership with the boards of nursing in Kansas, Alaska, Nevada, Vermont, and Minnesota from 2018 to 2022. All study participants were licensed nurses with a valid email account registered with one of the aforementioned boards of nursing. To determine whether nurses’ out-of-state practice patterns may have changed over time, data were compared to the findings from 2,612 nurses who participated in the 2014 NCSBN’s National NLC Evaluation Survey from the same five states.

Results

A total of 66,054 nurses responded to the survey for an overall response rate of 24%. At the time of the survey, 45% of respondents had provided nursing services outside of their licensure state during the previous 2 years, illustrating a 10% increase compared to the 35% of the respondents who reported out-of-state services in the 2014 survey. Among the respondents who practiced under their multistate license, 96% indicated that the NLC was beneficial to their nursing practice. Of the respondents who expressed their support or opposition, 95% indicated support for the NLC. These high rates of support for the NLC were consistent across study states, as well as across most demographics, including respondents’ state of residency, practice patterns, and union membership.

Conclusions

There is an increasing need for a flexible and mobile nursing workforce to practice across state borders. The multistate license benefits crossborder nursing practice and a majority of the respondents support and welcome the adoption of the NLC.