NURSE LICENSURE COMPACT (NLC)
2. (a) Has graduated from a board-approved education program; or (b) Has graduated from an international education program (approved by the authorized accrediting body in the applicable country and verified by an independent credentials review agency). 3. Has passed an English proficiency examination (applies to graduates of an international education program not taught in English or if English is not the individual’s native language). 4. Has passed an NCLEX-RN® or NCLEX-PN® Examination or predecessor exam. 5. Is eligible for or holds an active, unencumbered license (i.e., without active discipline). 6. Has submitted to state and federal fingerprint-based criminal background checks. 7. Has not been convicted or found guilty, or has entered into an agreed disposition, of a felony offense under applicable state or federal criminal law. 8. Has no misdemeanor convictions related to the practice of nursing (determined on a case-by-case basis). 9. Is not currently a participant in an alternative program. 10. Is required to self-disclose current participation in an alternative program. 11. Has a valid United States Social Security number (National Council of State Boards of Nursing, n.d.a). What does the eNLC mean for RNs? Besides the requirements above, the RN who is applying for an eNLC is also required to do the following: 1. On all application forms for multistate licensure in a party state, an applicant shall declare a primary state of residence. 2. A nurse who changes primary state of residence to another party state shall apply for a license in the new party state when the nurse declares to be a resident of the state and obtains privileges not ordinarily extended to nonresidents of the state. 3. A nurse shall not apply for a single state license in a party state while the nurse holds a multistate license in another party state (National Council of State Boards of Nursing, 2021). What it does allow nurses to do is practice across borders in other eNLC states, practice telenursing in all eNLC states, quickly respond to disasters in all eNLC states, and allow nurse educators with an eNLC to teach via distance education in all eNLC states (National Council of State Boards of Nursing, n.d.b).
To be able to provide nursing care where it is needed and to decrease the need for many different state-issued RN licenses, the NCSBN developed the Nurse Licensure Compact which began in 2000 (Oyeleve, 2019). Historically, each state had its own rules and regulations for RN practice, and requirements for sitting for licensure exams. For nurses who wanted to work in different states, the nurse had to meet the individual state requirements and apply for a license. This required a lot of time, energy, and money for nurses. This also prevented state BONs from disciplining a nurse who harmed a patient working remotely from another state. Finally, in 1995, the Pew Commission reported all 50 states entry into practice requirements were not standardized (Oyeleve, 2019). In 2000, the first states to pass legislation and agree to the NLC were Maryland, Texas, Utah and Wisconsin. Not all states and nurses were in agreement with this. There were concerns related to different state regulations for practice (not just licensure), state sovereignty on who could practice in the state, and public safety. Another concern was some inconsistencies between requirements, especially related to past criminal issues, where some states would bar a candidate for license and those listed in the NLC (Oyeleve, 2019). Even though there were issues and concerns with the NLC, states did join. However, in 2015 when the North Carolina BON and state legislature were thinking about joining, there were ongoing concerns. The NLC did not guarantee competency of the nurses between the different states (Oyeleve, 2019). Given this issue, the Nation Council of State Boards of Nursing examined all the concerns and developed the Enhanced Nursing Licensure Compact (eNLC). The eNLC was designed to replace the NLC with requirements that would address issues raised and improve confidence. The eNLC went into effect in July 2017 with a final implementation date in January, 2018 to allow nurses with NLCs to apply for eNLCs (Oyeleve, 2019). The eNLC has uniform requirements and federal background checks for any nurse applying for an eNLC if their state is a member. The eNLC also standardized key disciplinary provisions among all the member states and required reporting of all disciplinary actions against a nurse within the eNLC (Oyeleve, 2019). The following are the uniform requirements: 1. Meets the requirements for licensure in the home state (state of residency).
THE BON AND DISCIPLINARY CASES
● Fines. ● Civil penalties.
Most nurses are competent individuals whose primary goal is to provide safe, appropriate nursing care that enhances patient outcomes. However, when problems arise with a nurse’s performance, a complaint may be filed with the BON, which is responsible for reviews and action regarding complaints. The BON may act only if sufficient evidence exists that the nurse violated state laws or regulations (National Council of State Boards of Nursing, 2022b). Nursing consideration: In any given year there are over 12,000 nurses with adverse actions against them reported to the National Practitioner Data Bank. The National Practitioner Data Bank is managed by the US department of Health & Human Services (2022). What types of disciplinary action can be taken by a BON? The BON may act to impose such actions as the following (National Council of State Boards of Nursing, 2022b): Rules and position statements Nurses should also be aware of BON rules, regulations, and position statements. BONs have the authority to develop administrative rules to clarify laws. Rules must be consistent with the NPA, but cannot go beyond the law. For example, an NPA
● Public reprimand or censure for minor violations of the NPA. ● Referral to an alternative-to-discipline program for practice monitoring and recovery support. This may be offered to nurses with drug or alcohol dependence, or another type of mental or physical condition. ● Mandated monitoring, remediation, education, or other provisions established to meet the needs of specific situations. ● Limitations on practice such as restricting roles, the practice setting, and/or hours that may be worked. Nursing consideration: The actions taken by the BON are considered public information. Some BONs, believing that it is in the public interest to publicize actions taken against nurses, communicate actions via such means as newsletters and websites (National Council of State Boards of Nursing, 2022b). may mandate that nurses’ practice safely and competently, and a rule related to this mandate may specify a plan for ongoing continuing education so that nurses achieve and maintain their competency.
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