The healthcare industry in the United States continues to evolve rapidly, and nursing is at the heart of this transformation. One of the most significant developments shaping the future of nursing practice is the Nurse Licensure Compact (NLC). Designed to simplify multi-state practice, the NLC allows nurses to hold one license that grants them the ability to work across participating states.
As demand for qualified nurses grows, especially with the challenges of staffing shortages, pandemics, and the rise of telehealth, the expansion of the NLC has become increasingly important. This expansion improves workforce mobility, increases patient access to care, and strengthens the overall healthcare system.
This article explores the history, importance, benefits, challenges, and future outlook of the expansion of the Nurse Licensure Compact (NLC) in detail. It is written in an SEO-friendly, human-readable style to help students, professionals, and policymakers understand the topic thoroughly.
In This Article
What is the Nurse Licensure Compact (NLC)?
The Nurse Licensure Compact (NLC) is an agreement among U.S. states that allows registered nurses (RNs) and licensed practical/vocational nurses (LPNs/LVNs) to hold one multistate license. With this license, nurses can practice in their home state as well as other compact states without having to apply for individual licenses.
- Home State License: A nurse’s primary state of residence issues the license.
- Multistate Privilege: The license extends practice rights to all compact member states.
- Eligible Nurses: Registered Nurses (RNs) and Licensed Practical Nurses (LPNs/LVNs).
The NLC was developed by the National Council of State Boards of Nursing (NCSBN) and first introduced in 2000. Over the years, it has undergone revisions and has been modernized as the Enhanced Nurse Licensure Compact (eNLC), which came into effect in 2018.
History of the NLC and Its Expansion
- Initial Launch (2000) – The original NLC was introduced to allow greater flexibility for nurses and employers.
- Slow Adoption – Early adoption was limited as many states hesitated due to concerns about regulation, revenue, and background checks.
- Enhanced NLC (2018) – A revised compact addressed these issues by requiring uniform criminal background checks and stronger state collaboration.
- Rapid Expansion – Since 2018, more states have joined, significantly expanding the reach of the NLC.
- Current Status – As of 2025, over 41 jurisdictions (including most U.S. states) are members of the NLC.
Why Expansion of the NLC is Important
The expansion of the NLC is not just a bureaucratic change; it is a strategic healthcare solution that benefits multiple stakeholders.
- Nurses – Gain freedom to practice across state borders with reduced licensing barriers.
- Healthcare Facilities – Can fill staffing gaps more quickly, especially in emergencies.
- Patients – Benefit from greater access to qualified nurses, particularly in rural or underserved areas.
- Telehealth Growth – Nurses can provide virtual care to patients in multiple states legally.
The expansion also aligns with the U.S. healthcare system’s need for flexibility, mobility, and efficiency.
Key Benefits of NLC Expansion
1. Workforce Mobility
Nurses can easily move between states for work, reducing unemployment and filling staffing shortages.
2. Cost Savings
Eliminates the need for nurses to pay multiple licensing fees, saving time and money.
3. Faster Response to Crises
During natural disasters, pandemics, or emergencies, nurses from other compact states can provide immediate support.
4. Increased Telehealth Services
The NLC supports the expansion of telehealth, enabling nurses to provide care to patients beyond state boundaries.
5. Standardized Regulation
Uniform rules enhance patient safety and professional accountability across member states.
Challenges to NLC Expansion
Despite its clear benefits, the expansion of the NLC faces hurdles.
- State Revenue Loss – Some states rely on licensing fees as a revenue source and resist joining.
- Legislative Barriers – Each state legislature must pass a bill to join, and political delays can slow progress.
- Union Concerns – Nursing unions sometimes worry about wage competition and working conditions.
- Public Safety Concerns – Ensuring that all nurses undergo thorough background checks remains a priority.
- Non-Compact States – Nurses in non-compact states still face challenges when applying for work in compact jurisdictions.
States Currently in the NLC
As of 2025, more than 41 jurisdictions participate in the compact, including major states like Texas, Florida, and North Carolina. However, California, New York, and a few others remain outside the compact due to legislative or regulatory resistance.
Expansion Trends and Telehealth Growth
The rise of telehealth has been a major driver of NLC expansion. With remote patient monitoring, online consultations, and digital health platforms, nurses can now provide services across state lines. This requires a uniform licensing model something the NLC supports perfectly.
NLC vs. APRN Compact
It is important to note that the NLC applies only to RNs and LPNs/LVNs. Advanced Practice Registered Nurses (APRNs) have a separate agreement called the APRN Compact. The APRN Compact is still in its early stages of adoption, with fewer states currently participating.
Impact of NLC Expansion on Nursing Education
Nursing schools are adjusting their programs to educate students about multistate licensure. Graduates in compact states benefit from immediate career flexibility, making NLC participation an attractive feature for nursing programs.
Impact on Employers and Healthcare Systems
- Hospitals – Can hire out-of-state nurses faster.
- Travel Nursing Agencies – Expansion of the NLC makes it easier to place nurses in high-demand areas.
- Long-Term Care Facilities – Benefit from access to more nurses as shortages increase.
Global Perspective: Could the NLC Model Work Internationally?
While the NLC is unique to the U.S., similar licensing frameworks exist elsewhere:
- European Union – Mutual recognition of nursing qualifications across member states.
- Canada – Some provinces recognize cross-province nursing practice.
The success of the NLC could inspire broader adoption of international nursing compacts in the future.
List: Advantages of NLC Expansion
- Easier multi-state practice
- Better telehealth access
- Quicker disaster response
- Stronger healthcare workforce mobility
- Reduced costs for nurses
- Improved patient safety through uniform standards
Table: NLC Adoption Overview (as of 2025)
| Category | Details |
|---|---|
| First Introduced | 2000 |
| Enhanced Version (eNLC) | 2018 |
| Current Member States | 41+ |
| Non-Member States | CA, NY, OR, HI, AK, MA, NV (etc.) |
| Applies To | RNs and LPNs/LVNs |
| Separate Compact for APRNs | APRN Compact (few states) |
Future of NLC Expansion
Looking ahead, the expansion of the NLC will likely continue, with more states joining as the demand for healthcare workforce mobility grows. Telehealth will be a major driver, and pressure from patients and employers may push non-compact states to reconsider their stance.
The ultimate goal is nationwide participation, which would create a seamless system for nurses to practice across the United States.
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Conclusion:
The expansion of the Nurse Licensure Compact (NLC) is reshaping the nursing profession in the U.S. By reducing barriers, supporting telehealth, and improving workforce mobility, the NLC strengthens both patient care and professional growth for nurses. While challenges remain, particularly with non-member states, the momentum is clear.
In the coming years, the NLC will likely become a standard framework, providing nurses with the freedom they deserve and ensuring patients receive quality care wherever they are located.
