With newly emerging healthcare methods like telemedicine, hospitals and nursing groups are arguing that the rules of state licensing inhibit nurses’ abilities to use new methods of care in the digital age. This push to end state licensing proves the growing adoption of remote health services like online and over-the-phone patient care and monitoring. Telemedicine is expected to soar in revenue in the US, from $240 million in 2013 to $1.9 billion in 2018.

Hospitals and nursing groups have begun lobbying state legislators across the nation to do away with requirements that nurses be licensed in each state where they work, but legislators see it as a risk to patient safety. Not all states have the same nurse licensing standards, making it hard to regulate a transition to nationwide nurse licensing. Legislators also argue that it would erode bargaining power, especially by making it easier for hospitals to bring in out-of-state nurses to break a strike.

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The multistate agreement known as the nurse licensure compact was created in 1999 and state interest grew quickly with twenty-three states joining by 2010, but interest has stalled with only two states joining since. However, supporters hope a new version of the compact will trigger more states to join. A newly revised agreement would require member states to conduct fingerprint-based state and federal background checks on nurses they license so a nurse convicted of a felony can’t hold a multistate license.

Seven states have enacted legislation to join the current multistate compact so far, including Florida , Idaho, Oklahoma, South Dakota, Tennessee, Virginia, and Wyoming. Sandra Evans, chairwoman of the Nurse Licensure Compact Administrators, believes that more technology and different models of care will give increasing momentum to the success of the multistate agreement.

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Under the newly enhanced multistate compact, the state board that issues a nurse’s license is responsible for nurse licensing sanctions against that nurse if an infraction occurs in another member state. The member states will share information on sanctions through a database to keep all parties informed. Hospital officials in support of the compact like that it will allow them to offer nurses to practice by phone or internet without requiring multiple licenses, and it allows them to quickly group together staff in cases of natural disaster or emergency.

The multistate agreement effort and support from hospitals and nursing groups reflects growing acceptance for telemedicine. It’s an effort that could expand beyond nursing, with doctors, psychologists, physical therapists, emergency-service personnel, and dietitians all considering or moving ahead with interstate licensing models. There are still a lot of opponents to the multistate nurse licensing movement, but supporters believe it’s a source of labor-market efficiency to get practitioners to where the jobs are, and making it easier for nurses to find work when they have the ability to practice in other states without getting another license.

Christina Morgan
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