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President’s Message on a Multistate Compact
by ONA President Katy Cooper, BSN, RN, CCRN
May 27, 2016

Last weekend, you may have received an email from the Oregon State Board of Nursing (OSBN) asking your opinion on the issue of a multistate nursing license and whether you practice in more than one state. ONA has received numerous calls and emails from nurses wondering why this survey was sent out and asking for information about the multistate license. The OSBN did not provide additional information about the multistate license in the survey, but we believe it is important that nurses have more information about this issue before being asked to respond to survey questions.

Since 1998, states have discussed the advantages and disadvantages of joining a multistate Nurse Licensure Compact (NLC). The NLC would allow nurses in states who joined the compact to practice in any other compact state using their current license. For example, if Oregon and Washington both signed the compact, a nurse could practice in either or both states using a license from their state of residence.

Over the last 18 years, only about 50 percent of states have enacted legislation in favor of the compact. Oregon has not.

A multistate license does sound appealing. For nurses who practice in more than one state, only a license in their state of residence would be needed. The nurse or employer would pay only one license fee as well. However, these incremental benefits for a small number of nurses are overshadowed by the risks to states, the public and the nurses within those states.

Why? Simply put, the NLC forces states to give up their ability to set nursing standards.

If Oregon entered the compact, nurses in our state would no longer be required to meet the practice standards we’ve worked to establish. For example, the NLC would allow a nurse to be licensed in Oregon without having practiced in the last five years. Any other practice requirement specific to Oregon would also be invalid.

Despite troubling complications, a private Chicago-based trade group called the National Council of State Boards of Nursing (NCSBN) has continued pushing states to adopt NLCs for both RNs and NPs. It is devoting significant resources to “sell” the Compact.

In the NCSBN’s plan, the compact is overseen by an interstate commission which can make binding decisions on member states, without being held accountable to any state or government.

Handing over our state’s practice authority is not in the best interest of nurses or the public.

That’s why ONA and the American Nurses Association (ANA) have been working towards new solutions that simplify multistate practice for nurses, protect the public and retain individual states’ authority to establish and enforce practice standards.

As we consider important health care decisions like multistate licenses, it is critical that all nurses have access to the information we need to weigh both the risks and benefits of policy decisions and take an active role in the decision-making process.

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