Technology is often seen as a savior in times of crises. However, in the world of nursing it’s actually contributing to one. Due to advances in technology, the telemedicine industry is expected to reach $1.9 billion in 2018. This is creating a demand for nurses in an industry already experiencing a serious shortage. According to recent reports, there is expected to be over a million openings for nurses between now and 2022—with the shortage hitting epic proportions by 2025.

As a result, some hospitals and nursing groups are lobbying legislators to extend nursing licenses across state lines so they could provide telemedicine services outside of states where they are licensed. However, nursing unions are pushing back, arguing that all states don’t have uniform licensing standards—and this can put patients at risk.

Nurse Licensure Compact

Extending nursing licenses across states is not a new idea. A multistate agreement known as the nurse licensure compact was discussed and developed in 1999. The compact experienced strong initial momentum, as 23 states joined by 2010. However, since then only two more states have joined.

The compact has been recently revised, according to an article in The Wall Street Journal, to include stricter standards on background checks, and would prevent nurses with felonies from holding a multistate license. The revisions reflect new advances in technology, which advocates hope will alleviate some fears regarding patient safety and incentivize more states to join.

In addition to unifying requirements for licensing across the United States, the nurse licensure compact could assist with issues that plague the industry, such as drug diversion. The compact holds unique benefits in that it could maintain a central database of all sanctions, so any state in the compact could access these infractions. A lack of nurse tracking is a current loophole in drug diversion prevention, as hospitals often won’t disclose the reason for a nurse’s termination to another hospital, allowing a nurse caught diverting medication to operate in another state.

Other benefits of the compact include the ability to quickly add nursing staff in the event of a natural disaster or emergency, and allowing nurses to practice by phone or Internet without requiring multiple licenses. For nurses, this makes it easier to find work without having to worry about practicing within their licensed state.

Technology Necessitating Change

As the population ages and telemedicine plays a larger role in patient care, healthcare must evolve. Doctors and other members of healthcare teams are already exploring interstate licensing out of necessity.

However, based on pushback from state nursing boards and nursing unions, it appears that more work needs to be done for nurses to follow suit. More uniform regulations, higher education requirements for licensing and standardized reporting for patient concerns are needed before significant progress will be made on interstate licensing for nurses.

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