Nurse Licensure Compact

Position Statement

Issue: An individual license to practice in a state was sufficient to practice nursing for almost 100 years. The practice of nursing over distance using telecommunications technology has effectively made state boundary lines more transparent, thereby increasing the need to regulate telenursing practice by Boards of Nursing. The current model of licensure is insufficent to address protecting the health, safety and welfare of citizens and enforcement of Iowa's Nurse Practice Act.

Position: The Iowa Nurses' Association supports enactment of the nurse licensure compact as proposed by the Iowa Board of Nursing.

First, INA conducted a statewide focus group process as well as a study of the national perspective.

Second, there is a recognition that nurses in Iowa are highly impacted by practice patterns involving telehealth as the state is on the cutting edge in development of technology in large grant projects to promote these practices in rural settings.

Third, there has been identification of the numbers of nurses practicing on Iowa borders within multistate health delivery systems.

Fourth, INA acknowledges the growth of national health information systems that provide telephone nurse counseling and case management to millions of consumers.

Fifth, the states that endorse early will have increased involvement in the continued work on the language within the compact and the rulemaking that follows.

Discussion: Nurse licensure requirements are comparable in all states. All nurses graduate from accredited nursing programs and take the same national examination. Under mutual recognition, a nurse would hold a license in their state of residency and would be able to practice in any state that has signed an interstate compact with their multi-state privilege.

Any licensed nurse must follow the laws and regulations of the state in which they practice, just as occurs with the drivers license today. Individual nurses can avoid duplicative licensure fees once states agree to mutually recognize the nurse license. Boards of Nursing require nurses to be licensed in any state where the patient resides and to whom they are providing service. Employers share the responsibility in assuring that all professional staff are appropriately licensed and credentialed. Administrative details will need further refinement through the Compact Administrators rule making process.