Despite unprecedented and ongoing nurse staffing challenges, Oregon remains one of 14 states that does not currently participate in the multistate Nurse Licensure Compact (NLC). Two states, Ohio and Pennsylvania, have passed NLC legislation and expect to have their reciprocal licensing programs up and running soon. Seven other states have NLC legislation under review.
Proponents argue that multistate compacts can help mitigate staffing shortages by making it easier for professionals licensed in one participating state to work in other participating states. Detractors counter that such compacts can dilute state licensing standards and subject a state’s nurses to enhanced competition for jobs. To date, these latter arguments have held sway on the West Coast. But crisis-level recruitment and retention challenges have caused Washington and Alaska to reconsider their positions. Washington’s NLC bill, SB 5247, was reintroduced on January 10, 2022. Alaska’s counterpart, SB 67, continues to move through administrative hearings.
The strain on the nursing profession has been the subject of considerable media attention and national concern. A recent survey by a nurse staffing firm, found that 34% of nurses plan to quit their current jobs by the end of 2022; 44% cited burnout and high-stress environments as their reasons for leaving. OPB reports that the “nurse shortage at hospitals is making working conditions untenable.” On September 23, 2022, the Oregon legislature responded to the crisis, approving $14 million in funding to help hospitals hire temporary nurses.
It remains to be seen whether the passage of multistate compacts can help to curb staffing shortages or improve licensee morale. By 2030, California and Alaska, neither of which has passed NLC legislation, are projected to have the greatest shortage of registered nurses and greatest number of open registered nurse job postings, respectively. Yet most of the other states in the top 10 for these measures have had NLC statutes on the books for some time. It may therefore be the case that other factors—such as a state’s average nurse payment rate or perceived desirability as a place to live and work—have a greater effect than NLC legislation on recruitment success.
A considerable majority of states already participate in the NLC. Several more states have either passed or are currently considering NLC legislation. These facts seem to reflect a growing belief that the benefits outweigh the risks of interstate cooperation. Despite paying some of the highest nurse wages of any state, Oregon is struggling as a NLC holdout to fill its open nursing slots. The timing may never be better for the state to pass a NLC bill that provides needed relief to financially-strapped health care organizations, overwhelmed nurses, and, ultimately, Oregon patients.
Gary Bruce is a healthcare attorney with Schwabe, Williamson & Wyatt. Gary works with hospitals, health systems, and other healthcare organizations to find practical and patient-focused solutions to complex challenges.
This article summarizes aspects of the law and does not constitute legal advice. For legal advice for your situation, you should contact a lawyer.
