Industry Trends & Insights

The Future of Nurse Licensure Following COVID-19

Portia Wofford, LPN
April 21, 2020
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As the fight against COVID-19 continues, states are invoking new measures to ensure nurses are available to help patients in hard-hit areas. That includes bringing in nurses from other state lines when necessary. 

At least 41 states and territories have submitted to the CMS to waive specific medical provider licensing requirements. According to the American Association of Nurse Practitioners, at least 48 states have declared official states of emergency in some capacity, and eighteen states have enacted the Uniform Emergency Volunteer Health Practitioners Act

Some states have expedited the licensing processes or are permitting nurses to practice in their state temporarily. As nurses leave their homes states and cross state lines to help on the frontlines, many are questioning the need for such stringent licensing restrictions pre-COVID-19.

If nurses can cross state lines and safely care for patients, without licensure restrictions or long waits for endorsements, is there a need for such tight regulations? Will coronavirus open the door for uniform nurse licensure? 

What Is the Future of Nurse Licensure Following COVID-19?

Universal licensure guidelines

Currently, states that are a part of the eNLC have uniform licensure requirements:

  • Proof of identity
  • Be a graduate of a board-approved school of nursing
  • Pass the NCLEX
  • Meet home states’ licensure requirements
  • Pass an English proficiency exam (for international graduates)
  • Hold a license that’s not under a disciplinary program 
  • No current participation in an alternative program (applicants must disclose)
  • No felony convictions or misdemeanor convictions related to the practice of nursing

Universal licensure guidelines allow nurses to cross state borders and provide care without time-consuming barriers quickly. Additionally, these guidelines protect the public by setting consistent standards. 

More states joining the eNLC and subscribing to universal licensure requirements gives patients, states, and healthcare systems the safeguard of knowing nurses have met a standard set of minimum requirements. 

map book folded open on wood table map of united states nurse licensure compact states

The need for more compact states

Will more states join the eNLC following COVID-19? The short answer: They should. 

The Enhanced Nurse Licensure Compact (eNLC) allows any nurse who resides in one of the participating states to practice nursing in any state that’s a part of the eNLC. Currently, 32 states have enacted the nurse licensure compact (with two more currently awaiting legislation).

According to NCSBN, the licensure compact was created to address the nursing shortage and increase access to care for patients: “In the event of a disaster, the eNLC enables nurses from multiple states to easily respond to supply vital services.” While nurses continue to help out across the country during the pandemic, more states joining the eNLC will be beneficial to nurses, patients, and healthcare in the long run.

Increased Nurse Mobility

More states joining the compact allows nurses to work in locations where and when they are needed. Reducing regulatory burden helps to create access to care for patients. This includes both in-person as well as telehealth services, greatly mitigating local, in-state personnel needs (and bottlenecks).


Telehealth has proven to be critical during this COVID-19 pandemic. Because COVID-19 spreads quickly and easily, keeping patients experiencing non-urgent symptoms away from crowded emergency departments is essential. Some states have lifted telehealth restrictions and are allowing nurses to practice across state lines. 

Telehealth nurses are vital in triaging, educating, and performing virtual assessments on patients who feel symptoms but are afraid or unable to seek in-person treatment. After COVID-19, the need for clinical and mental health nurses will increase. 

As survivors deal with the effects and co-morbidities that may arise as a result of the coronavirus – and more people seek mental health resources – having competent, experienced nurses available is pertinent for a great healthcare system. 

Access To Care

Patients living in underserved or rural areas need access to healthcare. More states joining the eNLC will allow nurses to serve on a broader spectrum. Limiting the barriers, such as expense and time, makes it easier for nurses to start providing care. 

Ultimately, while maximizing portability for nurses and removing barriers to care, a shift to more universal regulations (and more compact states) can help in promoting a health care system that is more seamless and convenient for providers and patients alike.

Need help navigating any of the current state processes in preparation to travel outside of your state to work? Let us give you a hand!

Portia Wofford, LPN

Portia Wofford is an award-winning nurse, writer, and digital marketer. After dedicating her nursing career to creating content and solutions for employers that affected patient outcomes, these days, Portia empowers health businesses and nursing brands to grow their communities through engaging content that connects and converts. Follow her on Instagram and Twitter for her latest (@thewritenurse). As part of her mission to help nurses earn extra income, beyond the bedside, Portia teaches nurses how to get paid and published by showing them how to land their first paid freelance writing gig.

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