Getting all 50 US Licenses

Nurses General Nursing

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Okay so I'm venting a little but why in the world is it SO daunting to get an RN licensure in all 50 states? I mean I've been an RN for 12 years and am licensed in a compact state which already means that I'm good enough for 25 states by default. But Holy Cow, each additional state is a nightmare!

i am a telephone triage nurse and have to be licensed in all 50 states plus Washington DC and The Virgin Islands. Please don't get me wrong, I understand the money side of it and this isn't even about the money.

My my question is why does each state require fingerprints and background check through a different agency. I mean, no matter who I go through and pay for background checks, the fingerprints and information do not change! Don't get me wrong, it should be difficult to get licensed, but this is nonsense.

And it it seems each state adds one little caveat that is impossible. For example, Kansas requires that your out of state fingerprints be sent to them directly from the Sheriff's office. Hello, the Sheriff's offices DON'T DO THAT! My fingerprints don't change if I send them to you! Uggh! So frustrating! And don't even get me started on states that require a PAPER written application. It IS 2017!

Specializes in Cardiac (adult), CC, Peds, MH/Substance.

Since compact states require a state of residency / primary state, and have limits on how long you can work in another state without declaring it as your primary, I'm curious how you navigated past this.

I work in Colorado and am employed by a Colorado employer as a telephonic Triage nurse. I.e I take telephone calls from states that I am licensed in but am based in Colorado and not present in other states.

Specializes in Cardiac (adult), CC, Peds, MH/Substance.

That doesn't really answer my question about how you navigated past these issues.

Can you be more specific? Unless I am misunderstanding your question, I am Not declaring residence in another state and thus am covered to practice telephonic triage in any compact state.

I feel you are trying to insinuate there is a time limit you can perform telephone triage in another compact state before declaring residency. To my knowledge, there is no such rule or requirement. I would be open to reading that statute if you want to provide it. If I were traveling to another compact state and living in it to perform care physically, that would be different. But I am not.

The nurse compact limits on how long one can work in another state before declaring residency were designed to prevent a travel nurse from residing in another compact state for extended periods without declaring residency in that state. The compact does not restrict nursing telephonic services to or from another compact state as there is no physical residence change, at least to my knowledge.

Since compact states require a state of residency / primary state, and have limits on how long you can work in another state without declaring it as your primary,

I'm curious how you navigated past this.

That doesn't really answer my question about how you navigated past these issues.

What "issues"? The OP has already stated that she is a resident of CO, a compact state, and is using her CO license with compact privileges to provide telephonic nursing services in other compact states. That's exactly how the NLC works. She is free to use her CO compact license to work in any and all other compact states for as long as she wants, the rest of her career if she wants to, as long as she maintains her permanent residence in CO, which she is doing.

When I lived in NC (a compact state), I worked across the state line in TN (another compact state) for four years with my NC license. I could have done so for another 20 years if I wanted to, as long as I continued to live in NC. That's how the compact works.

If either of us (the OP or me) moved to another compact state, we would have to apply for new licenses. But not as long as we continue to live in our current home/primary state.

It's the same as driver's licenses (which are also based on a compact, the only difference being that all the US states decided to sign that one) -- you can use your current, home-state, driver's license to drive anywhere in the US you want, for as long as you want, for the rest of your life, as long as you continue to live in your home state; but, if you physically move and become a resident of another state, you have to apply for a new driver's license in that state.

the fingerprinting thing, maybe I can answer. I needed to submit fingerprints for something I'm doing outside of work and I asked about that since I had just done fingerprints for my employer, it was all still current, so did I really need to do it again. I was told that anytime a fingerprinting request is submitted it is assigned a specific ID number, and another agency won't have that number to request results on if they want to use the previous prints submission. Which means that if five different entities want fingerprint results on me I'd have to submit them five times, one coming from each entity. Same fingers lol but no way to give the results obtained from one ID to a different requesting entity. Annoying, but that's the system as I understand it.

Specializes in oncology, MS/tele/stepdown.

I recently started travel nursing and it is bizarre that different states have such varying requirements. One wants my transcript from RN school but another will just take my word for it that I meet their minimum clinical hour requirement but another doesn't care about any of that just send over fingerprints and pay the fee!

Going back to the original OP message, I agree. It's both expensive and a royal PIA to get licensed in other states -- I used to have 8 (I'm in a position to start letting most of them expire and go inactive now) , and I can't begin to imagine the massive hassles of getting all 50. Even if you don't have to be a resident of more than your home state (of course, you don't -- it's not like a driver's license).

As to doing telephone triage, it is correct that you must be licensed for all the states whose residents you call. Remember that the Boards of Nursing exist to protect the citizens of their states. However, if an employer requires this, that employer should obviously pay for all those licenses and, ideally, provide secretarial support for the grunt work of getting them.

The companies I worked for that did this made a concerted effort to divide up the work so individual case managers had a limited territory, ergo they only needed licensure for those states.

Specializes in Cardiac (adult), CC, Peds, MH/Substance.
I feel you are trying to insinuate there is a time limit you can perform telephone triage in another compact state before declaring residency. To my knowledge, there is no such rule or requirement. I would be open to reading that statute if you want to provide it. If I were traveling to another compact state and living in it to perform care physically, that would be different. But I am not.

I wasn't trying to insinuate. I was asking, because I want to eventually do some telephonic/video nursing, and wasn't sure how it works.

I just wanted to know how you did it. I didn't know it applied differently to telephonic. Was hoping to capitalize on your experience. That's why I asked :)

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