Confused about licensing

meandragonbrett · Dec 11, 2013

The license will expire just like your home license expires. You pay the renewal fees and you keep the license active.

elkpark · Dec 11, 2013

You can carry as many licenses as you are willing to pay for (and maintain CEUs, etc.) The only exception to the number of licenses you can hold is the NLC (Nurse Licensure Compact) -- you can only be licensed in one "compact state" at a time, and it must be your home state (the state in which you actually live). However, since your license with "compact privileges" is accepted by all other compact states for work purposes, that makes life a little easier if you're wanting to travel to compact states.

NedRN · Dec 11, 2013

Not a stupid question at all. First, you can keep state licenses as long as you like, even if you have never worked in that state. Most state licenses will ask you if you have worked some number of hours anywhere in the last two years as a qualifying question when renewing (or on the original application).

Depending on the state, you may not have to keep your license current. While you may have to pay extra for a lapsed license renewal, that is better financially than keeping your license current unless you will be working in those states every two years. Keeping 15 state licenses current is a lot of money and work. Three states that I have at least twice let my license lapse and simply dropped by the state board on the way to my assignment are California, Massachusetts, and Maine. I would call those very traveler friendly states in that regard. Two states that suck big in this regard include NJ and Florida which require paying back licensing fees and penalties for the entire lapsed period.

Some states do take a while to get the initial license by reciprocity. Some states, such as Massachusetts, require verification of every license ever held, not just the original or a current license like many states. Thus they can be quite expensive if you have traveled for a while. If you have a bucket list of states you want to travel to, consider planning the order in which you obtain licenses rather than traveling to the states on the top of your list first. PanTravelers has a state board list you can use to plan your license applications with more relevant information than you can often find on the state board's own web site.

Nursys is a collaboration of state boards for verifying licenses held - an online process. That makes it easier and cheaper than the old days where you had to send a signed form to each state whose license you needed to verify. However, there are a number of states, notably California who do not verify through Nursys (but rather confusingly will verify Nursys states held licenses when applying for their license). Thus not only will holding licenses in those states slow significantly future license applications, but will cost you more for each license where you need their license verified (like for states that require every license ever held to be verified). California is historically slow to verify their licenses to other states and you should count on a month to get other state licenses that require you verify your California license.

Another piece of the puzzle is the 24 states who comprise the the Nursing Compact states. If you reside in one of those states, your license is good in every other of those 24 states. Something to think about if you can choose where to live during your travel career. It is not as valuable as it appears, because lower barriers to entry means a lot more competition from other compact state nurses for assignments. The very highest paid states for nurses and nurse travelers are not in the Compact. These include WA, OR, CA, MA, and NJ. Holding those state licenses and working in those states will earn you more as a traveler generally. (I don't recommend NJ for the reasons above unless it is a must work state for you).

Many states now require fingerprint enable background checks for licenses and this usually slows the licensure by reciprocity process (especially if you have misdemeanors, felonies, or DWIs). Paper and ink prints used to be the standard, but now many states have a "Livescan" process that is basically scanning your prints like a fax machine. This works much better for fingerprint recognition than ink, especially for many nurses whose finger whorls are worn down from so much hand washing. Most states that have them require the Livescan to be done in-state, but a few like Florida can be done in any state.

One other useful bit of information is the so-called walkthrough states - states in which you can walk in and walk out with a valid state license (usually a temporary license but still fully valid to work in any hospital). Part of being a traveler, especially now, is to be able to get fast filling assignments. This means either having a state license in hand (as noted above, an expired license may be fine), or being lucky enough for the assignment to be in a walk-through state. There are 6 to 8 states or so that fit that definition to one degree or another. (look at PanTravelers for the names)

California is indeed a valuable license to hold, but can be notoriously slow to license by mail although they have recently improved their processes. But it is bad enough that most California hospitals will only look at traveler profiles with licenses in hand. Technically, California is a semi-walkthrough state and if all the stars align, you can get a license there in as little as a day But that does require a visit in person to the board and doing the Livescan in California (PanTravelers lists the process step by step). Either way, like your recruiter was encouraging you to do, you want it in your hand before being submitted to a California hospital.

That is a lot of information to take in, but fundamental to the traveling process and getting state licenses by reciprocity. Most traveler are not in your position where rational choices are possible, but most of us get through fine. You can choose to ignore most of this and you will also do fine.

I went to school in California and am old enough to have taken the written boards. They gave me a choice of what state to have my original licensure in and of course I chose California. Big mistake in hindsight! I didn't even work there first as there was a recession and jobs for new grads were scarce. But who could know how expensive California being my original state would be - $60 for every new state I went to to verify my never used California license (which was a lot of money back in 1995). Licensing trends continue to evolve (no background checks back then), but at the time when I started traveling in 1995, states always wanted your original license verified. But despite that, I've done better than OK by traveling. The paperwork to travel has increased tremendously in the last 19 years and seems to be accelerating with JC agency accreditation, and compact licensure (which ultimately will require the standards of the most difficult member state). CEUs are required by more states now.