Quote from docomo
Why can't we have one national nursing license and still give states the authority to have their own nurse practice act? Isn't that what the compact state license is doing? We already have the NCLEX, so who is keeping this from happening?
For the same reason the federal government got into trouble over gay marriage, educational standards and professional licensure are powers of the states for the most part with some exceptions such as the FAA.
NCLEX merely came about as states agreed to a national testing standard instead of fifty different state board exams. You still must meet whatever qualifications set down by a state to sit for the boards and each of the fifty states are members of the NCSBN: https://www.ncsbn.org/181.htm
One of the main powers federal government does have involves interstate commerce but nurses are labor.
Compact states merely allow mutual recognition of a nurse's license between member states. If you are licensed in RI and want to work in ND for instance. But if you want to permanently move from one state to another you will have to obtain licensure in your new home location.
In order to have a national license you would have to also have a national standard on everything from who can enter nursing programs, course content, requirements for graduation, scope of practice and so forth. You would also have to set up a national discipline system as well. There isn't even uniformity as to what constitutes "moral turpitude" and or being of "good moral character" when it comes to applying for a license. Criminal background ditto: here in NYS a disorderly conduct offense won't keep you from a license, but just across the Hudson River in NJ it can.