While many in Massachusetts are celebrating the state joining the multistate Nursing Licensure Compact as a way to reduce the shortage of nurses, opinions are divided about how the development will affect Rhode Island.
Some view the move in Massachusetts as a plus for the Ocean State while others say there’s a risk that the state’s already short supply of medical staff will grow even shorter.
Massachusetts is the 42nd state to join the compact, which provides nurses in those states with a multistate license allowing them to practice in other states in the compact. Rhode Island was one of the first states to join the compact in 2008 but allowed its membership to lapse in 2018 before state leaders opted to reenter in 2023.
Nursing union leaders in Rhode Island have questioned the compact’s effectiveness and say Massachusetts joining will only exacerbate the state’s struggles to properly staff hospitals.
“Rhode Island will almost certainly lose nurses to Massachusetts, resulting in [fewer] nurses to provide care for our patient population,” said Lynn Blais, president of the United Nurses & Allied Professionals. “We must ensure all health care workers earn good wages and benefits that compete with our neighbor states.”
Reports have shown that salaries for providers and insurance reimbursement rates are 20% to 25% lower in Rhode Island than in Massachusetts and Connecticut.
Still, Rhode Island’s health systems are welcoming Massachusetts into the compact.
Sherri Sprague, senior vice president of patient care services and chief nursing officer at Kent County Memorial Hospital, doesn’t think there’s a risk of losing nurses to Massachusetts now that both states are part of the compact. In fact, some nurses who took lucrative travel nurse positions during the COVID-19 pandemic have started returning to jobs in Rhode Island, she said.
“If there’s a group of nurses that live in Rhode Island and want to practice in Massachusetts then they’ve probably already gotten that license,” Sprague said. “I’m not overall worried about it.”
Since Rhode Island rejoined the compact in January 2024, Sprague said, it has been helpful for filling travel nursing vacancies because licensing is much easier for personnel moving from state to state.
She expects other health care facilities, such as nursing homes – which have also struggled to recruit and retain staff – to see the same benefits.
Ara Millette, director of talent acquisition at Brown University Health, said the fact that both Rhode Island and Massachusetts are part of the nursing compact likely won’t solve the workforce shortages on its own. Still, the change could help.
“Anything we can do to eliminate barriers for the front line nurse to be able to do their work is a win,” Millette said. “The more states participating in the compact, the better.”
For Brown Health, which recently purchased two hospitals in Massachusetts, the Bay State’s addition to the nursing compact is welcome news. Nurses on both sides of the state line can now move more freely throughout the health system, which is especially helpful in emergency staffing situations, Millette said.
Even though Rhode Island rejoined the compact a little more than a year ago, nursing professionals say it’s too early to determine if it’s been a positive for Rhode Island.
The compact’s enabling legislation includes a three-year period for data collection before it becomes permanent. The R.I. Board of Nurse Registration and Nursing Education has until the end of 2026, or early 2027 to provide a report to state lawmakers.
“Everything is still in transition,” said Donna Policastro, executive director of the Rhode Island State Nurses Association, adding she has not heard much about the compact’s effects so far in Rhode Island.
Whatever the outcome, Policastro said the data will help inform state leaders on how to better recruit nurses to Rhode Island.
Anecdotally, Millette said she's noticed fewer delays in getting nurses from different states authorized to practice in Rhode Island over the last year. She acknowledged that there is a risk of losing nurses to states with higher pay rates but hasn’t seen a high turnover within Brown University Health.
The compact also affects those who practice telehealth and teach nursing courses.
Nursing officials have noticed a rise in telehealth nursing; however, a nurse needs to be licensed to practice in the state where the patient is located. So, Massachusetts joining the compact gives those nurses more flexibility for whom they can provide telehealth services.
This is true for nursing educators teaching online courses because they need to be licensed in each state a student lives, officials said.
