After seeing what the shortage of health care workers did to Rhode Island hospitals during the COVID-19 pandemic, the state decided to reenter the Nurse Licensure Compact this year.
The General Assembly allowed the state’s compact membership to lapse in 2018, but its importance was examined in a new light when pandemic workforce shortages led Gov. Daniel J. McKee to mobilize the Rhode Island National Guard and President Joe Biden to send military personnel to help with staffing in January 2022.
The compact includes 41 states and provides nurses who live in those states a multistate license allowing them to practice medicine without obtaining a new nursing license when going to work in any of the other states.
But local nurse labor leaders are questioning whether the move will have a significant impact on easing staffing concerns, considering neighboring states do not participate.
Nonetheless, the state’s two major hospital operators are welcoming the development.
“I think this is going to make a big impact for us,” said Sherri Sprague, senior vice president for care service and chief nursing officer at Kent County Memorial Hospital, which is part of Care New England Health System. “I think nurses that are looking to relocate probably look for states where it’s easy to obtain licensure. … This is going to allow us to attract those applicants.”
Sprague said the state’s participation in the compact eliminates the four to 12 weeks that were otherwise needed for background checks, disciplinary inquiries and other processes required to obtain a Rhode Island license.
“We’ll be able to log into Nursys [the national database for nurse license verification] and we’ll be able to quickly see federal background checks and disciplinary actions from other states,” she said. “It’s really going to streamline the process.”
Ara Millette, director of talent acquisition and workforce development at Lifespan Corp. and treasurer at the Rhode Island State Nurses Association, said reentry into the compact will make a “huge difference” to the state, local hospitals and nurses.
“It gives nurses the ability to practice across state lines without needing to go through redundant regulatory processes and fees,” Millette said. “It’s certainly broadening our geographic catch and being able to recruit on a more national market.”
Millette said the compact, first established in 1999, will also help the state with its nursing school faculty shortage, and will enable innovations at Rhode Island’s hospitals involving internet-based remote nursing management.
“[Before the interstate compact], if you have nursing students from multiple states, you’d have to have licenses for every state the student sits in,” Millette said. “And virtual nursing is one solution we’re really taking a look at, and how we can recruit with a more national lens to identify deeply experienced nurses who might be able to support operations from afar as an expert, mentor or resource for our front-line nurses.”
According to the R.I. Department of Health,, 306 Rhode Island-licensed nurses who live in the state have applied for a multistate license as of Jan. 18.
All eligible nurses whose primary state of residence is Rhode Island will be issued a multistate license when their license is renewed, said the health department, adding that nurse licenses are renewed every two years.
There are around 11,200 nurses who live in Rhode Island, according to data gathered in 2022 by the U.S. Bureau of Labor Statistics. Millette, however, said there are now 30,000 registered nurses working in Rhode Island, half of whom are from out of state.
“We have notified all nurses whose license is due to be renewed in 2024, and we expect to issue more than 7,000 multistate licenses in the next six weeks,” Joseph Wendelken, spokesperson for the health department, said in a Jan. 19 email.
Lynn Blais, a registered nurse and president of United Nurses & Allied Professionals, which represents 7,000 health care workers in Rhode Island, said UNAP has never been in favor of the compact because it “took away part of the state’s ability to vet nurses” from other states and maintain a safe nursing environment.
“Our concern is always that a problem employee can move from place to place,” Blais said. “Other states are more lax. Those become our concerns. That’s what we’re going to watch and monitor over the coming years.”
Additionally, Blais said she and others are skeptical of whether the compact will assist Rhode Island in recruitment since Massachusetts and Connecticut do not participate.
“The two states that we border, that would make it most efficient – they are not participants,” Blais said. “[If they participated], you’d see portability be a much bigger asset.”
Blais said involvement in the compact could even backfire.
“My bigger concern is we’ll see more nurses now to freely leave the state because it’s easier to practice elsewhere,” Blais said. “I can pick up and go to Florida, Texas, Idaho or Pennsylvania and not have to apply for a license. I can just walk in and get a job.”
Lifespan is facing 368 vacancies in registered nursing positions as of late January, Millette said, adding the company lacked 500 registered nurses at the height of the pandemic.
Care New England has about a 10% vacancy within its 1,500 registered nursing positions, Sprague said.
Both Millette and Sprague say it’s too early to judge how big of a difference reentering the compact will make.
“We’ll be paying attention to out-of-state applicants and if we’re noticing any trends,” Millette said. “The compact is really one strategy that helps us to cope with the current nursing shortages. It’s certainly not a solution that will resolve our shortage, but it is one of the strategies we have in our tool belt to contend with it.”
