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The APRN Compact Rethinks Healthcare Portability for Nurses

The healthcare industry is taking a simple and effective step in protecting its nurse workforce: listening to and allying with their needs. Groups like the National Council of State Boards of Nursing (NCSBN) have put pieces in place to enhance the work-life balance of advanced practice registered nurses (APRN). The APRN compact, influenced by a big legislative push from the NCSBN, is restructuring how patients are treated across the U.S. The compact has opened a new channel for multi-state practice for nurses licensed in a state that has signed the agreement.

To be eligible for multi-state licensure, nurses must complete an advanced degree, 2080 hours of post-graduate experience, and fall into one of the four approved categories: certified registered nurse anesthetist (CRNA), certified nurse midwife (CNM), clinical nurse specialist (CNS), or certified nurse practitioner (CNP). The APRN compact smooths out policy disagreements between states by opting for a group consensus model. Since 2005, the APRN compact has merged states through their linkage agreement, though it has encountered resistance in rolling the plan out nationwide. The compact grew out of the nursing licensure compact (NLC) which greatly expanded practice options for registered nurses (RN) and prompted less of a rebuke from individual states. Now, the spotlight is on the APRN to create a similar arrangement for nurses who practice at the advanced level.

By removing disincentivizing regulations that impair an employee’s mobility, nursing professionals can align their busy schedules with their professional goals. The systematic flexibility of the compact strengthens the nursing workforce, builds internal morale, and supports a continuity of care for underserved populations. 

The Economic Liberty Task Force, under the guidance of the Federal Trade Commission, has highlighted the advantages of healthcare portability—stretching common, electable standards between states—as a long-term goal for the profession. Turning to the National Council of State Boards of Nursing (NCSBN) can ease any burning questions about how the compact could affect your options. Regardless of your state of practice, the APRN compact improves the lives of patients and providers. Leaving policy disputes outside of the treatment room lets nurses do what they do best.



Federal Trade Commission (2018). Policy perspectives: Options to enhance occupational license portability. (Report outlining the benefits and opportunities of interstate licensure agreements)

Fotsch, R. & Livanos, N. (2017). The enhanced nurse licensure compact and the aprn compact. (Presentation from the Iowa Nurse Practitioners Association about the NLC and APRN, offering general information that highlights the advantages of a compact)

National Council of State Boards of Nursing (NCSBN). The world leader in nursing regulatory knowledge. (Major source of nursing licensure, education, and professional guidance)

NCSBN Delegate Assembly (2020). Advanced practice registered nurse compact. (This document reviews the specific fine print policy of becoming an APRN party state)