Lessons · Nursing · the multistate licence, and who is not in it
The multistate licence, and the states it does not cover
Some states take part in an arrangement that issues a multistate licence: one licence, held in your home state, that authorises practice in the other participating states. Not every state takes part. A licence from a state outside the arrangement, or a single-state licence from one inside it, authorises practice in that state only.
Hone is a place to practise a career, one idea a day. This is one of its lessons, written out in full and free to read without an account.
In beta. This lesson was written for Hone and has not yet been checked by a licensed nurse. Practice material, not professional advice. What that means.
What it is for
This is the difference between taking an agency shift across a state line and committing a criminal offence, and it turns on a fact most nurses have never been told to check. It matters especially to anyone in one of the large non-participating states, California among them as things stand, because a colleague's multistate licence and yours are not the same document even when both say registered nurse. It also matters to travel and telehealth work, where the patient's location decides which licence is needed.
How to think about it
Establish two facts and write them down: is my home state in the arrangement, and is the licence I hold the multistate kind or the single-state kind? Both are published and neither is guessable from the card in your wallet. Then, for any work across a line, ask where the patient is, because that is the state whose licence you need. Boards publish their own requirements and change them, so the figure you plan around has to come from your board's own page rather than from here or from anybody who did this a few years ago.
Worked example
Home state participates, multistate licence heldPractice in the other participating states is authorised.
Home state participates, single-state licence heldThat state only. Holding one does not mean holding the other.
Home state does not participateThat state only, and an application by endorsement for anywhere else.
Work across a lineThe patient's location decides which licence is required.
Your turn
Say what a multistate licence is held in, as opposed to where the work happens.
A multistate licence is held in your state
Solve one, graded on the server
The trap
Assuming that because a friend can take a shift two states over, you can. Whether you can depends on your own state's participation and on which kind of licence you hold, and the arrangement's membership changes. Boards publish their own requirements and change them, so the figure you plan around has to come from your board's own page rather than from here or from anybody who did this a few years ago.