Moving from one state to another often means that physicians, nurses, dentists and other health care professionals must obtain new state licenses to practice their profession. In Illinois, for example, nurses could expect to wait weeks if not a month to obtain their Illinois license. For physicians, it was not uncommon for the process to take several months. Yet, with the onset of COVID-19 and the concern about a medical surge, Illinois and many other states implemented through emergency powers an expedited licensure process. Out-of-state nurses could get approval in as little as 48 hours, with physicians only slightly longer.

There has long been criticism of the cumbersome state-by-state process for professional licensing. In response to this problem, many states have adopted the Enhanced Nurse Licensure Compact (eNLC). Under this compact, states that had adopted an agreement whereby nurses that meet the agreed upon criteria of the compact can practice in other compact states. A large majority of states have adopted the compact, with notable exceptions being the Northeast, Upper Midwest and East Coast regions of the nation. See the map here.

Ironically, Governors in states without eNLC were among the first to issue Executive Orders waiving licensure requirements not only for nurses, but for many other health care professionals. Legislation to adopt the Nursing Compact has stalled in recent years in these states. Once a state has opened its borders to out-of-state licensing, with few reported problems, there will be momentum for states to adopt the Enhanced Nurse Licensure Compact and move towards opening its licensing process for other professions.