To deal with nursing shortages, a 24-state partnership permits nurses to use licenses obtained in one state to work in another, so that they can move to areas where they are needed most. But when states have been slow to act or share information, the pact has allowed some nurses with records of misconduct to cross state lines and continue to practice, putting patients in danger, according to a joint investigation by ProPublica and USA Today.
Some nurses have been able to keep multistate licenses even after they have been banned in one of the member states. They have made serious mistakes, forgotten tests and stolen pain medication, according to the investigation:
Critics say the compact may actually multiply the risk to patients. There is no central licensing for the compact, so policing nurses is left to the vigilance of member states.
Outside the compact, each state licenses and disciplines its own nurses. But within it, states effectively agree to allow in nurses they have never reviewed.
Compact states also have different standards and rules, making cooperation difficult. Some states don’t require criminal background checks, while others don’t have the power to immediately suspend nurses.
States like Ohio and Kansas decided not to join the compact because of these discrepancies.
“If an applicant has been convicted of certain crimes such as murder and rape, among others, the applicant cannot be considered for licensure in Ohio,” the Ohio Board of Nursing said in a statement.
State officials in California recently found 3,500 of its nurses had been in trouble in other states.
In the investigation, reporters found about 50 examples of nurses who retained their primary licenses, even though they’d been banned by another state in the agreement.
But proponents say that without a federal licensing system for nurses, the pact is one of the few ways to track nurses who work in different states, and compact administrators have said there is no evidence their system has put patients at risk.
There are also two national databases that are supposed to track disciplined nurses — one run by the federal government and one by the National Council of State Boards of Nursing — but the investigation found discrepancies and missing records in both systems.
