Joining nurse licensure compact would boost Washington’s workforce, proponents say, while opponents cite safety concerns

By

Shane Ersland

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Washington is one of only 13 states that is not a member of the interstate nurse licensure compact, but Sen. Mark Mullet (D-Issaquah) has introduced a bill that would change that.

 

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Members of the Senate Committee on Health and Long Term Care discussed Senate Bill 5499 during a public hearing on Friday. In order to acquire a registered nurse (RN) or licensed practical nurse (LPN) license, an applicant must successfully complete an approved nursing education program and a licensure exam. RNs and LPNs licensed in Washington must complete training for suicide assessment, treatment, and management as well. 

The nurse licensure compact expedites licensure for RNs and LPNs who are already licensed in another state. It allows RNs, LPNs, or vocational nurses to have one multi-state license in order to practice in their home state and other compact states without obtaining additional licenses, committee staffer Andie Parnell said. 

“States may join the compact by enacting the compact’s provisions into law,” Parnell said. “Currently, 37 states have enacted the compact.”

SB 5499 would enter Washington into the compact. Mullet discussed some of the feedback he heard from Washington nurses while putting the bill together. One concern they had regarded suicide prevention training, which some states don’t require.

“The compact has to be verbatim, letter by letter, word by word,” Mullet said. “But you can add other requirements. And that’s what we’ve done in this bill, to say that in Washington, even if you have a multi-state license, you still have to do the suicide prevention training that we know has been effective for our nurses, and we think is beneficial for the residents of Washington.”

The primary goals of SB 5499 are to attract nurses from other states to move to Washington and remove barriers so it’s easier for them to work in the state, Mullet said. He noted that Washington’s average RN salary is the fifth highest in the nation at $96,980.

“There are four states higher than us,” Mullet said. “None of those states are in the compact currently. So if Washington were to become the 38th state in the compact, we would be the best paid state out of all 38 states in the compact.”

New Jersey would follow Washington in the rankings with an average nurse salary of  $94,000 per year, Mullet said. 

“That is important in the sense that we’re dealing with a workforce shortage,” Mullet said. “So we know that if we put a higher value on this profession than the states that are currently in the compact, I think there will be an incentive for nurses working in other states. And I would prefer people move to Washington [rather] than take the traveler option, which is what we’re relying on now to deal with our workforce shortage. I don’t think the traveler option is sustainable financially for anybody in the healthcare space.”

Sara Gering, an intensive care unit nurse, testified against SB 5499, citing safety concerns. 

“On first review, a multi-state license does sound appealing and simple,” Gering said. “For nurses who practice in more than one state, only a license in our state would be needed. However, these marginal benefits for a small number of nurses would be overshadowed by potential risks to states like Washington that have worked hard to establish high nursing standards. And they pose unnecessary risks to the quality of patient care for the public nurses practicing within those states.”

Melissa Johnson, from the Washington State Nurses Association (WSNA), also raised safety concerns. She noted that thousands of nurses received bogus diplomas in Florida and were practicing all over the country. 

“In our state, thankfully, our nursing commission was able to identify four of these nurses because they had a Washington license,” Johnson said. “So they were able to run the names in their database, and revoke their licenses here. If we had been part of the compact, we wouldn’t have been able to do that. Our commission would not have had those names to run in that database. That’s a recent example of something fairly scary. We had people that were licensed as RNs that did not have the education and training, and were practicing here in Washington.”

WSNA has voiced support for SB 5582, which would reduce barriers and expand educational opportunities to increase the state’s nurse workforce, in other hearings.

Jennifer Burkhardt, chief talent and legal officer at Summit Pacific Medical Center in Elma, testified in support of SB 5499. 

“It is extremely difficult to recruit and retain nurses, particularly when one is a small, rural hospital competing against national competitors, as well as larger, more urban, much more well-resourced hospitals,” Burkhardt said. “We don’t believe this bill will single-handedly solve the nursing workforce shortage, but this is about looking at solutions from a comprehensive standpoint. 

We know we need to make efforts to retain our current nurses in the workforce. We need to attract new nurses to Washington, and we need to educate more nurses to develop a pipeline for the future. This bill helps with that effort to attract more licensed nurses to Washington. If we join the other 37 states that are in the compact, it would simply make it easier for nurses to come and practice in Washington.”

No action was taken on the bill as it will be considered in future hearings. Sen. Mike Padden (R-Spokane Valley) introduced SB 5247 relating to the nurse licensure compact last year, but the bill died in committee in March 2022.