Nurse licensure compact and mobility
Publication id: shakya-2022-nurse-licensure-compact-mobility
Status: verified
Citation: Shakya, S., Ghosh, S., & Norris, C. (2022). Nurse licensure compact and mobility. Journal of Labor Research. Download PDF
Facts¶
Policy hook¶
Occupational licensing restricts worker mobility, but loosening requirements raises quality concerns. Does the Nurse Licensure Compact—allowing multi-state practice without additional licenses—actually increase nurse mobility and address workforce shortages?
Main finding¶
Nurse Licensure Compact adoption increased nurse mobility by 11% among registered and practical/vocational nurses within compact states, addressing pandemic-era healthcare workforce needs.
Data and setting¶
State-level analysis as of March 2021 with 34 states in compact; regression analysis exploiting staggered state adoption timing.
Research design (plain language)¶
Quasi-experimental regression design exploited state-level staggered NLC adoptions to identify causal effects, comparing mobility changes within states over time.
One caveat¶
Analysis measures interstate migration but does not examine whether increased mobility improved patient outcomes, wages, or care quality metrics.
PDF or DOI¶
Why it matters¶
Nursing shortages are persistent, especially in rural areas and crisis periods. This paper shows that multi-state licensing agreements measurably increase nurse movement toward shortage areas. For states, the finding validates the Nurse Licensure Compact as an effective policy tool—it works. For healthcare administrators, the 11% mobility increase means that compact participation expands the geographic labor pool. The result is especially relevant post-COVID when nurse turnover spiked and travel nursing became critical: regulatory flexibility to enable movement was consequential. For other licensed professions (physicians, pharmacists, mental health), the paper provides a proof-of-concept that reciprocal licensing can overcome geographic supply-demand mismatches without compromising quality assurance. The finding also suggests that “nursing shortage” policy should focus on removing geographic barriers, not just increasing supply through education or recruitment.