Nurse Licensure. The Nursing Care Quality Assurance Commission (Commission) is responsible for licensure, license renewal, and discipline of registered nurses (RN) and licensed practical nurses (LPN). To receive an RN or LPN license, an applicant must:

• successfully complete an approved nursing education program, or its equivalent;
• successfully pass a licensure examination; and
• submit the required documentation.

LPN applicants must also provide written official evidence that they are over the age of 18.

An RN or LPN who is licensed in another state or territory of the United States that meets all other requirements for licensure in Washington may receive a license without examination.

RNs and LPNs licensed in Washington must complete a one-time training in suicide assessment, treatment, and management, approved by the Commission.

Interstate Nursing Licensure Compact. The Nurse Licensure Compact (Compact) is a proposal to create a system for expediting the licensure for RNs and LPNs already licensed by another state. States must enact model legislation to adopt the Compact and become a member to the licensure agreement. As of January 2023, 37 states have enacted the Compact and become party to the agreement.

Licensure Process. Each home state licensing board or commission may issue a multistate license to a qualified applicant residing in that state. The applicant must meet the state's qualifications for licensure, must submit to a criminal background check, including providing fingerprints or other biometric information necessary to complete the check, and must have passed an approved examination. Each license holder shall be eligible to renew their license if they continue to meet all qualifications, including having no disqualifying disciplinary or criminal history.
 
Each party state to the Compact must participate in a licensure information system and provide information to the system on licensure and disciplinary history of all licensed RNs and LPNs in the state. When an applicant applies for a multistate license, the home state must check the licensure information system to determine if the applicant holds or has ever held a multistate license issued by another state, is participating in an alternative licensing program, and whether the applicant has any disciplinary history. A nurse may only hold one multistate license at a time and upon moving to a new primary state of residence, must apply for licensure in their new home state.

Disciplinary Action. The practice of nursing in a party state under a multistate licensure privilege subjects a nurse to the jurisdiction of the licensing board, the courts, and the laws of the party state, including state practice laws, in which the client is located at the time of service.
 
Only the licensing commission of the home state may take disciplinary or other adverse action against an RN's or LPN's license issued by the home state. However, all party states are authorized to take adverse action against a nurse's multistate licensure privilege in that state and must notify the coordinated licensure information system promptly of any such action. The home state must give the same effect to reported conduct received from a remote state as it would if the conduct occurred in the home state. If a licensed nurse moves to a new state during an investigation, the home state may complete the investigation and take appropriate action. If the home state takes disciplinary or other adverse action, the nurse's multistate licensure privilege to work in all other party states must be deactivated until the encumbrance has been removed. The home state must report all adverse actions to the Compact's licensure information system.
 
Interstate Commission. An interstate commission of nurse licensure compact administrators is established. The head of the licensing board or commission of each state, or their designee, shall be a member of the interstate commission. The interstate commission may promulgate rules and bylaws for the Compact and each member shall have one vote. The interstate commission may not, through bylaw or rule, determine or alter:

• requirements to obtain or retain a multistate license in the applicant's home state;
• requirements to obtain or renew a single-state license;
• the scope of nursing practice in a state;
• the methods and grounds for disciplining a nurse in a state;
• state labor laws; or
• the obligation of any employer to comply with statutory requirements.

Joining and Withdrawing. States may join the Compact by enacting the Compact's provisions into law.  States that enact the Compact before it comes into effect are subject to review after the effective date of the Compact.  The Compact may be amended by enactments in all party states.  A state may withdraw from the Compact by repealing its enacting statute, but the withdrawal is not effective until six months after the statute's repeal.
 
Rulemaking.  The Nursing Quality Assurance Commission may adopt rules to implement the Compact.

Washington Application. In addition to the licensing fee for RNs and LPNs licensed in Washington and for nurses who hold a valid multistate license issued by the state of Washington, the Department of Health must impose an additional surcharge of $8 per year on all initial licenses and renewal licenses for RNs and LPNs. An individual seeking to practice as a RN or LPN in Washington may choose to apply for a Washington license or a multistate license.
 
Beginning September 1, 2023, individuals that hold a multistate nursing license issued by a state other than Washington and are employed by a licensed health care facility in Washington must, as a condition of employment, complete the following:

• any demographic data surveys required by the Washington Board of Nursing; and
• a one-time suicide assessment, treatment, and management training.

Beginning September 1, 2023, health care facilities must report to the board, within 30 days of employment:

• all nurses holding a multistate license issued by a state other than Washington; and
• an attestation that the employees holding a multistate license issued by a state other than Washington have completed the tasks required as a condition of employment.