Remote Nurses: How to Manage Multiple Nursing Licenses

If you’re just embarking on your remote nursing journey, you may question if your single-state nursing license is enough. After all, you may serve patients nationwide or review insurance claims from other states in your remote role.

But before you let your mind race 50 states and four U.S. territories ahead, remember that the nursing licensure a potential employer may require depends on the role. Here are some tips to get started.

How to Start Obtaining Multiple Nursing Licenses

Start by considering your ideal remote nursing job. If you’re new to remote nursing, you may have better luck searching locally. If you’re looking for a more prominent company, you may need more licenses to apply.

Here are a few examples of typical licensure expectations:

  • Local hospital system: A single-state license
  • State government health program: A single-state license
  • National insurance company case management or utilization review: Depending on your team, they may require a single-state, Compact license, or additional state licenses

A Note About Compact Licenses

The enhanced Nurse Licensure Compact (eNLC) allows nurses with a Compact license to practice in any of the compact states. 

If you live in a Compact state, your nursing license may not automatically convert to a Compact license. You may need to apply for and be granted a Compact license after confirming residency in that state, and some states may require additional fees to do so. If you don’t live in a Compact state, you are still free to apply to any single state individually, but you won’t be able to obtain a Compact license. A Compact license is a great place to start if you’re eligible. 

Managing Nursing Licensure Logistics

The main logistics to manage when pursuing nursing licensure are timelines and cost. 

The timeline to obtain a license depends on the time of year, the state, and the state’s staffing levels at that time. California is notorious for being a lengthier process, claiming at least a 3-month timeframe, but anecdotal evidence from nurses have described waiting 9 months or longer on some occasions.

In contrast, if you’re looking for a state with a relatively quick process, Connecticut and Nevada grant licensure relatively quickly, within a few short weeks.

The cost of licensure varies, too. Some states are in the low $100s, and California, one of the more expensive licenses, costs $350. Some licenses must be renewed yearly, and others require renewal every few years. Renewal fees range from less than $100 to over $200 dollars.

You can write off your nursing licensure expenses on your annual taxes to offset the cost, but this only matters if you itemize your deductions. Speak with an accountant to understand if this type of write-off makes sense for your financial situation. 

Nursing Licensure Processes

To get your first nursing license, you participated in a process called “nursing licensure by exam,” where you received a license upon passing the National Council Licensure Examination (NCLEX).  In order to gain a nursing license in a new state, the process is called “nursing licensure by endorsement.”

Achieving a license by endorsement usually entails the following steps:

  1. The board will verify you took your NCLEX in the United States and do not have a lapse in licensure, any suspension, or pending disciplinary action
  2. Complete an application on the intended state’s Board of Nursing (BON) website
  3. Submit any requested supporting documentation required by this particular state, which may include certain continuing education modules or attestations
  4. Pay the licensure fee for that state
  5. Participate in the background check and fingerprint process for that state
  6. Wait for the BON to endorse your license

Stay Organized

Keeping track of 6 or more steps for multiple states is too much for anyone to do in their head. Stay organized by maintaining a physical file folder or a Google Doc of all your licensure information. 

  • If you opt for a Google Doc, here is a template of information you may want to track:
  • Basic information
  • State name:
  • State BON website URL:
  • Username, password (if secure), and recovery email for the account:
  • Application fee amount: 
  • Licensure process:
  • URLs to relevant links (fingerprinting process, CE requirements, attestations):
  • Notes on unique steps for this state:
  • Dates and action items:
  • Started application: mm/dd/yy
  • Completed application: mm/dd/yy
  • Application fee paid: mm/dd/yy
  • Documents submitted: mm/dd/yy
  • Dates called BON for follow-up or license status:
  • License information:
  • License granted date: mm/dd/yy
  • License expiration date: mm/dd/yy
  • License number:
  • Next action item due (license renewal, next CE, etc.):
  • Put next action item into calendar?: Y/N

Maintain Nursing Licensure Compliance

Keeping up on licenses is just as important as obtaining your license.

Three key steps to maintain your license:

  1. Stay updated on the Nurse Practice Act in that state for information on your scope of practice and safety instructions in that state
  2. Renew your license at the appropriate intervals and pay the necessary fees
  3. Maintain your continuing education (CE) credits

The state BON can audit you randomly or if they suspect you are not compliant with maintaining your CEs. Don’t forget to add important follow-up dates to your calendar, and keep a record of your completed CEs in a safe place.

Conquer the Nation

Don’t let the fear of possibly needing multiple licenses stop you from reaching your career goals. Take it slow and start with positions willing to accept your current licenses or compensate you for obtaining additional licenses as necessary. 

Like everything in the remote nursing job search, a little organization and strategy go a long way. 
Interested in learning more about what you need for a remote nursing job? Check out the Nurse Fern resources page.