Compact Licensure Disciplinary Risks
The Nurse Licensure Compact (NLC) enables nurses to practice in other states besides the one in which they reside. There are currently 24 states included in the NLC, which includes Tennessee and neighboring Missouri, Arkansas, and Mississippi. Eligibility for a multistate license requires that a nurse legally reside in a compact state (National Council of State Boards of Nursing, 2014). There are no additional applications required to apply for a compact license. Only one multistate license can be active at a time. Therefore when issued a compact license, any previously active compact licenses are made inactive. Also it is important to note that nurses are required to practice according to the nurse practice act of the state for which they are actually practicing in rather than their primary state of residence. Therefore a nurse could be subject to disciplinary action in the states of practice. The nurse’s home state license is recognized in all compact states unless the nurse is under disciplinary action or restriction. With the compact licensure in place, the question is then raised to whether there is an increased risk for disciplinary actions in compact states opposed to non-compact states.
The article Troubled Nurses Skip from State to State Under Compact exposed nurses under disciplinary actions in one compact state were being able to continue practicing in another compact state. The article discusses the case of one particular nurse, Craig Peske, who was fired from a Wisconsin hospital in 2007. Peske was suspected of stealing Dilaudid, “when in a three-month period he signed out 245 syringes full of the drug – nine times the average of his fellow nurses” (Weber & Ornstein, 2010). Six months after he was fired, “Peske was charged with six felony counts of narcotic possession” (Weber & Ornstein, 2010). However by the time he was charged, he had already acquired a “multistate” license under the NLC to work as a traveling nurse at a hospital in North Carolina. Once in North Carolina, Peske’s drug use did not stop and a parent complained he fell asleep while trying to insert an IV in her child. The hospital then discovered he had again been stealing narcotics and the nursing board provided records of his firing in April 2008. Six months later he was banned from practicing as a nurse in North Carolina. Yet the problem was that his home state of Wisconsin failed to revoke his multistate license until January 2009. Even Peske himself admitted he should not have been allowed to continue to practice.
This investigation found several other cases where nurses that were banned from one state for such acts as ignoring patients’ needs, stealing patient medications, forgetting critical tests or missing critical changes in patient conditions were still able to continue practicing. Within five compact states the reporters found four dozen examples of nurses whose primary license...