In a Perfect World: What National Nursing Credentialing Could Look Like
BY PATTI ARTLEY, CHIEF NURSING OFFICER, MEDICAL SOLUTIONS, DNP, RN, NEA-BC
Imagine a day when a nurse licensed in Illinois can start a new position in Arizona without navigating a maze of paperwork and delays. Every license, continuing education credit, and professional document is stored securely in one digital location, ready to be verified instantly. Job sourcing is assisted by AI, and nurses can respond to shifting needs across the country with agility and confidence.
While this may sound idealistic, the opportunity to standardize credentialing in the United States is both real and urgently needed.
What I mean by credentialing
If you’re reading this, chances are you’re already well-versed in credentialing and all its complexities. Still, because it can mean slightly different things to different people, it’s worth clarifying.
When I say "credentialing," I’m referring to the full set of systems that verify whether a nurse is qualified to practice: licensure through a state board, certification in specialty areas, accreditation of education programs, and continuing education like CEUs.
These processes ensure competence and protect patient safety. They’ve long served as the gatekeepers of public trust in healthcare.
That said, even the most important systems can cause issues when they aren’t aligned. Each state operates under its own regulatory framework, with different documentation, timelines, and verification protocols. For nurses moving across state lines (or for healthcare employers trying to onboard them), it often means repeating the same steps in 50 different ways.
What should be a straightforward process becomes a barrier to mobility for nurses and a bottleneck to timely patient care.
A system built for a different time
The credentialing system we rely on today wasn’t built for how healthcare works now. It’s rooted in a time when care was more localized and professionals typically stayed in one place. State boards of nursing have long played a vital role in setting standards and protecting the public.
That structure made sense for decades, but today’s healthcare is faster, more mobile, and increasingly virtual. Patients move, providers move, and care happens across state lines. And yet, the systems for verifying a nurse’s ability to practice haven’t evolved with the profession.
Nurses willing to relocate or travel to meet staffing needs often face delays, gathering paperwork, paying redundant fees, and proving qualifications they already hold. It’s not that their credentials are in doubt. It’s that every state asks for the same information in slightly different ways, multiple times. Even more granularly, every hospital and every role require something slightly different to ensure that we meet the criteria to practice in that organization and ability to practice in that role.
We saw just how inefficient this could be during the COVID-19 pandemic. states temporarily waived or relaxed credentialing requirements. That moment proved how quickly systems can adapt when the stakes are high. But once the urgency faded, most of those changes disappeared, and the old inefficiencies returned.
We shouldn’t need a global emergency to modernize something as basic (and essential) as how we verify nursing credentials.
The role of the nurse licensure compact
One promising step toward progress is the Nurse Licensure Compact (NLC). While not perfect, the NLC has shown what’s possible when states work together. It allows registered nurses and licensed practical/vocational nurses to practice in any participating state under a single multistate license, a model built for the realities of modern care.
For nurses, this means less paperwork, lower costs, and faster transitions, whether relocating, taking a travel assignment, or delivering virtual care across state lines. For employers, it means quicker access to talent and a nimbler response to staffing needs. It also brings consistency thanks to shared expectations and licensure criteria.
In short, the compact is more cost-effective, more efficient, and less burdensome for everyone involved. It simplifies a process that too often gets in the way of care.
Still, its reach is limited. Ten states (including major healthcare markets) have yet to join. And the compact doesn’t include advanced practice registered nurses (APRNs), who face their own licensure hurdles. Given their growing role in expanding access to care, especially in underserved areas, that’s a gap we can’t afford to ignore. These credentialing challenges are even more complex as they are providing care also governed by the medical license system.
Expanding the compact and building similar solutions for APRNs would be a big step forward, but even those changes wouldn’t fully solve the broader challenge. What we need is a truly nationwide, standardized credentialing system.
Why standardization matters now
Standardizing credentialing isn’t about making life easier for HR teams or even nurses, though it would. It’s about addressing some of the most pressing challenges in healthcare today.
We’re facing a deepening nursing shortage, especially in rural and high-demand regions. When licensure processes are slow and fragmented, qualified professionals can’t get where they’re needed fast enough. That leads to persistent staffing gaps, rising burnout, and delays in care.
A standardized system could reduce administrative overhead, lower costs, and increase flexibility. It would also enable broader access to virtual care, allowing telehealth nurses to practice across state lines without jumping through unnecessary hoops.
At a time when every nurse counts, we can’t let outdated paperwork be the reason a patient goes without care.
Building the infrastructure for change
The technology to support standardization already exists. What’s needed is the will to implement it.
A secure, centralized digital platform (essentially a credential wallet) could allow nurses to manage their licensure, CEUs, certifications, and documents in one place. Employers could access verified credentials in real time, reducing onboarding delays and minimizing manual effort.
AI could assist by flagging upcoming expirations, verifying compliance, and recommending continuing education options. And with the right data-sharing standards in place, information could move smoothly between systems, giving nurses more control over their records and giving employers what they need, when they need it.
Such a platform would improve transparency, reduce errors, and free up time that nurses and HR teams currently spend chasing signatures and uploading the same documents again and again.
Navigating the challenges
Of course, creating a standardized system won’t be easy. States have different scopes of practice, particularly for APRNs. Medication protocols, education requirements, and even terminology can vary. Aligning those differences will require real collaboration among state boards, nursing organizations, and legislators.
Oversight is another sensitive issue. While a federal agency might seem like a straightforward solution, many stakeholders are cautious about ceding state control in a historically local process. A more balanced model could involve partnerships between national nursing associations, state representatives, and tech providers.
And we can’t overlook data security. Any system handling personal and professional information must be built with privacy, security, and accountability at its core.
A call for collective action
Despite the challenges, the path forward is clear and more urgent than ever. Expanding Nurse Licensure Compact participation, aligning core credentialing standards, and investing in modern infrastructure are all achievable steps. Together, they could reshape how we move qualified nurses to where they’re needed most.
The U.S. healthcare system is at a crossroads. Staffing shortages are growing, patient needs are more complex, and the demand for care continues to outpace supply. We can’t afford to let an outdated credentialing process slow us down.
By rethinking how we license and verify our nursing professionals, we have the opportunity to build a system that’s not only faster and fairer, but also future-ready.
Nursing leaders, HR professionals, educators, policymakers, and nurses themselves all have a role to play. This isn’t about lowering standards. It’s about setting higher expectations for how those standards are supported and sustained.
Nurses are already doing their part. It’s time our policies caught up and our states come together to create common standards for us all to practice under. Are we ready for the change? ♦
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Author bio:
With more than 35 years of nursing experience, Patti Artley, DNP, RN, NEA-BC oversees Medical Solutions’ Clinical and Performance Management teams. She partners with Chief Nursing Officers from existing and potential healthcare facilities to understand and address their clinical staffing needs. Before joining Medical Solutions, Patti served as the Chief Nursing Officer at Medical University of South Carolina (MUSC), where she also serves as an affiliate assistant professor. Patti has received the Senior Leader Award for Solutions for Patient Safety, the 2022 Excellence in Interprofessional Education and Collaborative Practice Award for the MUSC Health System, and several nursing leadership awards. Patti currently serves on the board of Ronald McDonald House Charities and was also a member of the executive committee for the American Heart Ball in Charleston. Patti earned her bachelor’s and a Master of Science in Nursing from Pennsylvania State University and her Doctorate in Nursing Practice, Nurse Executive from Old Dominion University. She maintains certification as an advanced nurse executive.
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