Although multistate practice requires no new regulatory scheme, evolving health care delivery systems and practice patterns of nurses which involve physical practice in more than one state require facilitation. Many state nursing regulatory agencies have long delays in processing application for a license. This impedes the ability of nurses to obtain a license in a new state in a timely way thus affecting employment and potentially, access for patients. The recommendations regarding rapid endorsement address this issue. Nursing practice is affected by new health care delivery systems and continuously evolving technology resulting in increasing interstate and multistate practice.
Interstate practice is the delivery of nursing services across a state border.
Such nursing services include advice lines, outreach services, poison control centers and video consultations. The nurse is in one state, the patient in another. Multistate practice occurs when a nurse practices in multiple jurisdictions. This may be an educator who is responsible for students of one academic institution having clinical placements in several states or a home health nurse who sees patients in more than one state even in a given day. Or a nurse may hold positions in more than one state.