In a moment of bipartisan wisdom, the Labor, Health, and Social Services Committee sponsored legislation allowing out-of-state nurses to practice in Wyoming. Like many states, Wyoming bars nurses not licensed by our nursing board to practice here. The status quo restricts the supply of nurses, preventing patients from accessing thousands of qualified nurses, not to mention raising healthcare costs. The committee’s members took a decisive step towards expanding healthcare access in the state of Wyoming.
The issue was whether to join the Nurse Licensure Compact, or NLC, and the Advanced Practice Registered Nurse (APRN) Compact. The APRN Compact is an interstate agreement where the license issued by any member state is accepted by all. It would apply to Nurse Practitioners, Anesthesiologists, Clinical Specialists, and Midwives. These are nurses with postsecondary degrees who can examine, diagnose, and treat patients.
The NLC works the same for Registered Nurses (RNs) and Licensed Practical Nurses (LPNs). Since its inception in 1999, 25 states have joined this compact, freeing 1.4 million nurse to care for patients across state lines. In the words of Cynthia LaBonde, the head of Wyoming’s board of Nursing, “It’s like a driver’s license. It gives nurses the ability to cross state lines and practice nursing in any other state that is a party state.”
However, states outside of these compacts, including Wyoming, don’t recognize licenses issued by other states, even though every state has virtually the same requirements for nurses to practice. Every state requires nurses to have an Associate or Bachelors nursing degree, in addition to completing the National Council Licensure Examination; a test established by the National Council of the State Boards of Nursing. States also require every APRN to complete postsecondary education. Despite these uniform standards, Wyoming and many other states bar talented nurses from caring for their residents.
For these reasons, even Wyoming’s Board of Nursing favors joining these compacts and allowing non-Wyoming nurses to practice here. According to Cynthia Labonde, these nurses will provide crucial medical support for hospitals, especially during times of emergencies.
She’s right. Wyoming is in desperate need of more healthcare professionals. According to the federal Department of Health and Human Services, a quarter of Wyoming’s population live in communities designated as Health Professional Shortage Areas. There are currently only 191 doctors for every 100,000 residents, compared to the national average of 260. Opening Wyoming’s borders to more nurses will not only help physicians care for their patients, but allow more APRNs to start their own independent practices as well.
In addition, advanced nursing care is far less expensive than physician care. The average salary for an APRN in Wyoming is $90,400, less than half of what physicians make, according to the Bureau of Labor Statistics. Utilizing more nurses will make our healthcare more accessible and more affordable.
But these compacts’ greatest contribution will be allowing future medical innovations to flourish. Using the latest information technologies, providers are finding new ways to care for patients remotely through Telemedicine. They can consult patients, diagnose diseases, deliver treatments, and monitor conditions without ever meeting in person.
Right now it’s illegal for nurses in other states to even consult with Wyoming patients by phone or video. By joining the APRN Compact, Wyoming patients will be able to access advanced nurses across the nation electronically for their healthcare needs. Senator Charlie Scott was particularly interested in this prospect. He said “They’ll be able to practice just like if they had a Wyoming license.”
Allowing out-of-state nurses to practice in Wyoming is a critical reform for better and cheaper medical care. Both Republicans and Democrats on Labor, Health, and Social Services Committee realize this. Let’s hope the rest of the Wyoming Legislature does as well.