Purpose
The purpose of this bulletin is to provide resources and information to hospitals and health care systems about the licensure process for Registered Nurses (RN) and Licensed Practical Nurses (LPN). WSHA has been approached by several members with questions to clarify the nurse licensure process.
WSHA’s goal is to share helpful information about the licensing process to ensure hospitals and health systems have the resources they need to license nurses as quickly and efficiently as possible given our state’s licensure structure. While WSHA has pushed hard for our state legislature to join the Nurse Licensure Compact, key legislators needed for its passage remain opposed. WSHA will continue to advocate in the licensure arena and is pleased to see the legislature requiring certain timeframes for nurse licensing. In its work on behalf of hospitals, WSHA has been in close communication with the Washington State Nursing Care Quality Assurance Commission and is appreciative of its great efforts to continue to streamline processes.
Applicability/Scope
This bulletin addresses the following types of applicants (more specific details on the process for each type is contained in the “overview” section below):
- Active Nurse License in Another U.S. State (Licensure by Endorsement) – When a nurse currently holds an active license in another state and applies for licensure in Washington (and meets all Washington licensure requirements), a Temporary Practice Permit (TPP) will be automatically issued to nurse applicants who have met all necessary requirements and are in good standing. According to the Nursing Commission, current processing time for a TPP is four business days after the applicant has turned in all the required application components. Once a nurse has a TPP they can practice nursing in the state of Washington.
- New Nurse Graduate (Licensure by Exam) – For recent nursing graduates of a nursing program who have not yet taken the national exam (NCLEX), the Nursing Commission is issuing emergency interim permits, allowing the applicant to work as a nurse during the declared emergency after meeting certain requirements. The new graduate must apply for full licensure through the online application if interested in obtaining an emergency interim permit.
Overview
There are two primary licensure pathways for nurses (RN and LPN) to practice in Washington state: (1) licensure by interstate endorsement, and (2) licensure by exam (NCLEX).
WSHA recommends nurses with currently active licenses in other states apply for full licensure by “Endorsement.” The Nursing Commission automatically issues a Temporary Practice Permit to nurse applicants who have met all the necessary requirements of WAC 246-840-090, have submitted a complete online application, and are in good standing. See below for specific details explaining this process.
Recent nursing graduates may receive an Emergency Interim Permit after graduating and before taking the NCLEX if they have applied for licensure through the online process. This type of permit allows a nurse to practice the full scope of their profession for up to 180 days during the declared emergency. The permit is temporary and will expire after 180 days or will be revoked if the nurse fails the NCLEX.
Below are more specific details outlining the licensure processes:
1. Active License in Another U.S. State (Licensure by Endorsement)
Licensure by interstate endorsement, applies to out of state nurses who currently have an active license in another U.S. state or territory. The requirements for licensure by endorsement, without examination, are outlined in WAC 246-840-090.
According to WAC 246-840-090, to be licensed in Washington by endorsement, the following requirements must be met:
- Graduating and holding a certain degree from an approved program,
- An active nursing license in another state or territory (or an inactive or expired license and has successfully completed the commission-approved refresher course),
- The applicant passed the National Council Licensure Examination (NCLEX),
- Certain English proficiency requirements for applicants who graduated from programs outside the U.S., and
- Specific considerations for Registered Nurses who are a graduate of a nontraditional nursing education program (see WAC for details).
Before starting the application for licensure, the applicant must first read and understand the licensure requirements. These requirements include:
- Submitting a completed application and application fee (which includes all required supporting documentation if applicable).
- Verification of initial licensure in the United States. For the majority of states, the applicant must follow the process outlined through the “nursys” system (https://www.nursys.com/NLV/NLVTerms.aspx). For licensees from California, Michigan, or Pennsylvania, you will need to use a separate process through your state’s licensing board (Non-Nursys verification form).
- Applicants must have an active license to apply for licensure by endorsement. For those applicants without an active license (i.e., inactive or lapsed), you must also enroll and complete a Nursing Commission approved refresher program. The enrollment in the course must be indicated on your application, and you must complete the course for a return to active status. The scheduling and fees vary by program.
- For applicants who have completed a non-traditional licensing program, they are required to submit work verification of a minimum of 1,000 hours of active nursing practice in another state. (The licensure requirements document discusses this in greater detail on page two).
- The Nursing Commission may require the applicant to submit official transcripts in certain cases, if they are unable to verify the nursing education program, degree, or graduation date on the verification of licensure. (This is also discussed in greater detail on page two of the licensure requirements document).
- FBI background checks are required by state law. After an application is received, the Nursing Commission will email the applicant instructions on how to complete the FBI fingerprint process (and is no longer mailing out fingerprint cards). The applicant is encouraged to complete the fingerprint process using Live Scan if available, or complete on the cards provided by the fingerprinting facility. The form and instructions for the fingerprint-based federal background check provides additional information about this process.
- The licensure instructions also include specific discussions about spouses of military personnel being transferred or stationed in Washington, as well as an English proficiency exam under certain circumstances. (See licensure requirements document).
The Nursing Commission will automatically issue a Temporary Practice Permit (TPP) to nurse applicants who have met all necessary requirements. To receive the TPP, the nurse applicant must apply for licensure. This is not a separate licensure process but the TPP will be issued after certain minimum requirements have been verified and pending the completion of the full process.
NOTE – As soon as the applicant meets all requirements, with the exception of the FBI fingerprint background check, they are automatically issued a TPP. The facility does not need to take any additional action at this point. However, the applicant is responsible for completing the fingerprint process in a timely manner. If the applicant does not submit fingerprints, they may receive an applicant closure warning letter. This will allow the applicant an additional 60 days after they receive the warning letter to submit fingerprints and complete their application file. If fingerprints are not submitted in the time allotted, the file would be closed, and the applicant would then need to reapply and is not licensed.
Brief Reminders for Licensure by Endorsement:
- Please review the application instructions prior to submitting an application. Incomplete applications will result in delayed processing.
- This includes verifying initial licensure in the United States either through the nursys.com system (for most states) or working directly with the nursing boards (in California, Pennsylvania, and Michigan) to provide license verification to the Washington Nursing Commission.
- Please encourage the applicant to complete the fingerprint process immediately, even after the applicant is issued a TPP, for fastest processing. Due to delays resulting from COVID-19, it can take from several weeks up to several months for the fingerprint process to be completed by the Department of Health’s FBI Unit.
- A nurse must have an active license to apply for licensure by endorsement.
2. New Nursing Graduates (Licensure by Exam)
All applicants who have successfully completed the pre-licensure requirements are eligible to apply for licensure by national exam (NCLEX). The guidance for pre-licensure requirements are outlined in WAC 246-840-025 (approved Washington nursing education programs), WAC 246-840-030 (out-of-state traditional nursing education program), and WAC 246-840-048 (nontraditional nursing program).
Here is a link for the NCLEX exam licensure requirements. The Nursing Commission site also includes a link to register for the NCLEX exam. Here are the instructions about how to apply online. There are various resources available to help new nursing graduates study for the exam (e.g., here is a link with some resources).
The Nursing Commission may issue a temporary Emergency Interim Permit (EIP), which is available upon request from the applicant, and allows the new graduate to practice the full scope of their profession for up to 180 days during an emergency and before sitting for the NCLEX exam. In order to request an Emergency Interim Permit, the applicant must complete the following steps:
- Complete exam application;
- Register for the NCLEX; and
- Official transcripts must be received by the NCQAC.
After a new nurse is granted an EIP and passes the NCLEX, there is nothing more they need to do. At this point in the process, the Nursing Commission would already have all the required documentation from the nurse to proceed with full licensure.
Additional Considerations
Nursing Programs Outside the U.S. – The Nursing Commission also provides guidance on their website about applicants who completed nursing education programs outside the United States (in accordance with WAC 246-840-045 or WAC 246-840-090). Here is a link to the licensing requirements for applicants educated outside the United States.
Emergency Volunteer Health Practitioners Act – While still a valid pathway to licensure, WSHA does not recommend utilizing the Emergency Volunteer Health Practitioner Act as an option at this time. The Emergency Volunteer Health Practitioners Act allows individuals to be approved to practice in Washington if they are already licensed in another state and are in good standing, and the emergency declaration is in effect. However, these volunteers are only to be utilized for COVID, and not designed to care for other patients. To be clear, this is not a license or permit, but instead, requires volunteers to register online with the Department of Health’s Volunteer Provider Unit. According to WSHA’s most recent conversations with the Nursing Commission, providers volunteering in this capacity must be only treating COVID-19 patients and have a dramatically limited scope.
Active License for Licensure by Endorsement – If the applicant does not have an active license in another state (e.g., inactive or lapsed), the applicant will be required to complete a Nursing Commission approved refresher program and likely clinical requirements to be verified. Enrollment in the refresher program will need to be indicated on the application. There are likely additional clinical requirements that must also be completed. WSHA recommends contacting the Nursing Commission to better understand this process.
Next Steps & Contact Information
If you have specific concerns about a particular application, please contact the Nursing Commission’s customer service team at 360-236-4703 or via email at nursing@doh.wa.gov. The team is available Monday through Friday, 8:00 am – 5:00 pm. As of the writing, WSHA understands the response time for questions is approximately 24 hours.
If you are experiencing a pattern of issues related to nurse licensing that you would like to elevate, please contact Alicia Eyler at AliciaE@WSHA.org or Chelene Whiteaker at CheleneW@WSHA.org.
References & Resources
- DOH Nurse Licensing Home Page
- DOH Nurse Licensing – Apply for a License
- RN or LPN License by Endorsement – Requirements (Read Before Applying)
- WAC 246-840-090 – Licensure for Nurses by Interstate Endorsement
- Nursys Licensure Verification (Complete Before Applying)
- Online Application Instructions (For Both New Graduates and Licensure by Endorsement)
- DOH Nurse License Instructional Video
WSHA’s 2021 New Law Implementation Guide
Please visit WSHA’s new law implementation guide online. The Government Affairs team is hard at work preparing resources and information on the high-priority bills that passed in 2021 to help members implement the new laws, as well as links to resources such as this bulletin. In addition, you will find the Government Affairs team’s schedule for the release of upcoming resources on other laws and additional resources for implementation.
