It is optional for a nurse account to enable two-factor authentication (2FA). If a nurse does not want to enable 2FA, there is an option to select "Maybe Later".
However, adding the 2FA creates a second verification step when signing in that will help protect a nurse's account from unauthorized users.
For the process to add 2FA as part of the sign in process please see, How do I enable two-factor authentication for an existing e-Notify account? (link after publish)