At first, Reeny Pereira didn’t care about the wait.
The Pennsylvania State Board of Nursing told Pereira it would take him about 12 weeks to obtain a license to work in the state. Pereira had worked long hours as a trauma nurse in Maryland and was ready for a break. She had just gotten married. She and her husband were moving to eastern Pennsylvania. And they had booked a honeymoon in Jamaica.
While on her honeymoon in late August, the Board of Nursing emailed her asking her to submit a copy of her Maryland state employment background check – and as a result, she would have to wait another 12 weeks.
Pereira says she called the nursing council helpline countless times over the next two months. Average wait times were an hour or more.
In November, after another hour of waiting, a call center worker told her she would have to wait another 12 weeks.
“That’s when I lost him,” Pereira says. “I asked if I could speak to a manager, and he said no. That’s when I hung up.”
Pereira did the only things she could do. She gave the Pennsylvania Nursing Licensing Board a one-star online rating. And she emailed the governor. Pereira recounts what she wrote:
“I understand that there are staff shortages everywhere. The state needs me.”
She received an automated reply in return.
The weeks passed. In January, his license was finally granted – five months and three weeks after he applied.
Finally, Pereira was allowed to work as a nurse in Pennsylvania.
Pennsylvania had one of the longest waits
Although she had to wait longer than some, her story is not unique. More than half of the 12,000 nurses who got licenses to work in Pennsylvania in 2021 waited three months or more to get them, according to an analysis of NPR data.
It’s one of the longest waits in the 32 states where data is available, NPR’s Austin Fast found in a survey that found license applications from newly graduated or moving nurses are often tangled in bureaucracy for months, waiting for state approval to treat patients.
The delays came in a year when as many as 1 in 4 nursing positions in Pennsylvania went unfilled, according to a survey by the Hospital and Healthsystem Association of Pennsylvania.
Nurses and health care groups say the failure to certify nurses quickly has added to critical staff shortages during some of the worst months of the coronavirus pandemic.
“They’re emotionally drained; they’re physically drained. We add to that the frustration of not being able to get your license,” says Betsy Snook, CEO of the Pennsylvania State Nurses Association. “Now you can’t even work. You’re at the mercy of the State Board of Nursing.”
For Kelleigh Eckenrode, the wait wasn’t worth it.
Eckenrode is a Registered Nurse with 10 years of experience previously licensed in Connecticut, Massachusetts and California. Like Pereira, she’s also licensed in Maryland — one of the states that’s part of a state-to-state agreement called the Nurse Licensure Compact. The pact allows a registered nurse in one state to work in other states included in the pact.
Pennsylvania has joined the pact, but its membership is not yet active. So when Eckenrode decided to work there to be closer to her family, she had to apply for a license.
Eckenrode, a nurse in the post-anesthesia care unit, applied in early August and was told to expect a four to six week wait. After being unemployed for a month, Eckenrode accepted a temporary assignment in North Carolina, an NLC state.
Some nurses give up and get jobs in another state
Four weeks later, she completed this mission and returned home. It had been eight weeks since she applied for her license in Pennsylvania.
Eventually, Eckenrode got tired of calling state customer service. She had recently renewed her license in California, so when she received a lucrative offer to work in San Francisco in early December, she decided to pack her bags.
About a week later, on December 15, Eckenrode’s Pennsylvania license was approved. It had taken 18 weeks.
“I just felt like it could have been handled better,” Eckenrode said. “When I called, no one had any sense of urgency or really cared, which is quite surprising to me knowing that we need nurses everywhere. It was just a little disappointing. “
Ellen Lyon, spokeswoman for the Pennsylvania Department of State, which oversees the State Board of Nursing, said the COVID-19 pandemic has affected the licensure system. She says the licensure process in Pennsylvania is more transparent than in most states, resulting in longer wait times and adds that wait times have since improved.
Additionally, according to Lyon, the department was barred from issuing waivers that would prevent temporary licenses from expiring — as it did earlier in the pandemic — due to a May 2021 election referendum that limited the governor’s power to issue emergency orders. The effort, led by the GOP-controlled state legislature, was widely seen as a rejection of Democratic Gov. Tom Wolf’s public health measures during the pandemic.
Ultimately, it’s patients who feel the effects of licensing delays, according to Janet Tomcavage, chief nursing officer at Geisinger Health System.
“Delays in getting nurses to the bedside are forcing our current staff to work significant overtime, which adds to the burnout and loss of nurses,” Tomcavage said. “It also forces hospitals to hire more agency staff, which increases the cost of health care and, in many cases, closes beds that cannot be staffed.”