NPR

Nurses are waiting months for licenses as hospital staffing shortages spread

Almost 1 in 10 nurses who were issued new licenses last year waited six months or more, an NPR analysis found. Nurses say patient care suffers as these delays make staffing shortages even worse.
Courtney Gramm waited seven months to receive her nurse practitioner license in California. Nursing boards, meant as a safeguard, have become an obstacle, preventing qualified nurses from getting into the workforce for months when basic vetting should take only weeks.

Three hours spent on hold. That's how long Courtney Gramm waited one day, all so that she might get her license from the state of California to work as a nurse.

That morning was just a snapshot from a long ordeal. "Panicked, anxious, frustrated, mad even," Gramm describes how she felt as she called over and over. "I just couldn't get any information out of them."

Gramm waited seven months for her nurse practitioner license at a time when COVID-19 cases were skyrocketing across the U.S. and hospitals were desperate to keep nurses on staff.

Her story is a familiar one for nurses throughout the country. Nursing boards, meant as a safeguard, have become an obstacle, preventing qualified nurses from getting into the workforce for months when basic vetting should take only weeks.

An NPR examination of license applications found that nurses fresh out of school and those moving to new states often get tangled in bureaucratic red tape for months, waiting for state approval to treat patients.

  • Almost 1 in 10 nurses who were issued new licenses last year waited six months or longer, according to an analysis of licensing records from 32 states. More than a third of these 226,000 registered nurses and licensed practical nurses waited at least three months.
  • Some states with lots of nurses are particularly slow: California, Pennsylvania, Texas, Ohio and others stretched average processing times for certain types of licenses to almost four months.
  • Wait times in some states underestimate the problem. NPR's investigation found that states often start the clock on processing times only after an application is marked complete. But nurses NPR spoke with described scenarios where they spent weeks or longer arguing that their applications were in fact complete. Many state boards don't count that lost time when measuring how long it takes

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