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New Erie nurse waits months, battles bureaucrats for permit to start first job

Erie Times-News logo Erie Times-News 7/20/2022 David Bruce, Erie Times-News

Jessica Space figured the final steps to becoming a working nurse would take two, three weeks at most.

Space, 30, graduated in May with an associate degree in nursing from Mercyhurst University. She had a job lined up in Saint Vincent Hospital's emergency department, where she already worked as a patient care technician.

All she needed was a graduate temporary practice permit from the Pennsylvania Board of Nursing that would allow her to work as a registered nurse until she passes her nursing board exam and receives a permanent license.

"I applied for the permit in April and sent a $200 payment," said Space, who lives in Erie. "I submitted my background checks and education history. There wasn't a problem. But I couldn't get my permit."

Nursing school graduates from across Pennsylvania are experiencing similar delays in receiving their permits from the state or getting their National Council Licensure Examination results posted so hospitals can check them before they start their jobs.

More: How much do nurses make? A breakdown of salaries by nursing career.

As a result, these graduates can't begin their nursing careers, even if they have jobs already in place. This comes at a time when hospitals, nursing homes and medical offices are scrambling for nurses due to a nationwide shortage.

"We expected to start 48 new nurses (July 18) and we can only start 20 of them," Luanne Zwick, R.N., Saint Vincent's nursing professional development specialist, said last week. "Sixteen of them were waiting to see if their permits or test results would come through and 12 others had to move their start dates to August."

Multiple reasons for delays

Zwick and other hospital officials said there have been delays in receiving permits and having NCLEX scores posted since the COVID-19 pandemic started in early 2020. But those delays have worsened in recent months as nursing schools this May graduated some of the largest nursing classes in their history, creating a logjam.

In addition, the state nursing board is understaffed, said a spokeswoman for the Pennsylvania Department of State, which oversees the nursing board.

"Since April, the nursing board has processed more than 3,900 licenses and more than 900 temporary practice permits," Ellen Lyon, Department of State spokeswoman, said in an email. "We have 20 staff members processing applications, which is not a full complement. The department is in the process of hiring an additional eight employees to offset the labor shortage, which is an issue that has impacted many employers."

More: Amid shortage of health care workers, Pennsylvania nurses have a long wait for licenses

Officials from health systems across Pennsylvania have been in contact with the state in an effort to end the delays and get these much-needed graduate nurses working in their hospitals and medical offices.

Saint Vincent's and UPMC Hamot's parent organizations have both worked with the Department of State, statewide hospital organizations and state government officials in an effort to end the delays.

"UPMC's government liaisons have been reaching out to the state, especially if someone is waiting an inordinate amount of time for a permit or license," said Jim Donnelly, R.N., Hamot's chief quality and nursing officer.

State Rep. Ryan Bizzarro, D-3rd Dist, of Millcreek Township, said his office frequently receives calls from recently graduated nursing students whose permit applications have been delayed.

The pandemic and subsequent labor shortage have played a role in the problem but there is another reason, Bizzarro said.

"A lot of it has to do with the more seasoned people in these departments who are leaving because we are near the end of the Wolf administration," said Bizzarro, referring to Gov. Tom Wolf's term-limited tenure ending in January. "You have less experienced people working their way up, and they are trying to do things more by the book. It can lead to delays."

More: Erie hospitals battle staffing crisis as COVID-19 pandemic continues

As weeks passed and Space had still not received her permit, she repeatedly called the state nursing board to get answers. She didn't find the responses reassuring.

"I spoke to an employee one day and they said, 'If you all would stop calling, we can process more permit applications,'" Space said.

Hospitals scramble to cover expected nursing shifts

Saint Vincent leaders have employed some graduate nurses in other jobs, such as nursing aides, until they receive their permit or test results, Zwick said.

In the meantime, hospitals statewide must continue to find ways to cover the shifts these new nurses would have otherwise worked.

"They either have to limit their number of patients, or spend more money on agency or traveling nurses," said Rob Shipp, vice president of population health and clinical affairs for the Hospital & Healthsystem Association of Pennsylvania.

More: 'We just don't talk about these things': Erie nurse describes COVID-19 stress, anxiety

The Department of State and the Bureau of Professional and Occupational Affairs have enacted some changes in recent months to shorten the delays.

They include emailing discrepancy notices directly to the applicant and allowing nursing schools to email education verification forms to the bureau.

The bureau also formed a help desk, adjusted a caller's queue that was plagued with long wait times and created a support ticket system.

New nurse now sharing her application hack

But Space created her own workaround to finally get her permit. Frustrated by the responses she had received from the nursing board, Space purposely called a board department that doesn't deal with permit applications.

"I talked to a supervisor in that department and they transferred me to someone higher up at the department I was supposed to deal with," Space said. "They said my application had not even been reviewed yet. I immediately called Gov. Wolf's office and asked if they could expedite my permit application. They checked and said it looks like the permit is there. It must have happened in those few minutes between my phone calls."

Space has since shared her application hack with fellow nursing school graduates and several of them have been able to get their permits.

On Monday, Space was scheduled to start her new career as an ER nurse at Saint Vincent. She said her salary will double.

"I'm so excited. Now the next step is to take my boards and get my permanent license," Space said.

Contact David Bruce at Follow him on Twitter @ETNBruce.

This article originally appeared on Erie Times-News: New Erie nurse waits months, battles bureaucrats for permit to start first job


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