When Bureaucracy Prevents Nurses from Working – It’s Not Pretty

America’s nursing shortage is so profound that one would think recent graduates could start in their new registered nurse jobs the day after graduation. But that is not how it works. Thanks to bureaucracy, graduates in some states need to wait weeks – or even months – before they can start working.

Bureaucratic delays are both unnecessary and illogical. But they are commonplace in any industry that requires workers to be licensed. From nursing to cosmetology and selling real estate, bureaucracy fouls everything up. The strange thing when it comes to nursing is that bureaucrats have not learned their lesson. How much worse does the nursing shortage have to get before something changes?

Waiting Months for a Permit

The Erie Times-News recently told the story of a nursing school graduate who was already working for a local hospital at the time she finished her education. She was employed as a patient care technician. Ready to begin working as a registered nurse, she only needed a temporary state permit to get her through until she passed the nursing boards and got a permanent license.

Getting a permit should be simple enough, right? Not in Pennsylvania. This particular young lady waited for months and still didn’t get it. And she is not alone. Both Pennsylvania’s Department of State and nursing board are overwhelmed with permit and license applications. They have processed some 4,800 applications since April 2022. The Department of State operates on a staff of just twenty.

You cannot fault state workers themselves. The system is not designed for efficiency. Rather, it is designed to be slow and tedious. The fact that aspiring nurses even need to make application is proof of that.

Licensing Is Largely Meaningless

What is so frustrating about this sort of thing is that licensing is largely meaningless. While hospitals and clinics are desperate to fill growing numbers of open registered nurse jobs, permit and license applications languish on government desks. Yet a license is little more than a piece of paper a nurse needs to pay to get. It doesn’t do anything.

A licensed nurse has undergone years of education and training. They have put in clinical hours. By the time they have earned their degree and finished their clinical rotations, they are ready to begin caring for patients. Obtaining a state license doesn’t make them a better nurse. It does not improve the quality of care they provide.

The Bureaucracy Persists

One of the hospitals the Erie Times-News spoke to told them they had plans to start four dozen new nurses in mid-July. When the time came, they could only start twenty. The remaining eighteen were waiting on licenses or scores from the nursing board. The hospital is looking at some of them not being available for another month.

The bureaucracy persists even in the face of desperate need. Meanwhile, the bureaucrats and politicians continue to promote licensing and accreditation as a way to guarantee only properly trained people can enter the nursing profession. But isn’t that what a college education is for?

Incidentally, bureaucratic licensing and accreditation are becoming increasingly more prevalent in the American workplace. It is getting to be that some states will not allow people to do anything without being licensed. And why? Is it about money? Is it about control?

There are few answers to the question of why. There is also a very little hope that the bureaucracy will go away. The one thing we can say for sure is that registered nurse jobs are available in spades. If you are looking for a career with an insatiable demand for workers, try nursing.


Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

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