“If we have a standard for a nurse or nurse practitioner, it should be the same from one state to the next.”

Ali Cosgrove says she started nursing out of a desire to serve. “I always knew I wanted to help others,” she said. When her grandmother was diagnosed with lung cancer while Cosgrove was in high school, she saw the difference that nurses made in her grandmother’s care before she transitioned to hospice help. 

After graduating with her nursing degree from the University of North Carolina Greensboro, Cosgrove worked for four years as a surgical intensive care nurse. She worked mainly with open-heart surgery patients and enjoyed her work, but wanted to do even more.

“I always knew that I wanted to further my career and didn’t want to stay completely at the bedside,” Cosgrove said in an interview with IWF. 

Cosgrove debated between becoming a nurse practitioner or a nurse anesthetist but ultimately decided to become a nurse practitioner because she wanted to maintain a relationship with her patients. But while working as a nurse practitioner, she missed the work-life balance and the critical care aspect. So after working for four years as a nurse practitioner, Cosgrove returned to school for nurse anesthesia. 

She’s currently in her second year of school and will graduate in August 2021. Due to the coronavirus pandemic, her clinical rotations were put on hold. Even though online classes continued, Cosgrove found herself with more time on her hands. She reached out to the hospital she still worked for as a nurse practitioner as well as another local hospital, but because the pandemic had not hit North Carolina too hard her extra help wasn’t needed. 

“I went into nursing to help others, and this was the prime time,” she said. “Our fellow colleagues needed our help and were drowning in the hot spots.” This desire to help prompted her to look for opportunities to travel and help in the hard-hit areas. 

One of her fellow classmates had the same idea and contacted Cosgrove on a Friday afternoon, asking if she’d like to go with him to New York. In a whirlwind of a weekend, Cosgrove contacted the travel agency on Friday, flew to New York on Sunday, and started work on Monday. 

Normally, it could take months to get an in-state license approved. But due to the increased need for medical professionals with the COVID-19 crisis, many states, including New York, temporarily recognized out-of-state licenses. 

Cosgrove provided the travel agency with her nursing license number, along with a resume and references. While she has maintained her nurse practitioner credentials, Cosgrove applied as a nurse because the agency told her that it was easier to get the out-of-state acceptance of her credentials as a nurse. 

The assignment was for one month in Buffalo, New York. Cosgrove worked the day shift from 6:30am-7:30pm, five days a week. While she was there, she continued with her online classes, juggling both demanding work assignments and school assignments. 

The hospital that Cosgrove and her friend worked at was a COVID-only hospital. Cosgrove explains: “Catholic health was the big hospital system and it had converted one of its community hospitals into a COVID-only hospital.” The hospital had reconverted into multiple intensive care units (ICUs) in order to accommodate more ventilated patients. 

Cosgrove explained that she usually had 3-5 patients. This was a big jump from the 1-2 patients that a nurse is normally assigned in an ICU. She had medical-surgical nurses that helped her but they did not have the same critical care skills because they did not have ICU training. She describes the experience as “overwhelming, sad and awful” because “there were too many patients who were critically ill with not enough resources.”

For intensive care nurses, it sometimes will take 3-6 months of training before a nurse will care for patients alone. Cosgrove explained: “There were a lot of travellers because the biggest issue with these hotspot areas, which were hit hard with coronavirus, was that there weren’t enough trained intensive care nurses.” 

Cosgrove describes being thrown into the frenzied care. “When we got there, it was worse than what the media was saying,” she said. “It was clear that this wasn’t made up. My first day, I had maybe a four hour orientation before being brought up to the ICU and given an assignment.” 

But despite the difficulties, she says her trip was worth it. “For such chaos, and such a difficult time with this pandemic, this hospital and the staff came together,” she said. “Everybody was so grateful for people coming to help and everyone pitched in wherever they could to help. It was pretty amazing, seeing the whole community come together to fight this virus.”

She even notes: “The hotel staff could make more money on unemployment, but they kept coming to work to care for us.” 

When asked about the challenges that she normally would have faced transferring licenses between states, Cosgrove said, “I think it’s unfortunate that politics are so involved and that each state has their own nursing board and rules. If we have a standard for a nurse or nurse practitioner, it should be the same from one state to the next.”

When asked about her overall impressions with the experience, Cosgrove responded that “there was a sense of camaraderie, everyone coming together and doing what we went into medicine for–taking care of the patients. I would totally do it again.”

Do you have a story about how occupational licenses are holding you back? Share your story here.