“To be a travel nurse, it’s hard to wait 6-8 weeks to get approved.”

“Traumatic and overwhelming.” That’s how New Mexico nurse Cara Alsafi described her first day working in a New Jersey hospital.

Alsafi answered a national call for nurses and doctors to travel to COVID-19-ravished areas in New York and New Jersey to help the overwhelmed medical professionals there. The intensive care unit (ICU) nurse joined colleagues Brittany Dickman and Jesse Gomez from Lovelace Regional Hospital in Roswell, New Mexico.

Alsafi, a mother of two boys aged seven and ten, has been a nurse for three years and specialized in emergency room nursing before starting in the ICU six months ago. She thought she was ready to work with crisis situations, but the number of patients she saw in New Jersey was staggering.

“There was no orientation,” Alsafi said in an interview with us. She just had to rely on her experience to dive right in a day after landing on the ground. 

Nurses were assigned three patients at a time. Each patient was hooked up to a ventilator and receiving anywhere from 4-9 medications on IV drips, all of which she had to monitor. The patients were intubated, sedated, and even paralyzed.

In the two weeks that Alsafi and her colleagues were there, despite their best efforts, not one person survived. It’s a scenario she hopes does not come to her small town in New Mexico, because the healthcare system would be overwhelmed.

The help that Alsafi and medical professionals from other states provided the hard-hit areas of New Jersey was made possible because the state relaxed its occupational licensing regulations to permit nurses and doctors from other states and even other countries to practice there during this crisis. 

Each state determines the requirements workers must satisfy to be licensed and relicensed on a regular basis. In some cases, there is a public health or safety rationale for the licensing requirements, but some regulations are unnecessarily onerous and only intended to keep people from working. 

New Jersey sped up the process to grant temporary 6-month licenses to nurses licensed in other states. Alsafi filed out a form and faxed it in on Monday. She got the approval on Tuesday, flew out on Thursday, and was working on Friday. “In 12-24 hours the state granted me a license. It usually takes 6-8 weeks to process a license for states not in the compact,” she explained.

A compact is an agreement among states to recognize each others’ licenses. Over 30 states belong to a national compact, but Alsafi points out that many Northeast states have not joined.

Outside of her regular job, Alfani is a traveling nurse regularly lending her time and expertise to nursing homes and rehabilitation centers less than two hours away from home. Companies that connect traveling nurses with work opportunities need more people like Alsafi, but the red tape and regulations nurses have to overcome can be onerous.

“To be a travel nurse, it’s hard to wait 6-8 weeks to get approved.”  She hopes that states like New York and New Jersey extend these reforms beyond the COVID-19 crisis or consider joining a national state compact of nurses.

The COVID-19 pandemic has forced states to scale back unnecessary regulations to better serve the needs of their citizens. While that is an encouraging effort, we hope that they will make these reforms permanent so that passionate workers like Alsafi can travel wherever there is a need or opportunity to help others.

Alsafi is back home now and able to return to work with self-monitoring after some days of self-quarantine. She is healthy but changed. “I have a greater understanding of what I do here because of my work there.”

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