Debbi Chapman spent years jumping through the hoops, as she calls it, of trying to maintain her specialized nursing license amid frequent moves from state to state. Both she and her husband, Matthew, were well into their highly skilled, life-and-death careers by the time they married in 2003.
He was an explosive ordnance disposal specialist in the Army, trained to defuse bombs and other improvised explosive devices that would later bedevil American troops in Afghanistan and Iraq. She had been a licensed nurse in Pennsylvania since 1992, specializing in intensive care treatment for patients immediately after open heart surgeries.
Early in their courtship, Matthew was stationed in Germany. In 2001, he received his transfer back to Fort Bragg, North Carolina, so Debbi moved there to be with him. She got a job as a nurse in the base hospital. Because it was a federal facility, she was able to use her Pennsylvania nursing license rather than get one in North Carolina.
Matthew was flying home from Germany on September 11, 2001, when terrorists crashed airplanes into the World Trade Center, the Pentagon, and a field in Pennsylvania.
After about a year working on base, Chapman got a job at a civilian hospital in Cape Fear, North Carolina, which had a large open heart surgery center. Because the Chapmans were not married at the time, she did not qualify for any special treatment under the state’s otherwise military-friendly laws and policies. Despite her experience in specialized nursing, it took about six months to wade through the paperwork and get her state license.
Three days after their 2003 wedding, Matthew Chapman was notified he was being deployed to Iraq.
Ironically, given her later experiences, Debbi Chapman recalls attending a conference in 2004 in which military and North Carolina state officials outlined new policies that states were developing to make it easier for military spouses to transfer their professional licenses when they moved. Particularly encouraging was an effort launched about 2000 called the Nurse Licensure Compact, an agreement among member states which was supposed to allow a nurse licensed in one state to practice in another without having to get a new license.
Then reality set in.
In 2005, the Chapmans were transferred to Florida. At the time, Florida was not in the nurses’ compact. It joined in 2016. That’s one of the main shortcomings of the compact and similar agreements: they do the military spouse no good if the state they are moving to or from does not participate. Currently 34 states are in the compact. “None of the states we have ever lived in have been compact states where the license would transfer,” Debbi Chapman said. “So every state I would have to redo the process.”
It took several months to get her Florida license, but since she’d started the application process early she was able to get it approved and start working with little downtime.
She was in Florida until 2010, when her husband got new orders and they moved to Korea, where she was unable to work because of restrictions on employing non-Korean nationals.
Then in 2012, the Chapmans’ new orders sent them to Savannah, Georgia.
Debbi Chapman said she looked into getting a new license in Georgia, but the process would have taken months and, as she puts it, cost a small fortune. In the end, she “just gave up” and left the profession. Chapman said she “absolutely” would have gotten a new license in Georgia if she could have simply transferred her nursing credentials. It wasn’t an easy decision, both professionally and financially, she said. Military pay is not great, especially for enlisted personnel.
“That became a joke in my house because I made exceedingly more than Matthew was making,” she said. “It’s frustrating, especially when you are losing money because you have to take this amount of time off because your license is not going through.”
Chapman, like other nurses interviewed by the Goldwater Institute, said the difficulty in transferring their licenses from state to state makes no sense. The job they do does not change. The standards for patient care do not change. And nurses, like people working in most other health-related professions, take the same national standards tests.
So why, they ask, does each state need its own set of rules to qualify for a license?
Things have not improved much since Chapman got out of the nursing profession, according to other nurses who described different hoops they had to jump through in transferring from state to state.
Many of the gripes are the same: States that will not allow existing licenses to be easily transferred, either because they are not in the nursing compact or because they have their own set of rules or qualifications. Nursing board websites are confusing or have no useful information about transferring a license. Bureaucrats are unable to explain the licensing process or any policies to expedite procedures for military spouses. Extensive and expensive paperwork and background checks must be repeated in each state. Different requirements for such things as education or experience make transferring a license from another state virtually impossible.
Even states that are in the nurse licensure compact don’t always make the moves easy, said Lindsey Evans, a registered nurse (RN) whose husband is an Air Force major and pilot.
Evans spent five years as a licensed practical nurse (LPN), and in 2018 became a licensed RN.
Her original LPN license was issued in Tennessee. Since her wedding in 2015, Evans has lived and been licensed in Kansas, Oklahoma, and Florida. Every move had its own unique difficulties.
The first move was from Tennessee to Kansas. Tennessee was part of the multistate compact at the time, but Kansas was not. So Evans needed to get a new license there, a process that took about four months.
Two years later she moved to Oklahoma, which was not in the nurse licensure compact at the time but has since joined.
So Evans had to go through the licensing process again. Oklahoma made it easier to transition than Kansas did, allowing Evans to obtain a temporary license good for six months and processing her paperwork before she moved there.
It was in Oklahoma that Evans was first licensed as an RN.
Next came Florida. Since both Oklahoma and Florida were by then in the multistate compact, Evans figured moving her RN license would be easy. She was wrong.
Florida only allowed state residents to apply for the multistate license. That meant Evans, who was living in Oklahoma when she wanted to start the application process, did not qualify. So she spent several months out of work while she secured the Florida license.
None of it made any sense, she said.
“So even though they are all in this compact and agreed the requirements are the same … that’s pretty much all they’ve agreed on,” Evans said. “They each have their own application process.”
Evans and her husband have had the “my turn” conversation. His term of enlistment expires soon, and a big factor in whether he stays in the military will be the difficulties she has in building a nursing career, she said.
“A large reason for why they get out is that it’s a toll on the family to move so frequently, and it’s a toll on the spouse’s career,” Evans said. “I worked really hard to get through school and become a nurse, and I couldn’t use it. When I did get a job I couldn’t use it to the full potential of what it could be.”
