A person wearing protective clothing and a respirator mask donates protective equipment to the Elmhurst Hospital Center in the Queens borough of New York, U.S., on Thursday, March 26, 2020. Angus Mordant | Bloomberg | Getty Images

Medical staffing firms are racing to help meet the demand for doctors and nurses in states where coronavirus outbreaks are creating an unprecedented need. But what they need most to build up medical staff quickly, they say, is for states to ease licensing regulations. "That's really where we need the help from everyone, is to make sure we have a quick licensing process and that we can get people on the ground where they're needed," said Dr. Cole Edmonson, chief clinical officer at staffing firm AMN Healthcare. AMN Healthcare is seeing the biggest demand right now from major hotspots for coronavirus infections, including New York, Los Angeles, San Jose, California, and Spokane, Washington. "We are seeing an increase in demand, in particular, for nurses in [intensive care unit] and emergency room care — but every specialty is really increasing the need right now," Edmonson said. The firm is also seeing a higher demand in Houston and Atlanta, though those areas are not considered major hotspots right now. Nomad Health, a staffing firm with more than 100,000 registered clinicians, is seeing demand for COVID-19 staffing across more than 30 states, with facilities in places such as Spokane, Washington, offering up to $120 an hour for medical ICU nurses, a number that's well above normal pay. "People are saying: 'We'll pay anything, we'll pay anything,'" said Nomad CEO Alexi Nazem. Nazem says while states are moving to ease credentialing, under the current emergency it would be more helpful to have a uniform national policy.

Temporary licensing rules can help

As of Friday, 30 states had temporarily eased requirements, allowing doctors and nurses already credentialed in other states to practice across state lines without having to apply for in-state licensing. More than two dozen states have also taken steps to make it easier for retired medical professionals whose licenses have lapsed to be recertified during the pandemic, according to data compiled by the Federation of State Medical Boards. New York has done both as the number of cases in the state has surged. Gov. Andrew Cuomo praised the outpouring of response from retired doctors and nurses in New York. The state saw 10,000 volunteers sign up in a single day, after asking for help and announcing that the state is easing rules for reinstatement. "These are people who are retired, who did their duty, who could just sit at home, but they are coming forward," said Cuomo. In all, New York has more than 62,500 clinicians who have volunteered to help with the pandemic response.

Beyond state licensing, hospital flexibility

Analysts at health-care consultancy Advisory Board say states may need to help hospitals meet the anticipated nursing shortage by easing credentialing rules around the nursing requirements in hospitals during the crisis. "People are going to have to be creative about what types of nurses are caring for which types of patients at any given time," said Christopher Kerns, Advisory Board vice president and director of health care strategy. Kerns said hospitals may need to let licensed practical nurses, or LPNs, take on duties that are typically done by registered nurses, or RNs, who have more training. LPNs typically have two-year degrees and assist with primary-care needs in doctor's offices, while RNs have four-year degrees. "A second way to manage this is to relax nurse-to-patient ratio ... so that nurses could care for more patients. In some areas that might be the only alternative," Kerns said. But putting more pressure on an already stretched staff could lead to more staffing issues.

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