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Spokane, Washington  Est. May 19, 1883

Washington Legislature looks to tackle growing nursing workforce shortages this year

MultiCare Deaconess Hospital in Spokane.   (DAN PELLE/THE SPOKESMAN-REVIEW)

OLYMPIA – Creating staff-to-patient ratios, allowing nurse licenses from other states to be recognized in Washington, repaying student loans for nurses.

Those ideas are all part of a larger discussion happening in the Legislature this year to address a growing shortage in nurses.

“Nurses are in crisis,” Sen. Jeff Holy, R-Cheney, said. “You can’t keep staff in the hospital.”

A survey from members of three health care unions in Washington found that almost half of health care workers say they are likely to leave the profession in the next few years and almost 80% said they were experiencing burnout.

Of the 1,200 health care workers from Service Employees International Union Healthcare 1199NW, United Food and Commercial Workers International Union 3000 and the Washington State Nurses Association that were surveyed, 45% said they felt unsafe in their job, according to the report.

Working conditions, burnout, low pay, lack of benefits, such as required overtime and meal breaks, are all leading to more nurses leaving the field, Rep. Marcus Riccelli, D-Spokane, said. The Legislature needs to address their conditions as well as access to training and education.

“We can’t have healthy communities and thrive if we don’t have an adequate workforce,” he said. “It’s very alarming we don’t have the workforce needed to make sure we have a healthy Washington.”

Here’s a look at some of the bills the Legislature is proposing this year:

Safe staffing

One way the Legislature is looking to address these concerns: creating a safe staffing standard.

A bill sponsored by Sen. June Robinson, D-Everett, would require the Department of Labor and Industries to adopt minimum staff to patient ratios that hospitals would have to follow. The bill has drawn support from nurses and unions who say more workers are needed to keep staff from burning out but has received criticism from hospitals who say they don’t have enough staff to follow the staffing quotas.

The bill passed a Senate committee last week on party lines and is awaiting a public hearing and vote in the Senate Ways and Means committee.

During a vote in the Senate Labor and Commerce committee last week, Sen. Curtis King, R-Yakima, said the bill was taking advantage of the dire COVID-19 situation.

Robinson pushed back on that, saying short staffing is not new. It was only exacerbated by COVID-19, she said.

“I am working hard to address a bigger picture that will help hospitals, but we can’t have hospitals in our state without nurses there to staff them, and I think it’s important that we look at all sides of the picture,” Robinson said.

Nurse license compact bill

A bill sponsored by Rep. Mike Volz, R-Spokane, creates an interstate nurse licensure compact, which would allow nurses to get licenses that are recognized in multiple states.

The proposal creates the Interstate Commission of Nurse Licensure Compact Administrators, which would be made up of the heads of licensing authorities in each state, It would meet at least once a year to create rules to facilitate and coordinate the implementation of the compact.

States could join the compact by enacting its provisions into law, according to the bill.

The bill has support from hospital officials who say it could help with short staffing but has received push back from unions who say there are other places to look to improve working conditions, such as through a safe staffing model.

The compact has been enacted in 39 states, according to Volz’s office.

“We are seeing workforce shortages across a broad spectrum of industries and occupations for a variety of reasons,” Volz said in a statement. “However, shortages in the health care sector have dangerous implications for the current and future health of our citizens and communities.”

The bill passed 11-3 in the House Postsecondary Education and Workforce Committee on Friday. Reps. Julia Reed, D-Seattle; Drew Hansen, D-Bainbridge Island; and Gerry Pollet, D-Seattle, voted against the bill.

Pollet said in conversations with nurses about the compact, he’s heard that it undermines the regulation and the safety that comes with the licensing process in Washington, which has given him great concerns about the bill.

Spokane Valley Republican Rep. Suzanne Schmidt said the bill had a lot of support in committee hearings, specifically from nurses who were open to the idea of the compact, which could improve the workforce shortages.

Loan repayment

Another bill to address the crisis would help nurses by repaying their student loans.

The bill, sponsored by Spokane Democrat Rep. Marcus Riccelli, would set up the Hospital-Based Nurse Student Loan Repayment Assistance Program. Under the program, nurses must commit to a service obligation, between three to five years, to provide nursing services as employees of participating hospitals or psychiatric hospitals.

The service obligation could be determined by the amount of award, according to the bill. Hospitals would be required to pay 50% of the amounts paid to the nurses, and the state would pay the other half.

Nurses who have received a scholarship or loan repayment from a number of other state programs would be ineligible to participate in the program.

The debt people take on for their education can affect the rest of their life, Riccelli said. This could incentivize more people to get into the workforce.

“Loan repayment is a proven technique to really attract people into the fields we need most,” he said.

In public hearings for the proposal, the bill received support from the state hospital association, hospitals and UFCW 3000, a union that represents some health care workers.

The House bill received a public hearing last week in the House Committee on Postsecondary Education and Workforce but has not been scheduled for a committee vote. The Senate version of the bill has made it out of the Senate Committee on Higher Education and Workforce Development and is awaiting a public hearing in the Ways and Means Committee.

Reducing barriers in education Holy is sponsoring a bill that would boost education access in an effort to increase the supply of nurses. The bill has three components: nursing credentials, nurse training and K-12 pathways into health care careers.

To address credentialing, the bill would require the State Board for Community and Technical Colleges to develop a plan to train more nurses, including certified nursing assistants, licensed practical nurses and registered nurses, over the next four years.

The plan, which would have to be completed by December 2024, would have to prioritize new capacity and expand training opportunities for rural and underserved students.

The bill would require the state board to develop an online curriculum for licensed practical nurses. It also would create an apprenticeship pilot program for licensed practical nurses.

The Department of Veteran’s Affairs would be required to use a certified nursing assistant program to address the shortage in state veteran’s homes.

To address bottlenecks in nursing training, the bill would give the Nursing Care Quality Assurance Commission permission to grant approval to bachelor’s degrees in nursing programs where the administrator holds a graduate degree with a major in nursing.

The commission also would be required to count one hour of simulation lab experience in place of two hours of clinical placement learning for at least half of the required hours for nurse licensing.

The commission also would be required to increase clinical opportunities, dropping the required number of hours for grant eligibility from 100 to 80.

The proposal also expands pathways from K-12 education to health care careers by establishing a grant program to allow districts to create or expand health science program offerings.

The Nursing Commission would create a certified nursing assistant training pilot program for high school students to help rural hospitals with staffing shortages.

A lack of nurse educators, nurses leaving the field and nursing students unable to pay their loans are symptoms of a larger problem, Holy said.

“This is an attempt to solve that problem,” Holy said.

In its public hearing, the bill received support from nurses associations, unions and the hospital association with no one testifying against it.

The bill is awaiting a public hearing in the Ways and Means committee.

Laurel Demkovich's reporting for The Spokesman-Review is funded in part by Report for America and by members of the Spokane community. This story can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper’s managing editor.