A quiet victory on nurse shortage

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A quiet victory on nurse shortage


By David S. Broder, 8/7/2002

WASHINGTONBY PATIENT negotiation and sheer persistence, members of Congress are sometimes able to bring bills of genuine public importance to the point where they command overwhelming bipartisan support and become law with a minimum of controversy or debate. As often as not, these victories are ignored by the press, which thrives on conflict and finds consensus boring.

A particularly vivid example of this distortion - which contributes so much to public disdain for the legislative branch - occurred on July 22, when the Nurse Reinvestment Act went through both the House and the Senate on the same afternoon, unnoticed and uncelebrated by almost everyone outside the health care profession.

Yet this legislation was remarkable for two reasons. More than almost any bill in this session, it bore the imprint of women legislators. And more than such well-publicized but never-finished measures as the ''patients' bill of rights,'' it has the potential to bring substantial benefits to untold millions of people during the decades ahead.

This country faces a critical shortage of nurses. That fact was first brought to my attention 15 months ago by Lynn Martin, a former Republican congresswoman from Illinois and secretary of labor in the first George Bush's Cabinet. Martin came to see me in May of last year, brandishing a report from a University of Illinois commission she had headed.

In blunt terms, it warned that unless steps are taken soon, health care in this country will be jeopardized by the convergence of three trends: a rapid increase in the number of elderly Americans requiring medical assistance, the retirement or dropout of an already aging and overworked generation of nurses, and a steep decline in the number of people entering the nursing profession.

From 2010 on, the situation will get steadily worse, the report warned. ''All Americans face the frightening prospect that the dramatic graying of our population ... is to be accompanied by a staggering decline and shortage of registered nurses ... and every other level of caregiver who provides geriatric nursing care. Technology is not the answer. ... It cannot change beds, dispense medicine, or bathe and dress people. There simply will not be enough people to provide the touch, the smile, and the skill to care for the elderly.''

What was news to me in Martin's report was old hat to three members of Congress who are themselves nurses. One of them, Democrat Lois Capps of California, decided to take on the issue. Capps, a school public health nurse in Santa Barbara, never thought about running for the House until 1997, when her husband, Walter, a well-liked member of Congress, died unexpectedly in midterm. But as a colleague said on the House floor, she ''would simply not let up on this issue.''

She drafted a bill and then, as a member of the health subcommittee, started seeking support, especially among the majority Republicans. By marshaling her facts and offering to accept others' ideas, she enlisted a remarkable variety of people on both sides of the Capitol. The sponsors on the Senate side ranged from liberals Hillary Clinton and Barbara Mikulski to conservatives Tim Hutchinson and Judd Gregg.

The bill is well designed to address the issues raised in Lynn Martin's report. It will launch a campaign of public service announcements to promote the nursing profession and offer scholarships for nursing students who agree, upon graduation, to work for a period of time in a facility facing a critical shortage of nurses.

It will cancel student loans for nurses who seek advanced degrees and agree to join the faculties of nursing schools. It will give those schools special grants to train nurses in geriatric care.

And it includes strategies to attack the burnout and frustration that are driving many people out of nursing and into less-demanding work. It provides grants to hospitals and other medical facilities that are willing to offer career incentives to nurses to advance in their field and to take on larger responsibilities in organizing and directing patient care.

Currently, fewer than five-dozen hospitals and medical centers are designated as ''magnet'' facilities, where nursing staff members are given larger supervisory roles. But they retain nurses an average of over eight years, twice as long as others without such programs.

The bill Capps sponsored authorizes, but does not itself finance, these new programs. But she told me her hope is that allies on the Appropriations Committee will boost the current $93 million a year of nursing education money substantially year by year now that the broader program is law.

As you can imagine, she is hard at work on that project now.

David S. Broder is a syndicated columnist.

This story ran on page A22 of the Boston Globe on 8/7/2002.

© Copyright 2002 Globe Newspaper Company.


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ANA President Barbara A. Blakeney, MS, APRN,BC, ANP, was interviewed by CNN Radio and ANA Executive Director Linda J. Stierle, MSN. RN, CNAA,BC, was interviewed by WJLA-TV, the local ABC affiliate in Washington, DC, to give ANA's views on the JCAHO report. The two applauded JCAHO's efforts in underscoring the long-standing concern of the ANA in regard to the critical shortage of RNs.

JCAHO's recommendations for addressing the nursing shortage affirm several of the findings and recommendations in a plan developed by the nursing community and released in April: Nursing's Agenda for the Future. Several of ANA's constituent member associations (state nurses associations) have also been featured in their local television affiliates and newspapers. ANA is continuing to work with the major networks and national newspapers on coverage of the nursing shortage.

The Washington Post also focused on the nursing shortage in advance of the JCAHO report's release. On Aug. 4, The Washington Post ran a special supplement to the employment section that featured an article called, "Nurse Reinvestment Act Addresses Recruitment and Retention," in which Blakeney is quoted. Blakeney also was interviewed by David Broder, the top political columnist for The Washington Post, and provided background information that Broder included in his Aug. 7 article on the Nurse Reinvestment Act, "The Nursing Bill: A Quiet Triumph." Rep. Lois Capps (D-CA), a registered nurse who sponsored the Nurse Reinvestment Act, also was quoted in the column.........">>>



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Such bills should include PAY incentives,especially an increase in Medicare reimbursement.Here in Iowa,we have the largest percentage of elderly citizens and the lowest Medicare reimbursement.It just won't work without higher pay for nurses. Who will want to go to nursing school,even if it's free for a LOW PAYING job? Nursing school is hard with high standards. Do you want someone taking care of you who is wrong more than 20% of the time? This bill is a good start,but only a start.


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Even a person who is usually negative (like I am can) see that progress is being made. I have been saying that we need a nurse clapping smilie. This would be a place to use it. Yes Pat, the sever cuts in goverment reinbursement is the mother of all this trouble.

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