pending Compact legislation in PA

NedRN · Jun 29, 2020

This might be better posted in the PA Allnurses forum.

https://allnurses.com/pennsylvania-nursing-c115/

While no doubt travelers from compact states will appreciate this move, PA legislators will ignore non-PA responses.

Personally, I'm not sure compact status is a good thing, even for travelers. For the most part, the best paying states for staff and travelers are historically not compact states, they are single license states with high union representation. Compact status means strikes can be easily staffed by replacements and the end result will be lower pay for all nurses. You don't see physicians making similar moves with their state by state licensure. Unlicensed personnel such as operating room techs and others are at the bottom of the pay scale in large part due to lack of licensure and ease of movement across state borders.

classicaldreams · Jun 30, 2020

Ned,

Most nurses in PA do not belong to a union and haven't gained many benefits, if any at all, despite advocacy by the unions.

The strike staffing argument has been made for years but I don't see the benefit in PA, so I think that argument is self-serving on the part of unions.

IR and Cath Lab Techs make as much money (and sometimes more) than RNs.

Compact exists for physicians in 23 states, with pending legislation in PA.

Compact licensure is here and more states have joined and/or have support for legislation in their states.

The old model of restricting a license to one state no longer serves nurses, employers, or patients.

.

NedRN · Jun 30, 2020

1 hour ago, classicaldreams said:
Most nurses in PA do not belong to a union and haven't gained many benefits, if any at all, despite advocacy by the unions.

Yup, and with compact licensing, they are less likely to form unions and strikes may fail more readily at the unionized hospitals left. However, the point I made was about national wages, and compact can only bring that down. Pay cannot get much lower in the South where there are no unionized hospitals. The same could be true in PA where compact may not have much of an effect, at least not in the short term. Should there be an upswing in unions though, it will hurt.

1 hour ago, classicaldreams said:
IR and Cath Lab Techs make as much money (and sometimes more) than RNs.

Indeed, and three quarters of states require licensure. However, just the amount of education required usually leads to higher pay in a true free market. In addition, many RT services are directly billable, unlike most nurses who are a hospital cost center, not a profit center. Paradoxically education doesn't seem to apply for some professionals like teachers, however with activism and walkouts and unions, there have been gains in recent years.

1 hour ago, classicaldreams said:
Compact exists for physicians in 23 states, with pending legislation in PA.

I didn't know that, thanks. However, physicians are part of a very effective national monopoly, the AMA, who has successfully kept supply lower than needed via a number of methods, a key ingredient.

Since MA went compact, my general statement that both travelers and staff are paid more in non-compact states is weakened, but still valid. Think about who compact status really benefits? The employers. Why are they pushing for it and unions are against it? Money. Also the reason why state BONs typically oppose it - weakens their own bureaucracy and lowers revenue from licensing travelers.

Yes, compact may allow more job choices for travelers from compact states, but they will make less money than working in non-compact states. One of those things that might seem great to an individual traveler but only in their small picture. You also have to consider there are only around 30,000 nurse travelers in peak "good times". That's about one tenth of one percent of all licensed nurses. While I'm certainly one to argue that contingent labor can be quite useful, that again is a very small picture view. The convenience of compact licensure in some limited areas, like travel and even more limited telenursing versus bargaining power and limited numbers of licensed nurses in a particular state does reduce compensation.

chare · Jun 30, 2020

2 hours ago, classicaldreams said:
[...]
Compact exists for physicians in 23 states, with pending legislation in PA.
[...]

I don't think this is the same concept as the -state licenses issued by Nurse Licensure Compact. Rather than allowing a physician to practice in multiple states on her or his home state license, it provides a pathway for expedited licensing.

From the Interstate Medical Licensure Compact site:

Quote
The Interstate Medical Licensure Compact offers a voluntary, expedited pathway to licensure for qualified physicians who wish to practice in multiple states. The Compact significantly streamlines the licensing process.
https://www.imlcc.org/information-for-physicians/

NedRN · Jun 30, 2020

2 hours ago, chare said:
Rather than allowing a physician to practice in multiple states on her or his home state license, it provides a pathway for expedited licensing.

The hospital credentialing process for physicians usually takes a good bit of time too.

DemystifiedRN, BSN · Jul 4, 2020

Hi Classicaldreams,

I will definitely sign that petition. I have been a traveling nurse since Nov 2017. I have actually been considering PA for my next assignment but was deterred because it's not a compact state and, from my research, the contracts are a bit skimpy. However, I've been willing to consider it because I am wanting to get closer to home.

I have to say that, in my experience, in regards to the highest paying states (compact vs. non-compact, CA excluded), it's not black and white. By far, for me, the best paying contract was Montana which is a compact state. I have found that (big surprise) rural states, compact or not, pay well. In Montana, my housing was paid and provided by the hospital (which was a shared, renovated townhome and I only had 2 housemates. We each had our own bedroom/bath). I ended up staying there for 6 months and saved an unbelievable amount of money in that short period of time because I did not have to pay for housing.

I am currently on contract in Alaska which is not a compact state. Once again, my housing is paid and provided by the hospital and I'm also provided a rental car as part of my contract. Believe it or not, Montana still paid better even though I have a rental car, which the hospital is paying for, here in Alaska. I also had a very well-paying contract in Nebraska which is also a compact state.

I've been trying to make it back home to Ohio but it is not a compact state and the pay (rural, urban, suburban) for travelers, in my opinion, is not worth the severe cut in pay.

Thanks again for the info re: PA!

NedRN · Jul 4, 2020

If you live in Ohio, you don’t have a legal compact license. Thus the compact status of PA doesn’t affect you.

Good paying contracts can happen in any state. I had a contract 12 years ago in Ohio paying $75 an hour. Your point?

DemystifiedRN, BSN · Jul 4, 2020

Ned RN-

I do not live in Ohio. However, I had lived there for over 20 years and have some family members that live there--therefore, it will always be a place I consider my home. My state of residence and the location of my physical home is Maryland. So, yes, I do have a compact license.

In regards to your point about good paying contracts as it relates to Ohio--that has not been my experience since 2017. However, it's great that you found a great paying contract there 12 years ago. I have worked with different travel companies off and on over the last few years in an effort to find a good paying contract in Ohio and, within the last few years, have not found one.

NedRN · Jul 4, 2020

So it was a super-specialty, CVOR. Not really applicable for bread and butter assignments. But rapid response crisis pay assignments do come up in every state, right down to tiny ones like Wyoming. Perhaps most agencies don't have access to them, as they occur when regular agencies have failed or cannot react fast enough. For regular assignments, again, non-compact states tend to pay more. Reduce supply, and cost goes up. Compact does just the opposite: increase supply and pay goes down. Basic economics which is strongly apparent in travel jobs. Staff jobs skew basic economic laws because of anti-labor employer practices and reduced mobility of staff (don't want to leave their home area). In Ohio, Cleveland Clinic effectively has a monopoly on Northern Ohio, and influences all heathcare compensation. Too much strength in the hands of employers or unions makes compensation less balanced and less subject to rules of supply and demand.

My first job was at University of Maryland, and my pay started at $13 an hour in 1992, and finished at $15 an hour in 1995 when I became a traveler (still the same pay as a new nursing graduate). No unions, and Johns Hopkins actually paid less - for the status of working there. In general, the South has a huge oversupply of nurses, and an almost total lack of nursing unions, a recipe for low staff pay in the decades since I started working there. I didn't care so much about the pay, I knew I was just putting my time in to becoming competent until I became a traveler. The training was priceless, but I do have compassion for the nurses stuck in the low paid South, and indeed most occupations.

Epidural, BSN, RN · Jul 5, 2020

I agree with this advice to write to your legislators. I have written to many legislators in quite a few states. I got a lot of responses from legislative aides. One state senator even answered me personally; another put my letter on the state legislature website.

According to Jim Puente, the director of the National Council of the State Boards of Nursing, Vermont and Pennsylvania should be the next two states to join the compact. Currently 34 states are compact. At least ten more states have groups who are lobbying for compact legislation.

My voice has made a difference; yours can too.

NedRN · Jul 5, 2020

Yes, the more workers that side with employers gives cover to legislators to appear labor friendly. History of our country.