Oregon lawmakers are considering a package of incentives to boost the state's nursing workforce. Hospitals have lacked nurses to meet patient demand. (Lynne Terry/Oregon Capital Chronicle)
State lawmakers want Oregon to build a pipeline that allows the state to have enough nurses to care for patients in hospitals, clinics and long-term care facilities.
A crisis is at the heart of the push: Hospitals and other health care providers often struggle to recruit and retain nurses. The pandemic hastened the state’s shortage of nurses as they left amid the stress and burnout, though it was already anticipated as the baby boomer generation began to retire in 2011.
Oregon has more than 80,000 registered nurses licensed with the state though not all of them are actively working. Thousands more are needed in the field, health care officials say. A 2021 Oregon Employment Department survey flagged three-fourth of registered nurse positions among 2,099 openings as difficult-to-fill.
The crisis impacts Oregonians needing care, forcing patients to wait for treatment, including surgery, or be shuffled from one hospital to another because of staffing shortages.
Lawmakers are weighing a slate of options to encourage Oregonians to pursue a nursing career, increase the number of nursing instructors and expand the clinical training nurses need to get certified.
It’s a complex challenge. Nursing instructors earn less when they teach instead of working in a clinical setting, leaving fewer openings for students. Clinical training options required for licensure are limited. New nurses may prefer to work in large urban centers instead of rural areas, causing a greater shortage there.
Three bills with incentives for nurses were discussed Monday in the House Committee on Behavioral Health and Health Care.
“We are in a nursing pipeline crisis with ramifications throughout the continuum of health care,” said Rep. Travis Nelson, D-NE Portland and a nurse.
The bills are:
- House Bill 2928 would expand an existing health care provider incentive program to include scholarships for students studying to be registered nurses and licensed practical nurses. To qualify, they would need to commit to working in a hospital that serves a rural or underserved community. The existing program started in 2015 and currently helps professions that include doctors, dentists and physician assistants.
- House Bill 2744 would make registered nurse instructors eligible for a state income tax credit that is currently granted to rural health care providers.
- House Bill 2926 would direct the Oregon Health Authority to start a program that gives money to hospitals that offer clinical training for nursing students. Hospitals would get a set amount, yet to be determined, as well as funding based on the number of participants.
The bills have bipartisan support. The chief sponsors are Nelson and Rep. Christine Goodwin, R-Canyonville.
Good for rural areas
Goodwin said the proposals would help rural communities attract much-needed nurses and instructors.
The proposals are needed as part of a “sustained long-term strategy,” Goodwin said in the hearing.
Nelson said lawmakers need to think about the nurse system as a whole – and what it needs. “We can only bring in as many new nurses as can be trained,” Nelson said.
The three bills have the support of the Oregon Association of Hospitals and Health Systems, the Oregon Nurses Association and the Service Employees International Union.
The hospitals association represents 62 community hospitals and the nurses union represents more than 15,000 nurses.
“It’s imperative that we collectively address these shortages,” Andi Easton, a lobbyist with the hospitals group, told lawmakers.
It’s unclear how much the proposal would cost. They’ll need to be scheduled for a vote by March 17 and eventually referred to the Joint Ways and Means Committee, which oversees the state budget.
The Oregon Nurses Association is also asking lawmakers to put minimum nurse staffing standards in place for hospitals. Its proposal, for example, would limit a registered nurse in an intensive care unit to one or two patients only, depending on their condition.
Under existing law, hospitals and nurses are supposed to draft staffing plans and follow them. The legislation, House Bill 2697, also puts a stronger enforcement mechanism in place when hospitals fail to comply, which the union says is necessary. The bill is up for a hearing next week.
It also would require the Oregon Health Authority to create an online portal for complaints.
Oregon may join compact
Lawmakers also discussed House Bill 2408, which would put Oregon in the Nurse Licensure Compact. Thirty-nine states are in the compact, which allows licensed nurses in those states to work and move from one state to another without needing to immediately get a license.
Other states, including Washington and Nevada are also considering joining the compact.
Supporters of the bill say it would help hospitals recruit nurses more easily from outside Oregon and save nurses money on license application fees.
But opponents raised concerns, including the differences in training requirements among states.
Tamarah “Tamie” Cline, president of the Oregon Nurses Association, said it’s important to invest in homegrown talent. At times, out-of-state nurses weren’t trained in procedures when Cline worked alongside them during the pandemic.
“I had to hang that IV bag and give that shot,” Cline said.
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