NURSING SHORTAGE: Relief Bill Reaches President
Congress on Tuesday sent to President Clinton a proposal that would alleviate the nursing shortage in underserved areas by providing temporary visas to foreign nurses. The measure, similar to a 1989 federal bill that expired several years ago, outlines a program that would offer up to 500 nonimmigrant visas per year for the next four years to qualified foreign nurses, who would work at hospitals facing the most severe shortages of professionals, typically rural and inner-city facilities (Associated Press, 11/3). The legislation contains wage and volume protections for domestic nursing staff -- stipulating that no more than one-third of a facility's RNs can be non-immigrant aliens -- and requires hospitals to document efforts to hire domestic workers before hiring foreign nurses. Hospitals taking advantage of the bill would be required to meet certain bed size and demographic criteria (H.R. 144). Rep. Bobby Rush (D-IL) introduced the original bill after a nursing shortage almost forced St. Bernard Hospital in Chicago's poor Englewood neighborhood to close (Cleeland, Los Angeles Times, 4/11). The AP reports that the legislation also includes a provision that facilitates hiring of foreign physicians in underserved areas, although no further details are provided (11/3).
Nursing Aides, Too
A hearing before the Senate Special Committee on Aging yesterday "generated tears, ovations and standing-room-only attendance." Chair Charles Grassley (R-IA) said, "Until now, we've focused on those who receive nursing home care. Today we'll focus on those who provide it. Aides make an average of $6.94 an hour and have a turnover rate of 94% annually. They also have the third highest rate of serious injury among private industry workers. Grassley said, "Does nursing home work have to pay so poorly? This industry will receive $39 billion this year from the federal government to care for the nation's nursing home residents." Grassley has requested a General Accounting Office study to investigate why aides aren't paid more. Aides testified in support of federally mandated staffing requirements, but industry representatives presented a different side. Florida nursing home administrator Leslie Williams said, "Mandating numbers will not guarantee hearts. You'll get bodies, hands and feet. Assuming that a law dictating the number of bodies in my center on a daily basis will guarantee quality is a flawed concept. While it is logical that 10 nursing assistants can get more done than six, give me six who love what they do as opposed to 10 who are (just) collecting a check." Beth Ferris, president of the Texas Advocates for Nursing Home Residents, argued, "The industry talks about how all we need is aides with 'heart.' Well, 'heart' can't turn a patient, 'heart' can't feed a patient." Although no federal legislation is in the works to mandate aide staffing, Rep. Pete Stark (D-CA) plans to introduce a bill that would require nursing homes to report how many nursing aides are on a shift (Adams, Washington Post, 11/4).
Meanwhile, Massachusetts nurses are joining a "growing nationwide chorus of nurses" and planning a protest against "alarming staffing levels" and "lack of support from state regulators." Nurses at St. Vincent Hospital in Worcester trying to negotiate their first contract since unionizing in 1997 have planned a demonstration tomorrow to call attention to a recent incident in which one nurse was caring for nine critically ill patients in one shift. Last week an anonymous complaint about staffing prompted the Joint Commission on Accreditation of Healthcare Organizations, a private industry-supported agency based in Illinois, to make a surprise visit. The commission's report has not yet been completed. St. Vincent spokesperson Paula Green said, "Oftentimes, we find that [the nurses] use the media to draw attention to their demands here at the hospital. Our staffing levels here at the hospital are in keeping with industry standards and are similar to hospitals in the area." In Boston, nurses at the Boston Medical Center plan to choose a strike date Monday. Nurses from several states plan to protest in front of the Board of Registration in Nursing in support of Barry Adams, a Cambridge nurse who lost his job after alleging unsafe staffing levels. David Schildmeier of the Massachusetts Nurses Association, said, "I can tell you, the nurse activism and the need to reach out to the public grows every year because of the conditions that nurses are working under" (Kong, Boston Globe, 11/4).