Update: Indiana to Effectively Join the Nurse Licensure Compact July 1, 2020
Update February 20, 2020: The Indiana State Board of Nursing announced its full implementation of the Enhanced Nurse Licensure Compact (eNLC) will be effective July 1, 2020. This comes one year later than what was initially expected and more than a year after legislation was passed to join the compact. Beginning July 1, 2020, Indiana nurses will be able to start applying for their multistate licenses and out of state nurses who hold a compact license will be able to practice within the state. In the Fall 2019 edition of NCSBN’s In Focus publication, a representative of the Indiana State Board of Nursing (ISBN) wrote: “Board members and staff are making substantial progress putting into place the technical and administrative updates necessary for multistate licenses to be issued. At the same time, ISBN is also working closely with state and national stakeholders, including NCSBN, to institute a seamless application process.” For updates and future resources about Indiana’s full implementation into the NLC, visit www.in.gov/pla/nursing.htm. Indiana lawmakers passed compact nursing license legislation during this year’s General Assembly, which ended last Wednesday. The bill allows for the Indiana State Board of Nursing to issue compact nursing licenses and allows nurses and licensed practical nurses who already have their compact license to practice in Indiana. Gov. Eric Holcomb signed the bill into law on Monday, according to data from StateScape. Indiana is the 32nd state to join the enhanced Nursing Licensure Compact, narrowly beating out Alabama in passing an eNLC bill into law. The new compact law will take effect on July 1, 2019, according to the bill’s text. Nurses and licensed practical nurses applying for a compact nursing license must pay $25 in addition to any other standard licensing fees. The bill is expected to cut down on the amount of time it takes for nurses outside of Indiana to start working in the state. Currently, it can take several weeks for a non-Indiana nurse to obtain a single-state license. Larry Jenkins, a client advisor for LiquidAgents Healthcare who frequently works with Indiana healthcare facilities, said the bill passing could greatly help hospitals fill travel jobs faster and more efficiently. “Indiana has a ton of jobs available, but it can be a struggle to fill them because they were not a compact state, and not a lot of nurses I see have their Indiana license,” Jenkins said. “This will be really helpful to get more candidates to Indiana. “I also see a lot of people from Kentucky [with a compact license] who want to work in Indiana, so this will be helpful for them as well.” House Rep. Ed Clere introduced the bill and has advocated for Indiana to join the compact since last year. After a legislative study session over the summer, the bill quickly gained support during the 2019 General Assembly and passed the House in January. “It’s important legislation for our area,” Clere told the News and Tribune. “It came to me about three years ago, and Hosparus Health and Baptist Health Floyd are two regional organizations that identified this as a top legislative priority. There are countless other providers that supported it and will benefit from it. It will help providers address workforce challenges and will improve access to quality health care.” Supporters of the bill hope this will address gaps in nursing service across the Indiana-Kentucky state line, which was a issue frequently brought up to push legislators to support the bill. “This is particularly important to border communities like Floyd County, where a nurse might live in Louisville and work in New Albany or vice versa,” the Indiana Chamber, a statewide business advocacy group, said in a press release. “For proponents, this is both a workforce and quality of care issue.” Editor’s note: This story will be updated as more information about the process for obtaining an Indiana compact nursing license becomes available. Additionally, the original story stated the bill became law without a signature from Gov. Eric Holcomb. Holcomb signed the bill on the date the story was published, so it has been updated to reflect that information.
10 Best Nursing Memes To Help You Survive Your Shift
If you are stuck inside working inside and can’t enjoy the beautiful summer weather in your neck of the woods, we’ve got the perfect solution to cure your day shift blues (Hint: It’s nursing memes). 1. If you could not pause for that long, that’d be great. – via Reddit user meg090 2. Who knew nursing was going to be this hard? – via Reddit user Drake_Pancake 3. “When I ask a 70-year-old patient if they have any pain and they tell me about their high school football career.” – via Reddit user starstuff89 4. Sure, safe ratios are nice, but have you heard of money? 5. On a scale of Vermeer to Dali, we’re feeling a bit Rembrandt. 6. “When my patient has 20 allergies listed.” -via Reddit user 711smoresicecream 7. “When my patient wants to leave AMA.” via Reddit user D5HalfNormal 8. We’re going to guess the manual on the right is used much more than the left. 9. “We’re going to be short staffed tomorrow. I can feel it.” 10. Excuse me while I go throw up outside.
Where To Find National Nurses Week Deals And Freebies
The theme of this year’s National Nurses Week celebration, which takes place from May 6-12, is “4 Million Reasons To Celebrate”, which highlights contributions of America’s 4 million registered nurses, according to the American Nurses Association website. Even if there are four million reasons, one of the best reasons for nurses to celebrate this week is that they get to cash in on tons of free food, giveaways and discounts! We’ve compiled a list of as many great National Nurses Week deals and freebies that we could find, but some are only available for a limited time. Editor’s note: We plan to update this page if we find more deals, so make sure to bookmark it and check back in throughout the week. Found a great deal you want to share? Submit it here or email it to us at news@hcttoday.com National Nurses Week Deals And Freebies Cinnabon May 6-11: Nurses can recieve a free MiniBon roll or four-count BonBites. Must show ID badge to receive free items. Sonny’s BBQ May 6: Complimentary Pork Big Deal at any of the chain’s 100 locations for nurses who can show their ID. MOD Pizza May 12: BOGO free deal on a MOD-size pizza or salad with a valid nurse ID. Only available for in-store orders. Uniform Advantage May 6-14: Up to 50 percent off on all products sitewide. Use the code “125FREE” to get free shipping on all orders over $125. Giordiano’s May 6-8: 20 percent off any order with the code 656-263-214. Offer valid for both dine-in and online and for both teachers and nurses. Enlightened Ice Cream May 6-12: Nurses or friends of nurses share their appreciation for all that nurses do by visiting this link: https://eatenlightened.com/pages/nurses-week. They can send themselves or their nurse friend a coupon for a free pint of ice cream or a free box of ice cream bars. PDQ Restaurant May 7: Teachers and nurses get 50 percent off their entire order with a valid ID at all PDQ locations. Hey, Teachers & Nurses! ☺️ On Tuesday, May 7th we’re hooking you up with 50% off your entire order with valid ID. Valid at all PDQ locations. pic.twitter.com/K1vpHWV0kr — PDQ Restaurant (@PDQFreshFood) May 3, 2019 Salata Salad Kitchen May 8: BOGO free offer Wednesday for nurses on salads and wraps with a valid ID on in-store orders. The free salad or wrap must be of equal or lesser value. Home Run Inn May 6-10: Teachers and nurses get 20 percent off their checks during Teacher Appreciation and National Nurses Week. Scooter’s Coffee May 6: 50 percent off any drink for all teachers and nurses. Cotton Patch Café May 6-10: 20 percent off on orders for all nurses when they show a valid ID. Sandals Resorts May 1-31: Sandals is giving away six-night, seven-day trips for free every day throughout the month of May to teachers, nurses and members of the military. Full giveaway details are here. DiscountGlasses.com May 6-12: 30 percent off any order with the code “HEARTNURSES30.” DiscountContactLenses.com May 6-12: 15 percent off contact lens orders with the code “HEARTNURSES15.”
Short-Staffed Nursing Homes See Drop In Medicare Ratings (KHN)
By Jordan Rau and Elizabeth Lucas, Kaiser Health News The federal government accelerated its crackdown on nursing homes that go days without a registered nurse by downgrading the rankings of a tenth of the nation’s homes on Medicare’s consumer website, new records show. In its update in April to Nursing Home Compare, the Centers for Medicare & Medicaid Services gave its lowest star rating for staffing — one star on its five-star scale — to 1,638 homes. Most were downgraded because their payroll records reported no registered-nurse hours at all for four days or more, while the remainder failed to submit their payroll records or sent data that couldn’t be verified through an audit. “Once you’re past four days [without registered nursing], it’s probably beyond calling in sick,” said David Grabowski, a health policy professor at Harvard Medical School. “It’s probably a systemic problem.” It was a tougher standard than Medicare had previously applied, when it demoted nursing homes with seven or more days without a registered nurse. “Nurse staffing has the greatest impact on the quality of care nursing homes deliver, which is why CMS analyzed the relationship between staffing levels and outcomes,” the agency announced in March. “CMS found that as staffing levels increase, quality increases.” The latest batch of payroll records, released in April, shows that even more nursing homes fell short of Medicare’s requirement that a registered nurse be on-site at least eight hours every day. Over the final three months of 2018, 2,633 of the nation’s 15,563 nursing homes reported that for four or more days, registered nurses worked fewer than eight hours, according to a Kaiser Health News analysis. Those facilities did not meet Medicare’s requirement even after counting nurses whose jobs are primarily administrative. CMS has been alarmed at the frequency of understaffing of registered nurses — the most highly trained category of nurses in a home — since the government last year began requiring homes to submit payroll records to verify staffing levels. Before that, Nursing Home Compare relied on two-week snapshots nursing homes reported to health inspectors when they visited — a method officials worried was too easy to manipulate. The records show staffing on weekends is often particularly anemic. CMS’ demotion of ratings on staffing is not as severe as it might seem, however. More than half of those homes were given a higher rating than one star for their overall assessment after CMS weighed inspection results and the facilities’ own measurement of residents’ health improvements. That overall rating is the one that garners the most attention on Nursing Home Compare and that some hospitals use when recommending where discharged patients might go. Of the 1,638 demoted nursing homes, 277 were rated as average in overall quality (three stars), 175 received four stars, and 48 received the top rating of five stars. Still, CMS’ overall changes to how the government assigns stars drew protests from nursing home groups. The American Health Care Association, a trade group for nursing homes, calculated that 36% of homes saw a drop in their ratings while 15% received improved ratings. “By moving the scoring ‘goal posts’ for two components of the Five-Star system,” the association wrote, “CMS will cause more than 30 percent of nursing centers nationwide to lose one or more stars overnight — even though nothing changed in staffing levels and in quality of care, which is still being practiced and delivered every day.” The association said in an email that the payroll records might exaggerate the absence of staff through unintentional omissions that homes make when submitting the data or because of problems on the government’s end. The association said it had raised concerns that salaried nurses face obstacles in recording time they worked above 40 hours a week. Also, the association added, homes must deduct a half-hour for every eight-hour shift for a meal break, even if the nurse worked through it. “Some of our member nursing homes have told us that their data is not showing up correctly on Nursing Home Compare, making it appear that they do not have the nurses and other staff that they in fact do have on duty,” LeadingAge, an association of nonprofit medical providers including nursing homes, said last year. Kaiser Health News has updated its interactive nursing home staffing tool with the latest data. You can use the tool to see the rating Medicare assigns to each facility for its registered nurse staffing and overall staffing levels. The tool also shows KHN-calculated ratios of patients to direct-care nurses and aides on the best- and worst-staffed days. This story originally appeared on Kaiser Health News. Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.
‘Sorry, I Don’t Have Any 8’s’: Nurses Slam State Senator On Social Media For ‘Nurses Play Cards’ Comments
UPDATE, 10:26 a.m., April 24, 2019 Washington Sen. Maureen Walsh released an official statement on the Washington State Senate Republican Caucus Website, apologizing for her comments last Tuesday. “I really don’t believe nurses at our critical access hospitals spend their days playing cards, but I did say it, and I wish I could reel it back,” Walsh said in the statement. You can read her full statement here: http://maureenwalsh.src.wastateleg.org/walsh-issues-statement-regarding-house-bill-1155/ Comments made by Washington Sen. Maureen Walsh during a recent debate about a bill regarding breaks and overtime for nurses spawned a massive wave of negative reactions over the weekend. Walsh made the comments during a Senate floor debate on Tuesday in opposition to SHB 1155, which would require uninterrupted meals and rest periods and would provide for stronger protections against mandatory overtime. Walsh argued for an amendment to the bill that would exclude rural critical access care hospitals, and said it would make it more difficult for those facilities to stay open. “By putting these types of mandates on a critical access hospital that literally serves a handful of individuals, I would submit to you those nurses probably do get breaks,” Walsh said. “They probably play cards for a considerable amount of the day.” The online backlash to Walsh’s comments from nurses around the country was swift and significant. Nurses and healthcare workers shared thousands of memes, Instagram posts, YouTube reaction videos and more over the Easter weekend in response, using hashtags #maureenwalsh and #nursesplaycards. A blog post condeming Walsh from the Washington State Nurses Association caused the organization’s website to crash over the weekend, as too many people tried to view the post at once, according to a USA Today report. “No, Senator, nurses are not sitting around playing cards. They are taking care of your neighbors, your family, your community,” Matthew Keller, WSNA’s director of nursing practice and health policy, said in the blog post. “And they do read the research: mandatory overtime is bad for patient care and it’s bad for your rural hospitals. With all due respect, Sen. Walsh: perhaps it’s time for you to put down the cards and pick up the literature.” Supporters created two petitions on Change.org, one calling for Walsh to shadow a nurse for a 12-hour shift, and another calling for her resignation. The shadowing petition had about 5,000 signatures by noon Saturday and has climbed to more than 560,000 as of Monday morning. Walsh told Tri-City Herald she regretted her comment and didn’t have any malicious intent when it was made. “I was tired,” Walsh said. “I said something I wish I hadn’t.” Walsh still supports an amendment to the bill that would exclude nurses at hospitals with fewer than 25 beds from uninterrupted breaks. An unamended version of the bill already passed through the state’s House, but will have to be reconciled in the Senate following a voice vote approval of a seperate amendment that would restrict state nurses to only working 8-hour shifts.
NYC Nurses Vote To Ratify Contract For Increased Pay, Safe Staffing Ratios
A majority of union nurses that work at NewYork-Presbyterian hospitals voted Thursday to ratify a four-year contract with the hospital that includes the establishment of minimum staffing ratios among other provisions, according to a Facebook post from the New York State Nurses Association (NYSNA). About 91 percent of the nurses at the hospital voted to ratify the contract agreement, according to the post. NYSNA members and representatives from some of the state’s largest hospitals reached the tentative contract agreement last Tuesday, ending a months-long feud and preventing a major nurse strike. The four-year contract includes a $100 million agreement to hire nearly 1,000 additional staff members at New York-Presbyterian Hospital, Montefiore, and Mount Sinai hospitals, a minimum wage increase of three percent annually and an extended window for nurse retiree health benefits. The provision of the contract praised the most by supporters on social media—and that was often the source of escalating tension between union members and the hospitals—was the agreement to create unit-specific staffing grids that would establish minimum nurse-to-patient ratios. This is the first time minimum staffing levels have been “spelled out in the contract with a meaningful enforcement mechanism,” according to a press release from NYSNA. Once both parties agree on the minimum staffing levels, a third-party arbitrator will be responsible for enforcing those levels and changing them based on patient census and acuity changes, according to the contract. Anthony Ciampa, first vice president of the New York State Nurses Association told the New York Times this agreement marks a groundbreaking achievement in addressing staffing issues statewide. “This is going to have a very positive impact, and it will be the trendsetter of the industry,” Ciampa told New York Times. “What we decide in these major city hospitals tends to set the framework for other hospitals.” Details of the full agreement can be view below:
New Ohio Legislation Would Ban Mandatory Overtime For Nurses
An Ohio House legislator introduced a new bill in March that would ban mandatory overtime for nurses, a move which supporters claim could greatly reduce mistakes at the bedside and increase nurse retention rates. If House Bill 144 is approved, Ohio would become the 19th state to implement a mandatory overtime ban for registered nurses and licensed practical nurses. “House Bill 144 stands up for Ohio’s nurses, which play a crucial and influential role in the treatment of patients,” Republican Rep. Don Manning, who introduced the legislation, said in a press release. “This bill makes patient safety the highest priority, and no one should have their nursing license or employment threatened for declining unscheduled overtime after a scheduled shift.” A ban on mandatory overtime means employers could not use it as a condition of employment, and nurses would be protected from discipline, retaliation or termination for choosing to not work overtime, according to the bill’s text. A similar bill was introduced in 2018 and passed the House almost unanimously, but failed to garner enough support in the Senate before the end of the legislative session. The Ohio Nurses Association announced their support of the bill in a recent press release. The union argues this legislation would help reduce work fatigue, and pointed out how studies have found a correlation between fatigue and an increased chance of medical errors. “…Furthermore, nurse burnout increases with regular extended shifts, leading to costly nurse-turnover for healthcare facilities,” Brian Burger, President of the Ohio Nurses Association stated in a press release. “The needs and safety of the patient and nurse need to be put first instead of trying to cut initial costs by using mandatory overtime to plug nurse staffing holes.” The Ohio Hospital Association has not released a statement about the current bill, but did argue against the 2018 version of the bill, according to a Becker’s Hospital Review report.
New Report Weighs Costs, Benefits Of Vermont Joining Nursing Compact
Vermont’s Office of Professional Regulation released a new report that found the state could see many benefits from joining the Nursing Licensure Compact, but also noted the change would have a large financial impact. Sen. Virginia Lyons introduced a nursing compact licensure bill on February 22 which would allow for Vermont to join the NLC. If approved, Vermont would become the 32nd state to join the compact. Registered nurses and licensed practical nurses from Vermont nurses could obtain a compact license, and current out-of-state compact license holders could work in Vermont without paying for a single-state license. In terms of regional impact, Vermont nurses would have easier access to New Hampshire and Maine, which are current NLC member states, and potentially Massachusetts, which also has NLC legislation in the works. The report found the benefits of joining the NLC “large and singular.” “The removal of the licensure barrier to practice in Compact States carries particular benefits for traveling nurses and military spouses, as well as in cases of disaster, labor action, or other surges in demand for nurse inflow,” the report finds. “Compact licensing also facilitates e-health and telehealth access, thereby improving the continuity of care.” The report also noted improving license mobility could potentially relieve pressure on healthcare facilities caused by nursing shortages, specifically during emergency situations. “If Vermont joins the eNLC, nurses from other Compact States will be able to provide services in Vermont without encountering the deterrent of obtaining an additional license,” the report finds. “Without these barriers to practice, nurses may be more likely to fill nursing vacancies in Vermont; however we find no studies or other data conclusively demonstrating that participation in the eNLC will alleviate state nursing shortages.” Potential costs of joining the NLC include a hit to the state nursing board’s annual revenue. The report estimated about 4,705 RNs and LPNs would no longer need a single-state license, which would cause a loss of nearly $1 million from the board’s $4 million annual revenue. “Nurses seeking Vermont-only licenses are likely to see licensing fees increase as these licensees bear a greater proportion of the State licensing administration and enforcement costs,” the report finds. “Due to the anticipated revenue loss the Office can forecast that prior to Compact adoption or shortly thereafter the Office will need to see a fee increase in this profession even after the proposed fee increase in the 2019 Legislative Session.” The current annual renewal fee for Vermont state RN and LPN licenses are $140, but if the proposed fee increase and NLC legislation are approved, the report estimates license costs will jump to $280 for RNs and $245 for LPNs. The report also pointed to costs in other areas, including increased administrative needs, staffing needs, the adaptation of licensing software, and the annual $6,000 membership fee owed to the National Council of State Boards of Nursing. Members of the state nursing board voted in support of the state joining the NLC in 2017, and the report noted many of the state’s nurses and major healthcare organizations support the legislation as well. The full report can be viewed here.
New York Nurses Set April Strike Date At 3 Hospital Systems
Registered nurses at three New York healthcare systems issued a 10-day strike notice on Monday, amid claims of unsafe working conditions caused by inadequate staffing, according to a recent union press release. New York State Nurses Association members delivered the strike notice to New York-Presbyterian Hospital, Montefiore, and Mount Sinai hospitals and set the strike date for April 2. The strike could affect more than 10,000 nurses at the three hospitals, according to the union, which have been in contract negotiations for several months with the New York City Hospital Alliance. More than 8,000 members of the nurses union voted earlier this month to authorize a strike if necessary. Union contracts at the facilities ended on December 31, but both parties have met about 30 times at barganing sessions with limited progress, according to an ABC 7 NY report. “Now is the time that all New Yorkers must have what they need and deserve,” Robin Krinsky, RN, NYSNA Board Member and negotiating committee member at Mount Sinai, said in a NYSNA Facebook post. “Safe patient care by educated professional nurses who know how to provide excellent care each and every time a patient requires it.” The union claims nurses are working with anywhere from 9 to 10 patients at at once, and has protested in support of legislation that would establish mandated nurse-to-patient ratios. A “Safe Staffing For Quality Care Act” bill that would establish mandated ratios statewide was reintroduced during this year’s legislative session, and is currently in committee for review. Advocates have pushed for mandated ratios since 2009, when a version of the bill was first introduced.
New York, Rhode Island Nursing Unions Vote To Authorize Strikes
Members of registered nurse unions in New York and Rhode Island have both voted to allow union representatives to issue 10-day strike notices if necessary, according to recent reports. United Nurses & Allied Professionals (UNAP) members in Rhode Island voted Wednesday to authorize a strike notice for Fatima Hospital, located in northern Providence. Workers want to bring attention to what they claim is a lack of commitment to patient and worker safety under Prospect CharterCARE, according to a WPRI report. Fatima Hospital is an affiliate of Prospect CharterCARE. “We don’t take this step lightly and we realize what’s at stake for each other, our patients and the community we are proudly a part of,” Cindy Fenchel, president of UNAP Local 5110 said to WPRI. “It’s time for Prospect CharterCARE to come to the table and make substantive commitments on improving patient care and strengthening worker safety.” In New York, more than 8,000 members of the New York State Nurses Association (NYSNA) voted to authorize a 10-day strike notice amid ongoing contract negotiations with New York City Hospital Alliance, according to a recent blog post. The collective bargaining agreement between the two organizations ended on December 31. NewYork-Presbyterian Hospital, Montefiore, Mt. Sinai, Mt. Sinai West, and St. Luke’s hospitals are involved in the negotiations, and a potential strike could affect an estimated 10,000 nurses at those facilities. Nurses held open protests against the 13 facilities in February over what they claim are unsafe working conditions and inadequate staffing levels. New York City Hospital Alliance disputes these claims and said NYSNA has not provided a “single shred of evidence” to support this claim, according to a CBS WLNY report. “We have remained committed to bargaining in good faith and have put forward a significant proposal that demonstrates the value we place on our nurses, who are the best in the business and should be rewarded for their essential role in the delivery of excellent care,” Farrell Sklerov, a spokesperson for the Hospital Alliance told WLNY.