Michigan fights nursing shortage

A proposed law would allow out-of-staters to practice here without separate license; union balks.

Sharon Terlep / The Detroit News

Nursing shortage
# The shortage of RNs in Michigan will total about 7,000 by 2010 and almost 18,000 by 2015
# Of all professional careers, nursing is expected to have the largest number of openings -- 110,000 nationwide -- by 2012.
# Michigan's nursing schools graduated 3,951 students in 2002-03, down from 4,260 in 1997-98.

Michigan lawmakers think they've found a way to help ease the state's nursing shortage and make it easier for patients to get nursing help over the phone and on the Internet.

But the state's major nursing union, which represents about 1,800 caregivers, is prepared to fight the plan.

A proposed state law would allow nurses who are licensed in some other states to practice in Michigan without getting a separate license here. Nurses also could provide over-the-phone or Internet help to patients in other states.

The move would put Michigan into a compact that includes 20 other states, all of which have agreed to share information about nurses and abide by set standards of practicing.

Supporters of the law, which the state House expects to vote on this week, say it will allow nurses to travel more freely between state lines, potentially bringing more nurses to Michigan. The bill also aims to allow nurses to deliver over-the-phone care to patients in other states -- an increasingly popular option as technology makes remote care a reality and hospitals start nursing help lines to answer patient questions.

"It's a matter of making it easier for nurses that want to come in to work," said Rep. John Stakoe, R-Highland, who introduced the bill. "It just seems to be a common-sense approach. I don't understand why the nurses would oppose it."

The Lansing-based Michigan Nurses Association has come out against the proposal, saying that allowing outsiders to practice here without a Michigan license could lead to less qualified caregivers and loopholes that allow nurses with discipline problems to keep practicing.

The union also believes that bringing in workers from other states and making telemedicine easier to practice avoids addressing the underlying problems behind the caregiver shortage, such as low pay and poor working conditions.

"This bill may be an attempt to put another Band-Aid on the nursing shortage," said John Armelagos, a nurse and the association's president of economic and general welfare.

"It falls short of including essential safeguards to ensure patients are protected."

Armelagos said the state should first address concerns about staffing and working conditions that drive nurses from the field.

The opposition came as a surprise to Stakoe, who said no one spoke out against the bill at a hearing last week. He said he didn't know how the union's opposition would affect the bill.

The compact that allows nurses to practice across state lines addresses worries about licensing standards and discipline, Stakoe said. The compact was launched in 2000 and initially included Texas, Utah and Wisconsin.

There's one national exam that nurses must pass to practice, so nurses in any state would have to meet the same licensure requirements, said Dawn Kappel, spokeswoman for the National Council of State Boards of Nursing, which oversees the compact.

While some states have specific standards of practice, such as a mandate for continuing education or for background checks, the requirements are basically the same, she said. States involved in the compact work together to ensure standards are acceptable to everyone involved.

As for addressing the shortage, the compact was never intended to be a solution, Kappel said. It was created primarily to address the advent of long-distance nursing care.

The nursing association worries, however, that while the compact aims to meet concerns over discipline and standards, it fails to do so.

"There's a lot of lip service," said Cheryl Johnson, president of the Michigan Nurses Association, "but the oversight isn't being done."


www.nursingagencystartup.com