Nursing Issues in the 108th Congress
The 108th Congress seems to be hard at work this session with many nursing issues that are quite relevant to students and nurses alike. The major legislation currently on the table addresses nursing shortages, workplace rights, and advanced practice nursing. This legislation has a direct and important impace on the future of the nursing work force.
Multiple and complex reasons drive the nursing shortage. While the "why" of the reasons seem to be the most talked about subject, some new legislation regarding "how to help fix" is currently being thrown around in Congress. The Nurse Reinvestment Act (NRA) takes a variety of approaches at encouraging new nurses to come into the field and current nurses to advance into higher education levels. The NRA offers scholarships and loan cancellation programs to new nursing students and current nurses wanting to become nursing school faculty. Grants are offerred for Magnet, geriatric training, schools of nursing for advanced training, and public service announcements encouraging nurse recruitment.
Legislation or Unionization? Legislation affecting the workplace is now seemingly held up in Congress. While many nursing organizations are pushing for the federal government to help solve workplace issues, other nurses are turning to unions like the United Association of Nurses (UAN) for answers. Manadatory overtime and whistleblower protection are some of the major concerns affecting the workplace. A recent ANA study of 5,000 nurses across the country showed that two-thirds of nurses are working unplanned overtime every month. Continual overtime increases nursing burnout and compromises patient safety. The Registered Nurse Safe Staffing Act of 2003 is currently being reviewed to help with this problem. Whistleblowers are members of the workplace who have gone public with their employer's unlawful or hazardous practices. The Whistler-Blower Protection Act is designed to hlep protect employees in the workplace who have "blown the whistle" on their employer's unjust activities. Unfortunately, this law is often incomplete or not effective. Many whistle-blowers still find themselves dismissed, harassed, or blacklisted by their employers.
The laws concerning Advanced Practice Rgistered Nurses (APRNs) are in an interesting state of change. The need for rural healthcare and other places with an insufficient number of physicians is growing. Some positive changes involving APRNs have occurred over the past several years, such as the Balanced Budget Act of 1997, which expanded reimbursement opportunities for APRNs. Still APRNs are running into barriers of entry and participation in the healthcare system. These barriers include restructions on reimbursement under Medicaid and private insurers, laws that limit direct reimbursement, and state laws that limit or do not allow for prescriptive authority (like Georgia). Some bills are now on the House and Senate floor that would allow for these barriers to be decreased. These bills include the Rural Provider Equity Act of 2003 and the Medicaid Nursing Incentive Act of 2003. If you would like to find out about federal legislation around nursing, please visit http://thomas.loc.gov.
I would like to make special mention about Georgia. Georgia remains the last and only state in the Union to not have passed a prescriptive authority act for APRNs (Senate Bill 36 in the Georgia General Assembly). While some healthcare professionals see this particularly as unimportant, it does beg the question: "Is this indicative of how the Georgia Legislators view its nursing professionals?" I will be getting in touch with some Georgia lawmakers for answers and printing them in upcoming articles. I will also be very clearly reminding them that losing Georgia nurses to the other 49 states only further contributes to Georgia's nursing shortage.
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