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Ky. statehouse measures poised to address longstanding nursing shortage

Nicholas Richter gets a measles vaccine shot from a nurse at a Louisville clinic.
Nicholas Richter gets a measles vaccine shot from a nurse at a Louisville clinic in 2019. State lawmakers are advancing measures to help address the longtime nursing shortage in Kentucky.

Two measures at the Kentucky statehouse could make a big dent in addressing the historical nursing shortage in the state. 

The Kentucky Nurses Association (KNA) reports that even with 89,000 nurses licensed in the state, it’s still 12% to 20% short on what’s needed to care for patients. 

The group predicts that on top of the current shortage, there will be an additional 16,000 nurses needed over the next two years. 

Kentucky SB 10, which could have a final vote in the House next week,  would improve the nursing workforce by allowing nurses licensed in other states and countries to get immediate temporary work permits. It would also lift caps on nursing school enrollment. 

And the Kentucky Senate passed a budget that includes $100 million in American Rescue Plan funds “to support a response to the nursing shortage.” Details of the budget will be ironed out in coming weeks. 

The funds are part of an ask last year from the KNA to help improve pay for nurses and their instructors, and create a campaign to draw and retain nurses to Kentucky. 

“We need more faculty, we need to enhance the image of nurses and we have to take care of the nurses we have right now,” said Delanor Manson, executive director at the KNA. “Because if we don't, they're going to leave.”

The KNA surveyed more than 800 nurses in October, and found that many felt overworked, underpaid and ready to leave. 

“What I’m hearing from nurses no matter where they work is that they’re really tired,” Manson said. “It’s very hard to stay on high alert all the time. There has to be some down time. And that isn’t happening.”

Three quarters of the survey’s respondents said they felt insufficient staffing and heavy patient loads have contributed to the shortage. A quarter said they were extremely likely to leave their current jobs within three months. Sixteen percent said they were likely to leave the field altogether. 

Robert Blair worked for a decade as a bedside nurse at several Louisville hospitals before moving to a new job in health care last fall. Bedside nurses provide direct medical and personal patient care in hospitals, clinics, homes and other settings.

Blair said the workload had started to take a toll on his young family and he felt undercompensated. 

But COVID made the situation more urgent, especially in the second year as hospitals saw more serious long-term illnesses in people who had put off care. 

“The patients were a lot sicker … their acuity was higher, they had put off things for a longer time, they were coming in with worse heart failure, later stroke admits,” he said. 

“We all on a daily basis discussed how much harder it was after … like going from 2019 to 2021, it was significant.”

Blair is now a VAD coordinator at a local hospital – he cares and manages patients with advanced heart failure who need a Ventricular Assist Device, or a heart pump. 

He loves his new spot, but will always have a place for bedside nursing. 

“Bedside is where my heart’s at,” he said. “There’s something about being with patients and their families while literally the worst thing is happening to them and you're there to comfort them, keep them calm, explaining what’s going to happen, giving them confidence.”

Blair said he worries that as he and others leave the bedside, there won’t be enough new nurses coming in to take their places and stick around. 

“The new graduates don’t stay at the bedside,” he said. “No one wants to be a bedside nurse anymore. It doesn't pay well, it's hard, physically hard, and you can just go back to school for two more years and make twice as much.”

The Bureau of Labor Statistics shows that in 2020, Licensed Practical Nurses in Kentucky made an average of $44,160, Registered Nurses made $64,730 and Nurse Practitioners made $102,460. 

The American Association of Colleges of Nursing reports that while enrollment rose in 2020 across the U.S., more than 80,000 qualified applicants were turned away due to lack of clinics, faculty and resources. 

Manson, with the Kentucky Nurses Association, said it’s not just COVID; other factors have contributed to the need for nurses, like the average age of nurses is in the 50s. They’ll hit retirement just as more Baby Boomers age into needing a higher level of care.

“It means less care for patients, it means the quality of care is going to change,” she said.
“It means that nurses may choose not to stay in the profession because they are unable to give the care that they were educated and trained to provide because they will have extreme frustration.”

Manson said the way to make sure that doesn't happen is to invest in the field now. 

“If we want to have quality health care for our future we must figure out a way to draw individuals into the profession so that they’ll be there to take care of us,” she said. “When I get old I want there to be a nurse to take care of me. So how are we going to get here?”

Aprile Rickert is LPM's Southern Indiana reporter. Email Aprile at arickert@lpm.org.

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