Several House Democrats called for installing federal nursing staff ratios and loan repayments to ease the impact of a massive labor shortage that has wreaked the healthcare industry.
The House Energy and Commerce Committee’s oversight panel held a hearing Wednesday speaking with front-line providers on the impact of COVID-19 on the workforce. Lawmakers detailed their policy proposals to handle staffing issues, especially those surrounding the nursing workforce.
“The nurses and healthcare workforce is in crisis,” said Rep. Jan Schakowsky, D-Illinois. “We know that there is a shortage of good-paying, permanent nursing jobs where nurses are fully valued for their work at the bedside.”
Schakowsky introduced last May legislation called Nurse Staffing Standards for Hospital Patient Safety and Quality Care that would install federal staffing requirements including a nurse-to-patient ratio. Only a few states have installed similar requirements.
Experts said there have been studies on the benefit of such ratios not just on quality, but also on combating burnout.
“There is ample evidence that having low nurse-to-patient ratios improves patient outcomes, decreases patient mortality, decreases staff burnout,” said Megan Ranney, M.D., an emergency physician for Rhode Island Hospital, during the committee hearing. “Asking nurses to take care of more than a certain number of patients … increases both patient harm and burnout.”
Lawmakers were also concerned about the increasing role of contract labor during the pandemic, which has led to higher expenses across the industry.
Rep. David McKinley, R-West Virginia, was concerned about how the reliance on contract labor is hurting smaller, rural hospitals that can’t afford high prices.
“How are small hospitals supposed to exist during a pandemic when their nurses are being robbed to go somewhere else?” he asked.
A potential solution could be investing more in the nursing pipeline that would at the very least decrease the dependence on contract labor, said Tawanda Austin, chief nursing officer at Emory University Hospital Midtown.
Austin said her facility had one of the best nurse staffing ratios in the city, but it has not been immune to what happened during the pandemic that has strained the workforce.
“We had to bolster our staff due to contract labor,” she said.
Experts called for efforts to improve the physician workforce as well, which has also faced massive problems with burnout.
Congress should explore loan repayment legislation to help retain physicians on the front lines, said Ranney.
The average physician graduates with typically $200,000 in debt, which can grow as they pursue residency, Ranney said. This debt could “dissuade folks from taking on lower-paying positions,” Ranney said.
Congress has explored loan repayments for front-line workers. Rep. Carolyn Maloney, D-New York, introduced legislation in 2020 to forgive loans for medical and professional training for healthcare workers that have made major contributions to COVID-19 patient care, but the legislation did not advance through that congressional session.