Caring for our caregivers

Tom Walton is a Democratic candidate in Iowa House district 28.

One of the reasons I am running for the Iowa House is to raise awareness of our state's serious nursing shortage and the current administration’s failure to address it. When so much depends on good nurses for Iowa, why do we spend valuable time on issues that don't touch our lives? How many last memories these past years have been the face, touch and simple kindness of a loving nurse?

The COVID-19 pandemic has been hard on all of us, but especially for front-line care givers like nurses. A 2020 study conducted before the pandemic by the Iowa Board of Nursing found 58 percent of respondents agreed that there is shortage of nurses in the state. 78 percent of long-term care facility respondents agreed. 

That was before the pandemic. Then it got worse.

Iowa spent an estimated $9 million to place 100 out-of-state nurses and respiratory therapists at the state’s larger health care facilities for six weeks during a COVID-19 spike. That contract was extended for four more weeks.

Given that a nursing degree from one recognized college in Iowa costs an estimated $59,335, the amount spent on out-of-state nurses would have supported 150 new nurses in Iowa. But that takes forethought and a willingness to invest in the nursing workforce.

A recent survey showed many nurses plan to leave by the end of 2022—for every ten nurses now, there will soon be six. Unbelievably, this administration’s Board of Nursing had no legislative proposals this year. 

In contrast, other states like New Mexico have done something to care for our caregivers and address the nursing shortage. The New Mexico legislature expanded nursing education programs and eased the process of licensing nurses who move in from out of state.

New Mexico also gave in-state hospital nurses a tax credit and provided $171 million for hospitals and nursing homes to recruit and retain health care professionals. $15 million will go to New Mexico nursing education programs to expand faculty members and allow for more nursing students, with a guarantee that the money will be available on a long-term basis.

Why this neglect in Iowa of this essential workforce? A late 2020 study in the Annals of the American Thoracic Society suggests an answer:

[W]e found that across news coverage, academic journals, and professional guidelines, nurse staffing shortages were rarely mentioned and discussed as part of COVID-19 planning and preparedness. These data and implications are in stark contrast to the central role that nurses play in patient care as well as the fact that they are the largest healthcare workforce and make up the majority of a hospital’s budget.

One reason for the lack of attention to nursing shortages may be the systematic undervaluing of care work, especially when performed by women or people of color; about 90% of nurses are women and 45% of nursing assistants are people of color.

Among other things, the authors of that study recommend creating incentives for students to choose nursing as a career, including tuition remissions, and increase the number of nursing educators. Exactly what New Mexico is doing.

A nurse I know with decades of front-line experience told me that special focus is due on Licensed Practical Nurses (LPNs), who have one year of training and provide basic nursing care and whose median income is about $48,000. At times, they have been disfavored by health care systems as compared to nurses with more advanced training. However, they are central to the growth of the nursing workforce because the position provides a career path for Certified Nursing Assistants (CNAs) as well as a stepping-stone to further nursing education.

Let's honor and support the LPNs in all our families. She also advises that nurses nearing retirement must be encouraged to stay and mentor new nurses.

The nursing shortage issue goes to the heart of quality of life for all Iowans. It is two sides of the same coin—quality jobs for Iowans and those moving here—heads—and quality care in times of emergency and for an aging population—tails. For Iowa, it’s a win-win. Let’s do it for those who want to nurse and those who need care. Learn more at the Iowa Nurses Association website.

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