- Associated Press - Saturday, February 1, 2014

LINCOLN, Neb. (AP) - As nurses age and more people gain access to health care, state officials and educators are concerned about a nursing shortage.

Nationally, there are expected to be 1.1 million job openings for registered nurses by 2022, according to the Bureau of Labor Statistics. And parts of Nebraska already are facing a shortage, with eight counties lacking a registered nurse, said Juan Ramirez, consultant for the Nebraska Center for Nursing.

Thirty-nine Nebraska counties lack a nurse practitioner, according to U.S. Department of Health and Human Services data.

Sen. Mike Gloor of Grand Island, a former hospital administrator, said it’s important for the state to address the issue.

“I think anytime you’ve got a shortage of any health care provider you worry that things may slip through the cracks in terms of the care that’s being provided,” Gloor said.

Registered nurses have either two or four years of education and have passed the national board exam to earn their license. A nurse practitioner has a graduate education, either a masters or a doctoral degree, and has passed a second national exam.

The University of Nebraska Medical Center College of Nursing has made changes to its program for registered nurses earning a bachelor’s degree in nursing. The hope is that the school will produce more highly trained nurses capable of dealing with increasingly complex health problems as the population ages and the Affordable Care Act ensures health care for more people.

“We expect more and more people will want access to primary care as they gain access to insurance,” said Juliann Sebastian, dean of the College of Nursing.

UNMC has reduced the number of credits students seeking a bachelor’s degree are required to take from 24 to 20 credit hours and is trying to align courses with a nurse’s prior education and experience, Sebastian said.

The college previously added a program to help those with a bachelor’s degree earn a Ph.D., to help with a shortage of nursing faculty, Sebastian said.

UNMC also wants to make sure there are enough nurse practitioners to supplement primary care physicians, she said.

In the Legislature, Sen. Sue Crawford, of Bellevue, introduced a bill intended to help recruit and retain nurse practitioners. The bill would remove the integrated practice agreement, which requires a doctor to sign on as someone who is working with the nurse practitioner, Crawford said. A nurse practitioner cannot currently practice in the state without the agreement.

Nurse practitioners still would be required to work with other providers for cases that are beyond their scope of practice, Crawford said.

Getting rid of the agreement would free nurse practitioners in rural communities who have not found a physician to sign with a practice in the area.

“I believe that it will address shortages throughout the state, including our rural areas,” she said.

Gloor, a former hospital chief executive officer, added his name to Crawford’s bill.

Gloor said previous nursing shortages have been cyclical and that salaries would increase when there weren’t enough nurses, prompting more people to seek degrees.

But because of the Affordable Care Act, Gloor said there may not be enough nurses to care for an influx of new patients.

The shortage could affect rural and urban communities in different ways.

Smaller communities may have a more stable workforce, but if they lose one or two of their medical personnel it becomes more difficult to replace them, Gloor said. Urban communities may have an easier time recruiting new employees, he said.


The bill is LB916

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