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Pa. hospitals look to new nursing hires as regulations soften

Cris Collingwood//September 15, 2023

Two paramedics are assisting a patient. The patient is connected to a ventilator. Thank you doctors and nurses. Urgent hospitalization. Vector illustration.

Pennsylvania’s nursing crisis may be alleviated by a new step being implemented by the Shapiro Administration

Pa. hospitals look to new nursing hires as regulations soften

Cris Collingwood//September 15, 2023

Penn State Health, like all major health care systems, is looking to the Nurse Licensure Compact (NLC) to help fill about 200 nursing positions.

On Sept. 5, the Department of State began permitting RNs and LPNs who hold a multistate license (MSL) from compact member states/territories to practice in the commonwealth. Those nurses will be able to provide in-person or telehealth services.

Michele Szkolnicki, senior vice president and chief nursing officer for Penn State Health Milton S. Hershey Medical Center, said that since the Shapiro Administration implemented one component of the NLC Sept. 5, she was prepared to file the necessary forms to enable the hospital to hire nurses from any one of the 41 states that are part of the NLC.

She said she hopes to start hiring sometime later in September.

While the full NLC is not being implemented yet, Szkolnicki said the ability to attract nurses from other states will be a big help in staffing the hospital and providing patients with the care they need.

Full implementation of NLC would mean nurses from Pennsylvania would be able to work in other states that have adopted NLC.

“We are appreciative to the Shapiro Administration for making this a priority,” said Nicole Stallings, president and CEO, The Hospital and Healthsystem Association of Pennsylvania. “The (nursing) shortage is real and this is an important first step.”

Hospitals have been implementing new models of care and utilizing virtual care when possible, Stallings said.

“The effect is not enough. When we don’t have enough nurses, it means beds have to be closed. We have to grow the workforce,” she said.

To participate in the program, Szkolnicki said Penn State Health must file an exemption form requesting participation. That request will then be posted on the PA Bulletin for public comment.

“This is a formality, and we will get it approval,” she said. “We expect it sometime in September.”

Bringing nurses to Pa.

Once approved, Szkolnicki said she doesn’t know if 200 nurses will apply, but said it gives nurses who want to work in the area an option.

“There is a lot of talk about this increasing the number of nurses, but we are just shifting the population. We are not creating more nurses, they can just move around,” Szkolnicki said.

That said, Szkolnicki said Pennsylvania has a lot to offer nurses, especially those looking for places where they can choose their specialties.

“We have a lot of major medical centers and universities,” she said. “And here in Hershey, we have an entertainment park. I think it’s an attractive place to work.”

Stallings agreed, saying, “Pennsylvania has a high concentration of nationally recognized hospitals, and we are in the top five states in the nation with 41 Magnet Hospitals.”

“Pennsylvania has the best medical care in the country,” Szkolnicki said. “We are a Magnet facility and offer the highest level of practice for nurses.”

According to the American Nurse Association, the Magnet Recognition Program designates organizations worldwide where nurse leaders align their strategic goals to improve the organization’s patient outcomes.

The ANA says for nurses, the recognition means education and development through every career stage.

Through Penn State Health’s tuition options at Penn State College of Medicine and Penn State University, Szkolnicki said nurses are expected to earn their Bachelor of Science in Nursing (BSN) within four years of joining the network.

A BSN is an undergraduate degree for registered nurses (RNs) that teaches patient care techniques, research, health promotion and safety, and quality within the health care system, according to ANA.

In addition to the “elite” colleges of nursing in Pennsylvania, Szkolnicki said the state is geographically a good place to live with major cities within a few hours’ drive and lots of outdoor recreation.

Stallings added that hospitals across the state offer competitive salaries, bonuses and tuition reimbursement, all of which are attractive, especially for nurses just graduating.

Szkolnicki said all nurses are licensed by the American College of Nursing, so everyone gets the same license. However, each state has a board that governs the licensing and must agree to NLC.

As the NLC progresses, Szkolnicki said a nurse’s license will be like a driver’s license in that it will be accepted by other states.

Penn State Health, like most other health systems, relied heavily on traveling nurses through agencies even before the pandemic, which created an even larger nursing shortage.

Szkolnicki said the ability to get a license in another state was always an option; the process was just long and often complicated. With the NLC, the process will be much easier.

“We’ve had some very good (agency) nurses,” she said. “We just hired six.”

Szkolnicki said she sees agency nurses as “outside eyes.”

“We have to have great teams to provide great care. I use them to see what we can improve on and where we exceed,” she said.

Finding new nurses

While the NLC is a step to ease the nursing shortage, Szkolnicki said the country needs to increase the number of nurses. She cited the American Association of Colleges of Nursing’s 2019 survey that showed 75,000 qualified applicants were turned away from schools due to a lack of faculty.

Another issue, she said, is the cutback in available foreign nurses. In 2022, 81% of new visa applicants were RNs, she said. The U.S. State Department capped the number of visas to 40,000.

“We are waiting to see what they do in October. We are working with an international nursing agency to bring them in,” Szkolnicki said.

Stallings said the state is addressing the nursing shortage, as well as all health care workers, by partnering with community colleges and four-year institutions.

“I want to emphasize that you don’t need a four-year degree to get into the medical field,” Stallings said. “Once you start, continuing education is available while you’re working.”

“We struggle every day to make sure our patients get the nurses they need because we need nurses,” Szkolnicki said. “We get them at a steep cost.”

Looking ahead to NLC, Szkolnicki said, while it isn’t a panacea, it is a step to helping fill the vacancies.