Final
Public Testimony
HEALTH CARE TASK FORCE
Votes:
Action Taken:
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02:46 PM -- Public Testimony
Paula Stearns, Executive Director, Colorado Nurses Association, distributed a handout of her testimony (Attachment X) and stated that bills relating to the nursing shortage may not be needed at this time. She discussed the 2002 additions to the Nurse Practice Act that were added to address the nursing shortage and what had been done with that act. She stated that one idea she feels can really be built on is the idea of a clearinghouse for a single point of contact for nurses to access shared resources. Ms. Stearns stressed to the committee that the answer to the nursing shortage is not to reduce the qualifications to become a nurse. She added that nursing licensure minimums in Colorado are one of the lowest already, thus they do not need to be made any lower. She also stated that Colorado has a really good career ladder concept that does not need to be changed either.
Senator Keller asked if the Colorado Nurses Association ever has discussions with hospitals on how they can change their format and how they can use staff on the floor to be more of a collaborative team approach. Ms. Stearns stated that the Colorado Nursing Association has not spoken with individual hospitals, but they have brought it up in general nursing discussions and meetings. She added that what works for one institution might not work for another. Senator Keller asked whether the Nurses Association is pushing nurses to talk with their own facilities rather than hiring consultants. Ms. Stearns agreed and stated that she feels the Nurses Association should take it further. Senator Keller urged her to do so and asked the committee for any further questions. Ms. Stearns concluded her testimony.
02:56 PM
Eve Hoygaard, a public health nurse, a nurse practitioner, and President of the Colorado Nurses Association, stated that the new generation of nurses are looking less at the money aspect, and more at the working schedule and lifestyle aspects of the job. As a result, Ms. Hoygaard stated that more and more nurses do not want to work Christmas, nights, or weekends. She explained that 12-hour shifts are a compromise to solve those problems and have worked well.
Ms. Hoygaard discussed the mature workforce and how to keep nurses in the profession. She stated that as nurses get older, 12-hour shifts become difficult. She suggested that part-time work options may help keep those nurses in the profession and reduce the workforce shortages.
02:59 PM
Gene Stile stated that one of the concerns he had not heard addressed was illegal immigration, and the cost hospitals incur by providing emergency services to this population. He stated that the money hospitals lose because of unpaid health care could be used instead to pay nurses salaries and benefits. Mr. Stile asked the committee to address the problem of illegal immigrants utilizing emergency rooms as their primary physician care. Senator Keller asked Mr. Stile if he had any data on how much emergency room care is given to illegals without insurance versus to U.S. citizens who do not have insurance. Mr. Stile responded that he did not know. He gave a personal account of the types of non-emergency problems people go to emergency rooms for instead of a doctor's office. Senator Keller agreed that it is a problem, and stated that the Joint Budget Committee visited a few hospitals in Grand Junction that have problems with the uninsured utilizing hospitals for primary care. She explained that the hospital in Grand Junction opened a nonprofit clinic for the uninsured to go to for non-emergencies. She stated that the committee could look at similar efforts. Senator Keller also noted that each patient at the clinic in Grand Junction pays a co-pay.
03:05 PM
Kristy Reuss, Department Head, Department of Nursing and Radiologic Sciences, Mesa State College, updated the committee on some of the innovations Mesa State has been doing as a regional education provider utilizing some of the resources the committee had heard about throughout the day. Ms. Reuss discussed the number of students who have and will be expected to graduate from Mesa's nursing program. She stated that within 5 years, Mesa State will have tripled the number of nursing students. Ms. Reuss stated that Mesa State College is able to do that by collaborating with the Workforce Development Center, the Colorado Trust and many local area hospitals. She stated that a Workforce Center grant allowed Mesa to bring back the associates degree program eliminated in the mid-1990s and to create an efficient and effective career ladder model allowing students to advance to the next level of education while working. She mentioned that Mesa will be extending the LPN program to the Montrose and Delta area.
Ms. Reuss stated that St. Mary's Hospital created a nursing lab for the school to use, and that scholarships for students to continue their education have been funded by the Colorado Trust. She stated that the Colorado Trust grant has also allowed them to have an LPN program at Mesa. Ms. Reuss explained that part of the Colorado Trust grant has been used to grow clinical faculty for the future. She stated that the western slope does not have very many Master's level nurses, so many of their clinical nurse faculty have BS degrees and work under the direction of a Master's prepared faculty member. Mesa has placed their Registered Nurse Bachelor of Science program on-line for education advancement. This also links nurses together throughout the region and allows them to share best practices.
Ms. Reuss stated that Mesa has been exploring with a private foundation the idea of a summer camp to recruit minority, middle, and high school students to explore health care careers. Senator Keller mentioned a recent trip the JBC had taken to the western slope where they visited Mesa State College and stated that is was a good program. Senator Mitchell stated that it seems health care impacts regional economics and asked if there were any unique western slope economics she would like to share. Ms. Reuss stated that Grand Junction is different than other parts of Colorado because it has a cluster of health care facilities within the community. She stated they are the regional hub for health care, they offer competitive salaries, and there is a good collaboration between staff. Ms. Reuss concluded her testimony.
03:17 PM
Virginia Gillispie stated that she is part of the Colorado Nurses Association and sits on the Nursing Practice and Professional Issues Committee. She explained that the American Nurses Association has looked at safe staffing, patient safety, and workplace safety for nursing and that her committee translates that to the local level.
Ms. Gillispie stated that if funding is available, she would like to see it spent on hands-on clinical training as well as technology. Senator Tochtrop commented on technology programs and asked why the Nursing Board allows nurses to train with a model, but will not use similar on-line programs for health care professionals who want to advance their careers. Ms. Gillispie described the types of simulation and on-line programs. Representative Butcher stressed the importance of the simulation models for rural areas and stated that it is good to have a percentage of clinicals done on models and the rest in a hospital. She stated that it would increase the capacity for clinical for nursing students.
Senator Mitchell asked if Ms. Gillispie could explain what she was referring to about priorities or spending decisions that are contributing to a shortage of training and education capacity for new nurses. Ms. Gillispie explained that since nursing faculty get paid significantly less than nurses in a health care delivery setting there is not much incentive to teach. Senator Mitchell commented that supply and demand should create rational pressure and rational incentives. Therefore, if there is a shortage of nurses, then it should affect the providers and cause them to remedy the problem. Ms. Gillispie mentioned some positive programs that have attempted to remedy the problem. Senator Keller added that the morning's presentations covered most of the innovative programs between hospitals, universities, nursing associations, and labor unions.
03:30 PM
Mike Kingsbury, a nurse at Denver Health Medical Center, commented on his personal philosophy as a nurse to treat every patient the same regardless of their racial background, county of origin, and citizenship status. He stated that, as a nurse, he is morally obligated and professionally bound to provide care to all persons no matter their status or ability to pay. Senator Keller closed public testimony.