West Virginia’s House has voted to let nursing aides give various prescription medications to patients at nursing homes.
Supporters of the bill, approved 55-44 on Tuesday, say the certified nurse aides would have to be trained every two years, work under the direction of a registered nurse, couldn’t give opioids and other drugs listed as having high potential for abuse and could give injections only with pre-filled insulin.
Aides would have to record every medication they give. They couldn’t calculate dosages or work from verbal doctor’s orders.
Opponents say their concerns are patient safety as well as the potential diversion of allowable medications, which include barbiturates that are potentially addictive.
Lawmakers on both sides note that 25 states allow the practice and 25 don’t.
A bill that sparked some debate in the Senate has made its way to the House of Delegates. It would make changes to the West Virginia Workplace Freedom Act, or the state’s right-to-work law.
The debate over whether West Virginia should be the 26th Right-to-Work state began during last year’s Legislative session.
Right-to-work laws make it illegal to require a worker in a union shop to pay union dues and fees if he or she is not a member.
Union’s argue that worker, however, is still benefiting from the contract negotiations the union pays for, without contributing to the cost.
Last year’s right-to-work bill brought on heated debates in both chambers, but ultimately passed. The legislation was vetoed by then-Governor Earl Ray Tomblin, but both the House and Senate overrode the veto and the bill became law.
Right-to-Work was challenged in court by the West Virginia AFL-CIO, the state’s largest workers’ union. Last month, a Kanawha County Judge deemed the right-to-work bill unconstitutional and the decision could end up in the state’s Supreme Court.
Senate Bill 330, which was on third reading in the House Thursday, seeks to clean up the language the judge saw as unconstitutional.
Delegate Scott Brewer, a Democrat from Mason County and a former construction worker, spoke in opposition to the bill.
“Why does this body want to jeopardize the ability of our industry partners, private business, to shake hands with private organizations and enter into an agreement that provides everything we need for these industries? Senate Bill 330 simply requires unions and labor organizations to spend their resources on people that won’t pay. That’s what this is about; spend your resources on people that will not pay,” Brewer explained.
Brewer was the only member of the body to speak to the bill, however the vote was close. It passed 52 to 48 and now heads back to the Senate.
Members of the House quickly approved 12 additional bills during their floor session on Thursday. One of those was House Bill 2522. It would enter West Virginia into an agreement with other states to allow nurses to practice across state lines without having to get multiple licenses. The compact includes both registered nurses and licensed practical nurses.
Delegate Jordan Hill, a Republican from Nicholas County, works in the Human Resources department for his local hospital, and he spoke in favor of the bill.
“I often find myself hiring numerous travel nurses at our local hospital monthly to fill vacancies that we cannot fill with West Virginia nurses, because of our shortage in the Mountain State,” Hill explained, “The current system of duplicative licensure and nurses practicing in multiple states is cumbersome and redundant for both nurses and states. We have an opportunity right now to step up to the plate and improve rural West Virginia and across the state.”
In the House’s Judiciary Committee, representatives of licensed practical nurses expressed concerns over the nurse licensure compact, arguing it wouldn’t resolve the state’s nursing shortage but allow LPNs from out-of-state to take jobs from West Virginians.
Despite concerns House Bill 2522 passed out of the chamber on a unanimous vote.
Members of the House’s Judiciary Committee are considering a bill that its sponsors hope will curb West Virginia’s nursing shortage.
House Bill 2522 would enter West Virginia into an agreement with other states to allow nurses to practice across state lines without having to get multiple licenses. The compact would include both registered nurses, or RNs, and licensed practical nurses, or LPNs, who packed the committee room Friday as members debated the bill.
There are currently 25 states in the nation that are part of a nursing licensure compact, including a number of states bordering West Virginia – Virginia, Maryland, and Kentucky for instance.
The first version of the compact was drafted in the late 1990s, and the first states signed on in 2000. In 2015, the compact was revised, adding requirements for background checks for nurses and creating a commission to oversee the agreements. So far, no states have adopted the new compact model from 2015 and West Virginia is the first to consider it.
Supporters of the bill say entering the agreement could help attract nurses to the state who don’t want to go through another licensing process. Del. Amy Summers is a sponsor of the bill. A nurse herself, she says West Virginia has had trouble keeping up with the demand for nurses, but the state has a low cost of living and the pay is good.
“We also have a very low cost of living here,” Summers noted, “I have lived in northern Virginia where the cost of living was more than double than what it is in West Virginia. The nurses are making a good wage in our state. There are sign-on bonuses; $10,000 that can attract you in if you want to come to a certain hospital. There are ways to make good money in nursing.”
Groups representing LPNs disagree with Summers though. Greg Chiartas is the President of the West Virginia State Board of Examiners for Licensed Practical Nurses.
“The bottom line is, is that there’s no evidence, at least based upon the surveys from the West Virginia Center for Nursing, that joining this compact is going to resolve any nursing shortage in West Virginia.”
Chiartas says entering the agreement could actually pose a problem for the group he represents.
“We are at a saturation point in West Virginia with LPNs; we have 26 schools, we have 8,000 licensed practical nurses in the state, and we don’t have really room or jobs available for additional nurses to be coming in from out-of-state and taking the LPN jobs that we have available,” Chiartas explained.
Bill supporters also say entering the compact could potentially increase the wages for nurses in West Virginia as the state attempts to compete with other members of the compact to keep them. But Chiartas doesn’t think that will be the result.
“Simple economics would dictate that if you have an oversupply, that you would drive down prices,” Chiartas said, “You would have increase competition which would drive down the amount of money that these nurses would make.”
Republican Del. Geoff Foster questioned Chiartas if he had evidence regarding other states that have adopted the compact and seen LPN wages drop. Chiartas said he did not.
Aside from just the potential impact to wages, some delegates were concerned that entering the compact would also make it easier for nurses to leave West Virginia.
Republican Del. Ray Hollen asked Chiartas about whether LPNs would have the opportunity to go to other states for higher wages if the state Legislature passed House Bill 2522.
“Certainly they could,” Chiartas said, “As of right now, we don’t have a lot of LPNs that leave our state. They take jobs in our state, and they stay in our state.”
Delegates on the House Judiciary Committee adjourned from their morning meeting before voting on the bill, but the committee returned to discuss the bill after the House floor session Friday afternoon. House Bill 2522 was approved on a voice vote and now goes to the full chamber for a vote likely next week.
Despite best efforts, CPR is not always successful in a hospital. But the death of a patient after CPR can be really stressful for critical care nurses. New research tries to help identify nurses most at risk for postcode stress and post traumatic stress disorder with the hope of improving resiliency in medical providers.
Registered nurses have one of the highest turnover rates of any medical profession with a national average of more than 17 percent. Finding ways to help nurses cope following the death of a patient may help combat high turnover and vacancy rates for critical care nurses, said Dawn McMeekin, lead author of the study.
The researchers conducted an online survey with a national sample of 490 critical care nurses to try to determine levels of post stress code and PTSD. They found that critical care nurses showed moderate levels of postcode stress. However, those who participated in institutional debriefing reported significantly lower levels. One recent initiative to help decrease stress in nurses, includes “pausing” after the death of a patient to honor the life of the person who passed.
The study was published this month in the American Journal of Critical Care.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation, Charleston Area Medical Center and WVU Medicine.
West Virginia University School of Nursing is using a $1.2 million federal grant to train advance practice nursing students.
The university says the three-year grant from the Health Resources and Services Administration will be used to implement the “Improving Nursing Scholarship, Practice, Innovation, Research and Education to Care for WV,” or INSPIRE to Care for WV project.
The School of Nursing intends to collaborate with new and expanded health care partners in West Virginia to strengthen the education of family nurse practitioner students to care for state residents who are vulnerable or live in rural and underserved areas.
U.S. Senators Shelley Moore Capito and Joe Manchin announced West Virginia University will receive an almost $420,000 grant designed to help train more specialized nurses.
The grant comes from the U.S. Department of Health and Human Resources and aims to train more specialized nurses in primary care. According to Teresa Ritchie, the Coordinator for the WVU School of Nursing, there are a total of 2,000 Advanced Practice Registered Nurses in West Virginia and 220,000 nurse practitioners in the country.
There are currently 130 students in WVU’s Advanced Practice program, and Ritchie anticipates more with the help of the grant.
In a news release, Senator Capito said the funds will assist nurse trainees with the costs for materials and lead to a stronger, more robust health care system.
This announcement came less than a week after the inception of a bill that grants West Virginia’s experienced, advanced nurses independent practice.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.
