Legislature looks to fix Washington’s nursing shortage with funding for education, training

OLYMPIA – Washington’s Legislature is debating a number of proposals to attract more people to become nurses.

Ideas under consideration include helping students repay student loans and creating nursing programs at Eastern and Western Washington universities.

“We put a lot of effort into training and helping people into the field,” lead budget writer Sen. Christine Rolfes, D-Bainbridge Island, said of the Senate budget proposal.

The nursing shortage and pipeline problem predate the pandemic in Washington and in past years, adjusting nursing educator salaries in community colleges was helpful, program leaders say. But they argue more is needed. In 2020, nursing programs in the Inland Northwest were not accepting even half of applicants who apply each cycle, and a recent survey of nursing union members found 49% of them were considering leaving the industry in the next few years.

One bill awaiting a vote in a state Senate fiscal committee would create a Nurse Educator Loan Repayment Program. It would allow nurse educators who teach for an approved nursing program to apply for loan repayment grants.

Nurse educators must hold an advanced nursing degree.

Nurse educators who are a faculty member for an approved nursing program would qualify. The bill seeks to address an issue seen at many four-year nursing programs in the state: Nurses with advanced degrees can make way more money in the field than teaching.

An advanced degree, which is needed to teach, is also expensive.

Louise Kaplan, an associate professor at Washington State University College of Nursing and a family nurse practitioner, said the expense of graduate school is a huge barrier for those nurses interested in becoming educators.

“If you have family responsibilities or have to work, how do you balance and pay for it?” she said. “It’s expensive to get a graduate degree.”

The exact amounts, the required service to be eligible and penalties for those who do not complete their service obligation would be decided by the Washington Student Achievement Council.

Sen. Emily Randall, chair of the Senate Higher Education and Workforce Development committee, said Thursday the Legislature has spent extensive time this session talking about the importance of expanding the nursing workforce.

Ensuring educators are able to pay off their student loans is an important part of building the nurse pipeline and making sure educators stay on the job, Randall said.

Sen. Jeff Holy, R-Spokane, said he hopes the bill will provide adequate resources that allow nurse educators to “help us prepare the next generation.”

The bill passed unanimously out of the higher education and workforce development committee. It now heads to the Senate Ways and Means committee.

Susan Stacey, chief executive of Providence Health and Services’ Inland Northwest, said the nursing educator bill will help get the caregivers the state “desperately needs” into the field.

“Those are the kinds of programs that I feel are going to make a difference in increasing the number of nurses,” Stacey said.

The Washington State Hospital Association supports the nurse educator loan forgiveness program, but senior director of government affairs Ashlen Strong acknowledged there’s still more to be done, such as improving recruitment in rural areas and allowing more nursing students to do clinical rotations.

Improving the wages for nursing educators is also important, said Darcy Jaffe, senior vice president for safety and quality at the association.

“The reality is even with loan forgiveness for nurse educators, they are still not paid in a way that’s competitive,” Jaffe said.

The Washington State Nurses Association, which represents thousands of nurses statewide, supports the loan repayment bill and calls it “common-sense” legislation because of the support it gives to educators. The union is hopeful it will attract more nurse educators to the field, a statement from the association says.

Unions representing nurses and other health care workers also are advocating for legislation that would establish patient-to-staff ratios to ensure patient safety and retain staff.

This proposal has divided the hospital association and unions in what they believe will be most effective to recruit and retain health care staff.

The proposed state budgets this session don’t include money for bonuses or retention, but instead focus on education and training.

Rolfes said the Senate had discussed a bill that would have provided bonuses, but there was “a lot of uncertainty” around the idea.

House Majority Leader Pat Sullivan told reporters the House budget proposal also focuses more on getting nurses into the pipeline by funding additional slots for students, financial assistance and a significant amount of new equipment. He said it was the quickest and easiest way to get nurses ready to enter the workforce.

The Senate proposal has more than $6 million in the next two years for Eastern Washington University to create a bachelor’s of science in nursing program.

The House proposal does not include funding for the program at Eastern, but it has much of the same ideas for nurse education as the Senate’s.

Both the Senate and the House have proposed funding to establish a master’s of science in nursing program at Western Washington University, as well as funding to increase enrollment in the university’s undergraduate program.

Both proposals also include funding for the Nursing Care Quality Assurance Commission to hire 10 employees to process nursing applications to shorten the turnaround time. Last year’s budget established a seven-day standard for turnaround, but the commission is currently turning licenses around in 12 days, according to the proposal.

Other proposals include one-time funding for the Office of the Superintendent of Public Instruction and community and technical colleges to purchase or upgrade lab equipment and a proposal to help community colleges increase the number of slots and graduates in their programs.

Advocates and educators agree that there are multiple approaches needed to address the state’s nursing shortage, and this session’s attempts likely are just some.

Kaplan said she doesn’t think this year’s budget will accomplish everything.

“We have to consider how to better fund graduate education so that we can have more opportunities for people to earn their graduate degrees,” she said. “I think we need more scholarship funds and perhaps better supplements for tuition to be lowered.”