The Failure of New York State Bill AO 3001

The current New York State administration has proposed a bill, AO 3001, that would give the governor control over scholarships to nursing schools.  On its face, this idea seems to have some merit.  The state faces an overwhelming nursing shortage.  By the year 2010, New York State will have 20% fewer nurses than demanded by the capacity of its health care facilities.
This shortage places everyone connected with these facilities at risk, not only patients and their families, but the health care staff as well.  With insufficient nurses available to oversee and to provide adequate care, nurses are forced to work longer shifts or extra shifts during the course of each pay period.  In addition, some care facilities find themselves replacing full-time nursing staff with either part-time or temporary nursing staff, or supplementing the available nursing care provided with nurses’ aides trained to take on lower level nursing tasks.
In addition to the lack of available nursing staff, many of those nurses already employed by New York State are nearing retirement age.  With so many of the currently employed nurses and nurse educators nearing the ends of their careers, it is becoming even more imperative to bring new nurses into the system before these men and women leave it.  However, New York State Bill AO 3001 is not the manner in which to bring new nurses into the nursing field.

According to its summary, the purpose AO 3001 is to provide scholarship and grant funding to individuals who study to enter the nursing profession.  These funds would be provided based on certain criteria and preferences specified in the bill.  Two of these items are similar to that of other awards, in that they call for evidence of academic merit and for evidence of financial need.  However, among other things, preference is given to individuals who have already obtained experience working in a healthcare setting and the “highest degree of preference” will be given “to recipients applying for second or subsequent years of funding” (Title VI, Section 2, subdivision 4-6).
While some degree of selectivity must be given when allotting scholarships and grants to students, it is the provision that the Commissioner of Education will select between candidates should the number of candidates exceed the number of awards that causes some concern.  How will these awards be made and to what criteria?  Can we be certain that the criteria being used will be to the best interest of the nursing profession?
In addition, the Commissioner can also decide where to assign the nurses who accept this funding.  According to Title VI, Section 2, subdivision 7, these nurses must work in a nursing capacity for 18 months or as nurse educators for three semesters at a minimum if they receive these funds, which is a reasonable requirement; however, the nurses must also agree to work in a facility that serves Medicaid beneficiaries or social services client, as well.  It is reasonable to expect nurses, or any scholarship recipient, to perform certain reasonable tasks to fulfill the requirements of a scholarship or grant.  Some teachers, for example, are forgiven their educational debts if they work in certain areas of the country.
However, these teachers choose what areas of the country in which they will teach and with which population of students that they will fulfill the requirements of the agreement.  To limit new nurses to working for facilities in which they may not have access to the equipment and to the funds that will enable them to best use and improve upon the skills that they have attained in their education, particularly when this knowledge is fresh in their minds, will simply hurt their futures in the profession.
Bringing new nurses into the profession is indeed a major problem facing New York State, as well as other areas of the country.  The true difficulty, however, lies with retention once these students have graduated.  Nurses face schedules that leave them sleep deprived and at risk for injuries.  Nurses are often asked to perform their jobs with substandard equipment or with insufficient funding.
In many facilities, nurses still do not receive the respect that their positions as highly trained and educated members of the health care profession demand.  In addition to all of these things, nurses typically receive inadequate pay for the work that they do, even as they attempt to pay back expensive educational loans.  A far better solution to the nursing shortage would seem to be a two-pronged attack.  First, nurses should be paid at the value of their work to ensure that nurses do not leave the field in search of higher paid work.  Second, instead of restrictive scholarships and grants that send nurses to locations decided upon by the Commissioner, a solution similar to that provided for teachers should be offered.  Both solutions would leave the decision of who should be a nurse and where these nurses should practice in the hands of those best qualified to decide: nurses and other members of the health care profession.
Reference
New York State Assembly.  (2007).  New York State Bill AO 3001.  Retrieved 12 August 2007 from http://assembly.state.ny.us/leg/?bn=A03001