A Conversation with Congressman Peter Welch on the Nursing Shortage

Vermont will need more than 3,900 nurses between October 2018 and next spring, according to the Vermont Talent Pipeline. Last week I participated in a roundtable discussion on workforce with Congressman Peter Welch and several other health care leaders and advocates.
Laura Pelosi, who represents VAHHS and other health care organizations, set the stage for the conversation and mentioned two potential federal solutions–loan repayment, and foreign worker visas. She asked Welch for more federal dollars to help medical professionals, particularly nurses, to pay back student loans. She also said that raising the cap on H-2B visas, which allow foreigners to work temporarily in the U.S., could allow Vermont to recruit more nurses.
Patricia Moulton, president of Vermont Technical College, highlighted another challenge: the issue of credentialing for nurse educators. Nationally, nurse educators require a masters’ degree. Vermont has few masters-level nurses and many prefer to work in hospital settings. This puts a bottleneck on the number of nursing students that can be educated here. Last year, Vermont Tech was only able to accept 62.5% of qualified applicants because they didn’t have enough clinical nursing educators.

Since nurses educated in our state are more likely to practice here, that contributes to the shortage. Phyllis Mitchell, RN, MSN, executive director of the Vermont State Board of Nursing, said the number of nurses graduating each year is pretty stagnant due to this issue. The nursing workforce requires a growth of around 400 nurses a year, and VT is only producing around 200. 
Anna Noonan, president and COO of Central Vermont Medical Center and a nurse herself, said she felt nurses who had bachelors’ degrees and solid work experience should be eligible to teach. Welch said if clinical nurse educators have appropriate qualifications and experience, and there were guard rails around assuring the quality of care for patients, they should be allowed to teach.
During our discussion, participants highlighted the work hospitals are doing to recruit and retain nurses including a high school nurse-shadowing program in Brattleboro and learn-while-you-earn LNA to LPN training programs at CCV in partnership with Northwestern Medical Center and Central Vermont Medical Center.
Jill Olson, who leads the VNA’s of Vermont, commented that her members have employed telehealth and telemonitoring to address workforce challenges and expand access. Welch said he has strongly supported telehealth legislation, as such bills are important to rural communities.
I am grateful to Peter Welch for convening the group to discuss this important issue, which affects rural areas disproportionately but all of us—patients as well as hospitals and every other provider.  I also agree with the Congressman that at a time when bipartisan agreement can be difficult, the workforce challenge offers common ground.

Even with innovative ideas and interventions, Vermont will struggle to grow its workforce.  The high cost of housing, transportation and child care are real systemic issues in our state and they affect nurses just as they do Vermonters in other occupations. Vermont needs to be an attractive place for nurses to work and live. As I said to conclude the session, our state should prioritize economic development to build and sustain the workforce, particularly in health care.

 Jeff Tieman, President and CEO