By REP. KATHY RAPP

We all want hospitals to have fully staffed nursing teams to ensure patients are receiving proper care. Nurses are the backbone for any well-run hospital. Canadian physician and founder of Johns Hopkins University Dr. William Osler once said, “the trained nurse has become one of the great blessings of humanity, taking a place beside the physician and the priest.”

The only problem with the nursing situation in the Commonwealth is that there are not enough of them.

House Bill 106 would mandate strict nurse staffing ratios in hospitals across Pennsylvania. If hospitals fail to meet these ratios, they will be subject to fines of up to $15,000 from the Department of Health for each violation. There is no limit to the number of fines that can be issued, so at three shifts per day, a hospital that falls below the threshold could be fined $45,000 per day. Too many of these violations could even result in a hospital’s license being revoked.

In order to prevent this, I fear hospitals would have no choice but to close beds or stop offering certain specialty services altogether to ensure they meet these nurse staffing requirements.

I’ve heard testimony from nurses in House Health Committee meetings describing how overworked and understaffed their hospital floors have become since the pandemic. I’ve also heard testimony from Dr. Linda Aiken from the University of Pennsylvania. She’s conducted acclaimed research on nurse staffing. While that research points to benefits from implementing nurse staffing ratios, her studies only accounted for hospitals with more than 100 beds. Will nurse staffing mandates help our Commonwealth’s rural hospitals in the middle of a chronic nursing shortage? Possibly, but as of now, I don’t believe we have the data to back up this idea.

This bill operates under the assumption that there are enough unemployed nurses out there that hospitals are not interested in hiring. However, based on further House Health Committee testimony, I don’t believe this is the case. Committee members heard the Hospital and Healthsystem Association of Pennsylvania testify that some hospitals offered $15,000, or even $30,000 sign-on bonuses with increased wages, higher shift differentials, more flexible scheduling options and other enticement. After all those recruitment efforts, some smaller hospitals still report RN vacancies in the range of 130-350 nurses. For larger hospitals, that figure sometimes climbed over 1,000.

Issuing mandates on our hospitals will not change the fact that we are facing a national crisis in the nursing sector. Rather than fining our health systems, let’s focus on how to address the nursing shortage. We could push for increased funding in scholarship programs, NCLEX prep courses and nurse residency programs for new graduates. These would help fight the source of the problem, rather than a symptom.

We need more nurses, not more mandates.

State Rep. Kathy Rapp represents Warren, Crawford and Forest counties.