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Commentary Health Care

Opinion: Maryland Needs a Proven Tool to Confront Nursing Shortages

A report urges Maryland policymakers to take steps to ease the state’s nursing shortage. photo by RODNAE Productions.

By Bob Atlas and Gene M. Ransom III

The writers are, respectively, president and CEO of Maryland Hospital Association and CEO of The Maryland State Medical Society, known as MedChi.

The two-year COVID-19 siege exacerbated health care workforce challenges in Maryland and across the country. Hospital and health care workers are leaving the industry in droves. We face a staggering health care workforce crisis.

The issue is particularly dire related to nurses.

Registered nurses, licensed practical nurses and nursing assistants make up 39% of the hospital workforce, according to a Maryland Hospital Association survey conducted this month. And hospital nurse vacancies jumped 50% in five months beginning last August. Shortages are also felt in private physician offices, nursing homes and other health care settings.

Now is the time to support a proven and effective program to address the shortage and increase health care services for all — the Maryland Loan Repayment Program.

Health care employers across the state struggle to find qualified workers — including physicians, nurses and behavioral health clinicians — to address the needs of their communities. Scarcity of health care workers hinders access to all types of services such as treatment for substance misuse, and depression and chronic physical conditions such as asthma and diabetes.

A shortage in health care practitioners means patients wait weeks to get services, drive long distances to access care or go without care altogether.

We need to find practical solutions to recruit and retain health care workers. Many health care workers express how important loan repayment assistance is in helping them to stay in medically underserved communities where care is desperately needed. Loan repayment attracts and keeps health care workers in our state.

The General Assembly in 2020 passed important legislation (SB501/HB998) to support physicians across the state through the Maryland Loan Assistance Repayment Program, and we are grateful to Gov. Larry Hogan’s administration for fully funding it this year. This proven tool benefits physicians and physician assistants in rural and other underserved communities.

We want to do the same for nurses.

We propose using the same successful principles in a similar initiative for nurses — the Maryland Loan Assistance Repayment Program Fund for Nurses and Nursing Workers.

With bipartisan sponsorship, companion bills (SB696/HB975) offer loan repayment for certain types of nurses. In exchange they commit to practice in Maryland for at least two years. Modeled after the program for physicians, the effort eases the burden of education debt for nurses and expands access to care across the state.

There are significant barriers for people looking to start careers in nursing — from the cost to the limited spots available at local colleges. This legislation provides much-need aid to those who make up the backbone of the Maryland health system, our nurses.

At the same time, our organizations are launching other vital initiatives to build the health care workforce. We are investing in new, creative measures to attract and retain nurses, including:

  • Teaming with community colleges, high schools, and middle schools to promote health care careers;
  • Investing in and promoting health careers to first generation college students; and
  • Building different on-the-job learning methods and expanding clinical learning sites
  • Investing in our own employees by building career paths and education opportunities.

With the closeness of Maryland, Northern Virginia and Washington, D.C., we are partnering to shorten the time it takes for nurses to get licensed in multiple states. In 2018, hospitals and physicians collaborated to have our state’s physicians included in the Interstate Medical Licensure Compact. MedChi and MHA are now working toward the same flexibilities for nurses.

Loan repayment improves recruitment and retention of our invaluable nursing workforce and encourages nurses to pursue advanced education. Maryland physicians and hospitals support SB696/HB975. Investments in loan repayment are investments in access to care for all Marylanders.

We need every tool we can get.


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Opinion: Maryland Needs a Proven Tool to Confront Nursing Shortages