In the pantheon of pandemic heroes, surely nurses rank near the top. They have ministered to untold numbers of dying patients, worked grueling hours under war-zone conditions, and endured verbal abuse and even physical assault by the very patients they cared for.
It should come as no surprise, then, that many nurses have fled the profession over the past two years. Their departures have contributed to dire nursing shortages in most states, and Massachusetts is no exception: state officials estimate that some 5,000 more nurses are needed to fully staff the state’s acute care hospitals, twice the size of the shortage before the pandemic.
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A lack of nurses has been a chronic ailment of America’s health care system since before the pandemic, and fixing it will require an array of long-term policies. But the Baker administration, in alliance with the Massachusetts Health and Hospital Association, thinks its has a shorter-term fix that will reduce the shortage at least in part, and quickly.
The measure calls for Massachusetts to join the Nursing Licensure Compact, an interstate agreement that allows nurses who receive a multi-state license to practice in any of the 37 compact states — two more, Ohio and Pennsylvania, are in the process of joining — without obtaining a local license, a process that can take months.
The governor’s office asserts that joining the compact will not only give Massachusetts ready access to a pool of out-of-state nurses — including from Vermont, New Hampshire, and Maine — but also enable those nurses with a multi-state license to practice telemedicine across state lines. By streamlining licensing, it will also benefit Massachusetts nurses looking to cross state borders for work.
Additionally, the compact should make it easier for nurses in military families that frequently move around the country to find work in new states. To that end, the measure has been tucked into broader legislation intended to assist military families that is now before the Legislature.
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And in a changing health care market where patients increasingly travel to different states for care, it would enable nurses to continue caring for those patients when they return home. State officials predict that such cross-border care will increase as more women come to Massachusetts for abortions in the wake of the Supreme Court’s reversal of the Roe v. Wade decision.
The compact has been endorsed by the Health Policy Commission, a quasi-independent state agency that monitors health care costs. But one vitally important player remains opposed: the Massachusetts Nurses Association, the state’s largest nurses union.
The association contends the compact has done little to reduce nursing shortages in other states, will allow less qualified nurses to practice in Massachusetts, and distracts from the real issues that have caused nurses to flee the profession. Joining the compact, the union fears, will simply empower Massachusetts hospitals to replace burnt out nurses without confronting the difficult working conditions that cause the burnout to begin with.
Moreover, they assert, the Baker administration has already addressed the current pandemic shortage through an executive order that has sped-up nurse licensing.
But that executive order will run out this year and might not be extended by the next governor. Moreover, the largely positive experience of having out-of-state nurses work in Massachusetts under that order belies the argument that the compact would dilute standards. (The compact requires all out-of-state nurses to meet Massachusetts professional standards.)
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Still, the union has a point, one on which the Baker administration and hospital industry agree: It will take much more to really solve the nursing shortage. Working conditions and pay for nurses could absolutely be improved.
Some of those issues must be addressed in contract negotiations, but the Legislature could also play a role by considering a bill to improve hospital security for workers, a measure the hospital association broadly supports. There is no good reason why the Legislature could not enact both bills this session.
The two sides also broadly agree that considerably more should be done long term to grow the nursing workforce. Expanding classes at nursing schools and creating programs to retrain college graduates for nursing careers would be good starting points.
For now, though, the state is still battling the coronavirus, and hospitals remain under stress keeping up with manifold other health care needs that have been shunted aside during the pandemic. Time is running out in this legislative session. Taking this step, even if it is a limited one, is the least the Legislature can do to help a beleaguered and too-often forgotten profession, even if its union disagrees.
Editorials represent the views of the Boston Globe Editorial Board. Follow us @GlobeOpinion.
