House approves incentives to graduate more nurses

By JACKIE STONE Associated Press Writer © 2009 The Associated Press
April 22, 2009, 6:56PM
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AUSTIN, Texas — An estimated shortage of 22,000 nurses across Texas drove the state House on Wednesday to tentatively approve a measure that would increase the incentives some nursing schools get for hiring more teachers and graduating more nurses.

The issue is on the minds of many lawmakers this session, and in many bills seeking to move forward in the final weeks of the session.

"Nurses are good jobs, and we're having to import nurses. Yet when you look at the kinds of jobs you want your children and other people's children to have, this one jumps to the forefront," said Rep. Lois Kolkhorst, R-Brenham, the author of the bill approved Wednesday.

Kolkhorst's proposal would target some state grants toward hiring nursing faculty at some nursing schools. She is also behind incentives in the state budget to reward nursing schools that have a more than 70 percent graduation rate.

The state estimates that if Texas fails to graduate more nurses as the population grows, demand will outstrip registered nurses by 70,000 in 2020. Kolhorst said her measures aim to catch up to demand by 2013.

Supporters of Kolkhorst's bill say nursing schools can't get more graduates until they have more teachers.

Texas nursing schools had to turn away 8,000 qualified applicants in 2008 because they didn't have enough faculty, said Rep. Donna Howard, D-Austin.

"That's one of the biggest kinks in the pipeline, is lack of faculty," said Howard, a former nurse who is supporting the bill. "Nurses with advanced degrees can typically make at least $20,000 more working in a clinical setting rather than in academia."

The state has had a grant program, called the Professional Nursing Shortage Reduction Program, to give incentives to nursing schools since 2005. Currently the grants are handed out based on how much nursing schools increase the number of graduates each year, said Chris Fowler with the Texas Higher Education Coordinating Board. The board hands out the grants.

"There are three stipulations (for use of the money). For new faculty, salary supplements for current faculty, and preceptors," Fowler said. Preceptors are hospitals nurses who agree to take on nursing students for their clinical training, she said.

Kolkhorst's bill would smooth the way for some of that grant money to be given to schools up front, rather than after a school has established higher graduation rates.

Fowler said if the changes are made, the board could direct about half of the $24.7 million each year in grant money proposed in a House version of the two-year state budget to schools that need the funding in order to increase graduation rates.

"(Schools) would say, we agree to graduate 30 more students two years from now, but we need up front money in order to build our enrollment," she said.

The House version of the budget still has to be reconciled with a Senate version, so funding for the grants could change.

Some other bills still winding their way through the Legislature would focus on retaining nurses by creating a better work environment.

The National Nurses Organizing Committee, a new union group for Texas nurses, insists that the nursing shortage can't be solved by graduating more nurses.

"We have all the qualified nurses we need out there right now. They just can't stomach working in the hospitals," said Shum Preston, a spokesman for the union group.

Preston said nurses would come back if they had better working conditions and hospitals had mandated staffing ratios to keep nurses from being understaffed and overworked.

The union group supports House and Senate legislation that would create nurse ratios.

Other lawmakers and organizations like the Texas Hospital Association agree retaining nurses through better work conditions is a piece of the puzzle. But they say mandatory ratios do not allow for the flexibility hospitals need in staffing, particularly when dealing with patients who have different levels of need.

"One size does not fit all," Howard said.

The nursing school grant bill must pass a final vote in the House before it can be sent to the Senate, where some efforts focus on giving money to hospitals.

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The nursing school bill is HB4471