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Minnesota’s shortage of trained ICU nurses shows why we should join the national Nurse Licensure Compact

A shortage of ICU nurses rather than of ICU beds

Recently, I wrote about the alleged shortage of Intensive Care Unit (ICU) beds in Minnesota. This is not driven by an unexpected, exponential surge in Covid-19 cases requiring hospitalization – the surge was expected and has been much slower than forecast – but by Gov. Walz’ decision to impose a ban on elective surgeries and then lift that ban.

Even so, I noted that:

…the state government reports that there are currently 1,257 ICU beds in Minnesota (of which 1,010 are in use) with another 585 available at 24 hours notice and a further 541 available at 72 hours notice.

Indeed, it might be the case that it isn’t a shortage of facilities that is the problem but a shortage of people qualified to staff them. As the Star Tribune reports:

Several hospitals are already activating those extra beds, though in some cases they are finding it difficult to find the critical care nurses to staff existing ICU beds — much less new ones, said Dr. Rahul Koranne, president of the Minnesota Hospital Association. Staffing difficulties, rather than a lack of physical bed space, caused some of the hospitals to divert patients.

Nurses in the Twin Cities reported being called in for overtime shifts for the Memorial Day weekend…

Joining the national Nurse Licensure Compact could help

This illustrates why Gov. Walz was correct to sign an order allowing healthcare workers licensed in other states to work in Minnesota, something we had previously called on him to do.

The Minnesota Hospital Association has long called for our state to join the national Nurse Licensure Compact. As the Minnesota Board of Nursing describes it:

The Nurse Licensure Compact (NLC) allows a nurse (RN and LPN/VN) to have one compact license in the nurse’s primary state of residence (the home state) with authority to practice in person or via telehealth in other compact states (remote states). The nurse must follow the nurse practice act of each state. The mission of the Nurse Licensure Compact is: The Nurse Licensure Compact advances public protection and access to care through the mutual recognition of one state-based license that is enforced locally and recognized nationally. 

Currently 34 states are members of the compact.

Membership would improve our situation regarding qualified ICU nurses. As the Star Tribune reported when Gov. Walz signed this order:

At a legislative hearing earlier this month, Mary Krinkie, the vice president for government relations at the Minnesota Hospital Association, told lawmakers that hospitals wanted flexibility with licensure rules so they could bring in health care workers from other states. There are “float pools” of professionals who don’t want to go to places like New York or California, she said, but they would come to Minnesota.

“Our members have been especially concerned that they will need physicians and nurses who specialize in intensive and critical care and respiratory therapists to care for an increasing number of COVID-19 patients,” the Minnesota Hospital Association said in a statement issued Saturday. “This will help alleviate workforce concerns as the number of patients increase.”

Those concerns seem to be being borne out.

The Minnesota Nurses Association opposes joining the scheme but, like any union, it exists primarily to look after the interests of its members, not those of the general public. As the Covid-19 crisis shows, their interests would be best served by being in it.

John Phelan is an economist at the Center of the American Experiment. 

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