Nursing rule waiver finally approved
From the outset of the coronavirus outbreak, officials have worried that patients would overwhelm medical facilities and there would be too few health staff to deal with a spiraling number of sick people. States including Maryland and New York quickly relaxed regulations that kept qualified nurses from finishing their degrees and being available at hospitals and clinics.
That was a sensible approach that California recently — albeit belatedly — adopted. On March 30, Gov. Gavin Newsom signed a far-reaching health care executive order that gave the director of the state Department of Consumer Affairs the power to “waive any of the professional licensing requirements” related to “any hospital or health facility.”
One of the biggest impediments to getting nurses in the pipeline is a state regulation requiring nursing students to spend 75 percent of their clinical-training hours in a hospital or other facility with direct patient interaction. Only 25 percent of such training can be conducted through simulated, classroom-style activities. Obviously, the COVID-19 situation has imposed strains on health care facilities, which has led them to suspend these clinical rotations.
Eighteen lawmakers from both parties, called on the Department of Consumer Affairs Director Kimberly Kirchmeyer to “amend the licensing requirements that are preventing 14,000 nursing students across the state from graduating, becoming licensed, and assisting with the COVID-19 response efforts.” Kirchmeyer agreed late last week to temporarily waive those clinical-hour requirements.
That’s a great development. As the Associated Press reported, dozens of nursing schools had been pleading with the state to relax these rules since early March — shortly after the governor had declared a state of emergency in the wake of the spreading virus. “In the interim, valuable time was lost for nearly 10,000 nursing students in their last semester,” thus delaying the state’s ability to staff additional 66,000 new hospital beds,” the report noted.
We can chalk up the delays to California bureaucratic, union-controlled health care system, which artificially limits medical personnel to boost pay levels. The system has done this for a long time, leading to a long-standing shortage of nurses and physicians. The coronavirus situation, however, has turned a troubling problem into a lifethreatening one.
Another example is the California Board of Registered Nursing, which restricts the number of students that private nursing colleges can enroll over concerns about adequate rotation slots.
Fortunately, the governor’s executive order has set the stage for other meaningful rule waivers. It allows hospitals to suspend California’s strict nurse-to-patient staffing law — a union-backed effort that was championed as a way to improve patient care, but which mainly has reduced hospital flexibility.
Unions aren’t the only interest groups to promote burdensome occupational-licensing regulations that are designed mainly to reduce the competition. The California Medical Association has opposed efforts give nurse practitioners more independence. We’re pleased the executive order lets these practitioners temporarily receive expanded “scope of practice” without physician oversight — something that can alleviate medical-staff shortages.
These various temporary waivers do raise the obvious question: If removing bureaucratic barriers to entry helps in a crisis, why do we need these rules at all?
These various temporary waivers do raise the obvious question: If removing bureaucratic barriers to entry helps in a crisis, why do we need these rules at all?