Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2004-Continued

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2004—CONTINUED

Ms. COLLINS. Madam President, I am very pleased to join my friend and colleague from Maryland in offering this important amendment to the appropriations bill. Senator Mikulski and I have teamed up on many health care issues, ranging from home health care, ensuring adequate reimbursements to diabetes research, to helping draft the Nurse Reinvestment Act as members of the Health, Education, Labor, and Pensions Committee.

Today we team up once again to increase the funding for the Nurse Reinvestment Act and other nursing workforce development programs by $63 million. I join my colleague from Maryland in saluting the efforts of Senator Specter and Senator Harkin in providing some significant funding for nursing education programs. Our amendment, however, would bring the total level of funding for these vital programs up to $175 million in fiscal year 2004. That is not up to the full authorized level, but it is an amount that we believe would allow us to make real progress in remedying the extreme nursing shortage facing our Nation.

In fact, the United States is facing a nursing shortage of critical proportions. Moreover, this shortage is only expected to worsen as the baby boom generation ages and their need—our need—for health care grows. According to the American Hospital Association, there currently are more than 126,000 nursing vacancies in hospitals alone. The Department of Health and Human Services estimates that by the year 2010, there will be a shortage of 275,000 registered nurses, more than double the current number. In Maine, almost 1 out of 10 nursing positions at hospitals across our State is vacant.
We also face persistent shortages of certified nursing assistants and other front-line health care workers in our hospitals, home health agencies, nursing homes, and other health care facilities.

The current nursing shortage poses a significant threat to the ability of our health care system to deliver quality care. The New England Journal of Medicine published a disturbing study last year which found that nursing shortages in hospitals are associated with a higher risk of complications and even death. The study reported in the New England Journal of Medicine found that patients in hospitals with fewer registered nurses were more likely to suffer from complications such as urinary infections and pneumonia; they were more likely to stay in the hospital longer; and they were more likely to die from treatable conditions such as shock and gastrointestinal bleeding.

The fact is that nurses are the eyes and ears of our hospitals. They often serve as an early warning system when complications begin to develop. But the problems cannot be detected and treated early if nurses do not have sufficient time to spend with their patients.

Another study reported in the Journal of the American Medical Association last year found that each additional patient in a nurse's workload meant an increase of about 7 percent in the likelihood that the patient would die within 30 days of admission.

This is literally a matter of life and death. If there are more nurses, if hospitals, nursing homes, and other health care facilities are adequately staffed with nurses, the quality of care provided to patients and the likelihood of a successful outcome are much higher.

While the situation is grave today, we face even greater threats and crises in the future. Our current nursing workforce is aging. In Maine, 61 percent of our registered nurses are at least 40 years old. As a consequence, many of them will be retiring just as we aging baby boomers begin to place additional demands on our health care system. The nursing shortage therefore is sure to worsen if we do not make the critical investments today—now. We need to act more to support our current nursing workforce and to encourage more young people to choose nursing as their profession.

Last year, Congress passed the Nursing Reinvestment Act to do just that. This legislation had overwhelming bipartisan support. It authorizes scholarships to nursing students who agree to provide at least 2 years of service in a health care facility with a critical nursing shortage. It creates career ladders to help nurses and other health professionals advance in their careers. It provides loan cancellation for nurses with advanced degrees in exchange for teaching at schools of nursing.

Let me expand on that point.

Last year, I had the privilege of meeting with the nursing deans of Husson, the University of Maine, and what is now Eastern Maine Community College. They told me that they are being overwhelmed with applications from students who are eager to study nursing, but they simply cannot accommodate the qualified applicants who wish to enter the nursing program. The reason: A shortage of nursing professors.

There is a very important provision in this bill that encourages nurses with advanced degrees to teach at schools of nursing to help close that gap and lessen that shortage so that we can start training more nurses. It is not only a matter of encouraging more people to go into nursing but also to make sure that we have the nursing faculties available to educate these young students.

The Nursing Reinvestment Act builds on existing title 8 nursing education programs that provide loan repayments to nurses, improves the diversity of the nursing workforce, and expands opportunities for nursing education at all levels. All of these programs play a vital role in recruiting nurses and making sure that they have the training required to effectively and compassionately care for their patients.

The promise of this new law and other nursing educational programs will not be kept without an adequate investment of funds. That is why I felt so strongly about joining with my colleague from Maryland in this amendment. Increasing the funding level for these important programs to $175 million in fiscal year 2004 will allow them to expand to address nursing shortages in communities across the country.

I urge all of our colleagues to join us in supporting this vital amendment.

Thank you, Madam President.