Responding to Unprecedented Workforce Challenges
Nurse leaders throughout our region have grappled with workforce challenges for years. The COVID-19 pandemic exacerbated existing issues and introduced new demands, making it harder than ever before to recruit and maintain a nursing workforce that supports safe, effective patient care. These expanded challenges persist even now.
Supporting a healthy, strong nursing workforce unsurprisingly remains a high priority for nurse leaders across the region. ONL has sustained a focus on driving regional solutions to this critical issue.
A Sustained Voice for Licensure Flexibility
ONL has long advocated in support of decreasing regulatory barriers associated with state-based licensing. At the onset of the COVID-19 pandemic, many states issued executive or emergency orders to allow interstate nursing practice. ONL has continued to lend support and influence to have these orders adopted into legislation.
The Nurse Licensure Compact (NLC) has been enacted by all New England states!
In a win for nurses, patients, and communities throughout our region, all New England states have joined the Nurse Licensure Compact (NLC). The NLC allows nurses to practice and communicate with patients across state lines without additional licenses, thereby increasing access to care, strengthening emergency readiness, and helping underserved areas. The NLC is also a critical tool for growing the ranks of the nursing workforce as health care organizations in the region continue to navigate workforce shortages.
- NLC Enacted, Implementation Underway: Connecticut and Massachusetts
Massachusetts became the 43rd jurisdiction to join the NLC in November 2024, rounding out New England's participation and concluding sustained advocacy efforts spanning more than a decade. ONL is monitoring implementation. In Connecticut, the NLC was signed into law in May 2024 and will go into effect this October. Former ONL Board Member Jeannette Bronsord, DNP, MSN, MS, RN, NEA-BC and member Lisa Sundean, PhD, MHA, RN, are serving on Connecticut's NLC Implementation Workgroup.
- NLC Fully Implemented: Maine, New Hampshire. Rhode Island, and Vermont
Rhode Island rejoined the NLC in 2024, while Maine, New Hampshire, and Vermont were early adopters.
Commentary: A policy change needed to address the nursing shortage in Mass.
ONL Board Member and Massachusetts Health and Hospital Association VP of Clinical Affairs Patricia M. Noga and ONL Senior Director of Leadership Development and Government Affairs and Associate Chief Nursing Officer Ashley Waddell authored an op-ed published by the Boston Business Journal that makes the case for why the Nurse Licensure Compact (NLC) is a proven, common-sense policy that can help ease the nursing shortage.
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Graduate Nurse Practice
Utilizing any and all qualified practitioners was a priority during the pandemic. Prior to the pandemic, organizations in NH and CT had the flexibility to hire newly graduated nurses into nursing roles. Executive orders during the pandemic allowed MA and VT to use graduate nurses in similar ways. ONL has been working with various stakeholders to determine what the use of Graduate Nurses will be moving forward.
- In April 2024, Massachusetts Governor Maura Healey signed into law the Fiscal Year 2024 Supplemental Budget Act (Chapter 88 of the Acts of 2024) Session Law, which authorizes graduates of an approved nursing program and individuals who are nursing students attending the last semester of an approved nursing program to practice nursing prior to obtaining licensure as a registered nurse or licensed practical nurse. This authorization to practice is intended as an interim plan to allow recent graduates and senior students to work while they prepare for and take the NCLEX examination and apply for licensure.
Support for State-Based Workforce Task Forces
- Connecticut Center for Nursing Workforce: ONL is supporting and engaging with leaders to advance the important work being led by the Connecticut Center for Nursing Workforce, which works toward a robust, sustainable, diverse and exceptional healthcare workforce in Connecticut.
https://www.ctcenterfornursingworkforce.com/
- Massachusetts Nursing Council on Workforce Sustainability (NCWS) : The Massachusetts Nursing Council on Workforce Sustainability is part of a statewide effort to tackle the nursing shortages in Massachusetts. ONL is partnering with the NCWS to create a statewide advisory board and participate in the development of a charter, strategic plan, and implementation plan to achieve the Council’s goals.
https://www.ncwsma.org/
Increasing Funding for Nursing Workforce Development
In March 2022, the United States Department of Labor invited ONL to participate in a roundtable of nurse leaders from practice and academia. This event gave ONL the opportunity to voice support for allocating federal funds to the development of the nursing workforce with members of Secretary of Labor Martin J. Walsh's team.
Addressing Workforce Challenges Resources
Nursing Workforce Report: Challenges and Solutions during the COVID Era
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ONL convened a regional think tank to inventory nursing workforce challenges and gather best practices and strategies to address them. These leaders convened during the summer of 2021 and again at ONL’s Fall Quarterly Meeting. The result of this effort is a report titled Nursing Workforce Report: Challenges and Solutions during the COVID Era. It breaks down the current challenges with nurse recruitment and retention, provides insights on compensation, and offers advice for leveraging metrics, evidence-based strategies, and emerging ideas to retain and engage the nursing workforce.
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Supporting New Nurses Entering Practice during the Pandemic
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The pandemic served as a catalyst to convene a task force co-led by the Organization of Nurse Leaders and the Massachusetts Rhode Island League for Nursing. Together we produced a comprehensive report titled, Supporting New Nurse Transition into Practice During the Covid-19 Pandemic - Opportunities for Academic & Practice Nurse Educator Collaboration. It includes actionable strategies that can be implemented between academic and practice partners to collaboratively support new nurses’ transition into practice during the pandemic. ONL and MARILN also co-sponsored weekly online forums for new grads to connect with expert RNs throughout the pandemic.
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Paid Family Medical Leave of Absence: Policy Analysis
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Though the implementation of paid family and medical leave provides benefits to workers and is an important tool for supporting employee wellness, it has been a significant challenge for nurse leaders who are working tirelessly to maintain staffing levels. ONL provided an analysis of PFMLA in the New England region along with guidance on anticipating the potential impact.
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