>> Kentucky nurses makeup half of the health care workforce, even more.

But as a reporter would ask us, where have all the nurses gone?

Well, why are they leaving the industry and what are we going to do if they all go?

Well, we have the president, the Kentucky Nurses Association with us Miss Dellinger Manson to talk to us about the issues facing the industry and what can be done that's now on connections.

Thank you for joining us for connections today.

I'm Renee Shaw.

You've heard this before that Kentucky and indeed the nation is facing a critical shortage in a lot of areas in our health care industry.

Among them nurses, there was a report and 2012 that said that Kentucky would need 16,000 more nurses.

>> By the year 2024.

Will.

Today's guest tells us that number is blown out of the water.

How much is the nursing shortage and what's being done to shore it up?

What ideas are before the legislature, perhaps in the next time they meet with the Advocate for a lot of this policy to move the needle in the right direction is with us today.

Miss donor Manson who was president of the Kentucky Nurses Association.

I'm a big fan of hers in many ways and I do want to talk a little bit about your background.

You've been on Doctor Wayne talks and show Kentucky Health before talking about this very issue.

But your career in the healthcare industry, I want you to share that for just a little bit with our viewers.

Well, it's little >> I'm a graduate of the UK College of Nursing and then I joined the Navy to see the world.

I served for 27 years and retired as a Navy captain.

And I've worked in places hospice but now with the Kentucky Nurses Association is the best I've ever had.

Is it really it really?

But it's a tough time.

It is a tough time at we represent 89,000 nurses in the state of Kentucky.

Everything that we do is supporting those 89,000 nurses.

So it's a tough time because of the shortage.

It's a tough time because of burnout.

It's a tough time.

March 2020, our healthcare heroes.

He would see clips in the beginning during the middle.

And after all of the newscast heralding and trumpeting the work of our healthcare heroes.

And then that waned over time.

Do you think that your profession is adequately respected?

Oh, absolutely not.

In 2020, as you said, we were heroes.

as recent as the end of 2021, nurse reported to me that she went to the grocery store.

And Chad owners scrubs and someone spit on her.

She was at the grocery store.

She was at the grocery store and a person in the grocery store spit on her.

So that's a long fall from a hero to a person that gets picked on.

And a lot of that is that nurses are the people that you encounter the most in health care.

As you said, we are 53.3% of the health care and the nurses are the people who are asking.

Please wear a mask.

Please get vaccinated.

Please wash your hands, please.

Social distance.

We are the not only the care providers.

We are also the people who protect the patients.

And so we're asking people to do the right thing.

Do you think it was the mitigation efforts and mandates requirements?

>> That really.

Created the fault line for people to change their attitude about the disease and how to prevent it or even if it was a disease at all.

>> Renee.

>> I thought you want to talk about the If you want to talk about her to cry.

But I think from as far as from the perspective of how it's impacted the nursing industry, I mean, I think one of the reason why bring up Mister Manson is because I remember talking to someone recently about if the messaging had come from the medical community rather than politicians, perhaps the behavior in the attitudes would have been different by some of those who were resistant to mitigation measures and to vaccinations, true or false.

In your view, I'm not sure because here's the real deal.

And that is that COVID is real.

And no matter where the information came from, it was designed to protect and so my plumber tells me that I need to wear a mask because it'll keep me safe.

I'm probably going to wear that mask.

And so you can think about.

The source of the message as the problem or you can say the problem is the problem and how how we're going to address that right to get to where have all the nurses gone?

Where did they go?

Do they retire?

Or did they find new careers?

I mean, because I would imagine that many of the nurses I know they're full of life in the prime of life.

We did a survey in October of 2021 and we did that survey based on being told that there wasn't a huge nursing shortage.

And I have to say that the nursing shortage existed prior to the but it has COVID has exacerbated the nursing shortage.

And so when we did the survey, we found out that nurses really felt disrespected.

There weren't enough nurses.

They felt as if they were part of the decision-making and that no one really cared about decision-making where where decisions are made about staffing about pay about shifts about care models about how to care for patients about who cares for patients.

Those types of really critical decisions.

But we heard often I remember talking to a I'm a physician and Louisville who said if it weren't for the nurses because the doctors were so Sen right that the nurses were the ones who are with the patients and who pulled up the iPad so that they could have final engagements with their families and who would hold their hand or have hot water balloons that mimic the human hand, right?

You those were nurses in the rooms during those times.

>> They were there in most cases, the nurses are more more than the physicians are right.

But it was really important during this time because patients were all alone except for those nurses.

Those nurses are currently going through burnout.

And that's part of the reason that they're leaving.

A lot of other nurses are leaving because they're retiring in the retiring And then of course, we have the shortage where we can't get enough students of nursing schools.

we don't.

How are they enrolling in nursing schools to begin with?

>> we had a major shortage of enrollees in our nursing schools about 1700 open seats, open seat, 171700 open are saying, OK, so you're saying, well, how do we get those seats Part of the reason that we had open seats is because we don't have enough equity to teach the students and then we get the students.

We have to have clinical rotations, places where they can go and have that clinical experience.

We don't have enough of those either.

Wow.

So and there's a shortage of faculty because they don't get paid much UC Merced and school faculty have to be.

Very, very well educated phd's.

The MPs masters.

How are they don't get paid?

What other people get paid who have similar degrees so they don't get paid much.

They have school loans because they had to go back to school and wanted to get these to get the advanced degrees and 10 degrees as many of these instructors are working 2, 3, chops to pay their student loan its new.

Okay.

So we don't have enough instructors.

Haha, we don't have enough clinical sites.

>> And we don't have enough student know what's the reason for not having enough clinical sites?

We only have so many hospitals and long-term care facilities.

However, we need to think about.

Clinical sites that are non-traditional those of the traditional site, right?

Things hospice care, home care, military facilities, the Ames.

So we need to start thinking differently about where we allow our students to train.

For instance, the COVID in hospitals.

Long-term care or not accepting students mainly because they didn't have PPE 4th.

Right?

Okay.

But we found a way to get some clinical rotations per soon as we as in the Kentucky Nurses Association, we coordinated with the schools to take their students out to Lew, Vax so they can participate in vaccinations.

Wow.

And then we continue to utilize those students in our mobile mission And in fact, there's a team out today doing testing and I'm one of our So we've incorporated students into our testing and vaccines.

I want to go to the reasons you mentioned the survey from October 2021. and the top contributors to the nursing shortage by rank number one.

73% lack of sufficient nursing staff.

>> Heavy patient loads.

We heard this particularly during the onset of COVID and even and the lingering that it just was almost it was untenable, right?

Not enough pay number 2 physical exhaustion, fear of transmitting COVID to family friends doing to to working as a nurse and then finally lack of support staff to alleviate non nursing tasks.

I want to ask you, particularly about what's a non nursing task that a nurse was having to assume.

Washing beds.

Transporting patients.

Running to the lab.

Serving meals.

Things like that.

Things that patients need.

I but not enough people to get those types of things to it.

Mopping floors.

That those are things that nurses were doing.

And it's not because nurses wanted to do it.

It just needed to be done.

And because there were so many patients that played havoc with staffing.

If you've got patients lined up in the hall in the emergency, I'm not sure if you saw the segment on 60 minutes and you could see the patients one lined up in the hall.

That wasn't an anomaly.

Yeah.

It's a regular occurrence in regular currents and then having patients to have to wait in the emergency room because there were no beds.

Then the nurse had to strip the bed watched the bed, get ready so that the patient could come up and get an iPad.

Yeah.

Lack of administration or lack of support for nurses from management administration.

You did hit on that.

It's not about the pay.

I mean, only 41% said it's not about the pay, not enough pay, but the first one was the and sufficient nursing staff and the heavy patient loads.

So they're not in it for the money.

They're not.

Well, it doesn't hurt for nurses to be paid adequately But but one of the things that you can say is when the travelers >> started coming on the scene, traveling nurses, traveling, nurses were being paid.

>> $150 200, an hour now.

And so many of those people who had school loans.

Took those jobs so they could pay off their school loans.

Yeah.

Where did the traveling nurses come from him?

Are they not pay from the same pot of money as the nurses who are stationary?

In many cases now because they're like contractors.

Yeah, you know, you have to worry about the full package, right?

That's right.

Plus, but you know, when you're thinking about doing your budget, I mean, it's like when I do my budget, I have my regular budget includes all my salaries, but my contractors come out of a different pot of money, right?

Right.

Different pot of money.

So traveling nurses become the thing I mean, is that has that really sway?

Like you said, many found that that was the way to go.

If they were in a position to do that.

I mean, you've got to be one pretty mobile inability to after so many months.

And so those who have >> the stability and then the commitments of the family, etcetera, may not be in that position to do that.

What we something really unusual happened all over the country.

We're travel.

Nurses would lead to their regular position.

>> And tech take a travel position at the hospital across the street.

Oh, wow.

Or they would go to another place if they went outside a state, they get travel pay.

They got a stipend for living allowance in food.

And transportation.

>> They're banking all that money, right?

A lot of them are right.

But who could blame them?

No one could blame him.

And I also want to say thank goodness for travel nurses because we were so short.

>> In every place where nurses work, not just hospitals and long-term care.

I mean, every place where nurses work corrections, as I mentioned, the hospice.

If we didn't have travel nurses, the school nurse, you know, we need school those travel nurses filled holes that work So we appreciate the travel nurses, but we really appreciate the nurses who stayed in their communities and serve their communities during COVID.

>> Someone same as mentioned will now we're almost on the other side of COVID.

Things will get.

Okay.

Okay.

Don't respond to What I've heart, but it is as things normalize little washer industry stabilize and just by natural nature of business.

Well, things not get better.

They will not.

>> First of as I said before, the nursing shortage existed before COVID, it is exact was exacerbated by COVID and it is it is going to be even more exacerbated at this point because as I mentioned about the mental health Also, how nurses are people treated in the workplace by patients, their families and even their colleagues.

>> What you mean by that?

some bullying going on in health care organizations of nurses to nurse position, Turner's health care provider 2 years.

That's And for those organizations that do not have a 0 tolerance of workplace well, they do not have a 0 tolerance of workplace abuse.

They're going to lose those nurses because there are jobs everywhere.

They don't have to stay there.

All right.

They can go wherever they want to go.

Our Kentucky lawmakers hearing your call.

>> Hearing your cry and answering accordingly.

Well, I can tell you that nationally.

>> The American Nurses Association is putting forth bills national recognition of abuse.

And so that's happening.

So at the local level, we need to do that as >> And and that's in the works.

Perhaps perhaps perhaps right that there was some legislation that was adopted by the General Assembly passed will be come law.

I don't know if Senate Bill 10 had an emergency clause.

Can't remember a should know that.

But if not, it becomes effective.

July first.

Yes.

So this bill was supposed to be the answer.

A positive itself as being the answer or part of the answer to the nursing shortage in Kentucky.

Your assessment of whether it does that or not?

I want to say that legislators meant well.

>> They really did.

They really wanted to help.

And they saw that we had a nursing shortage and they addressed it through what I call a pipeline opportunity to find that force, if you will, pipeline means that we have to get them through nursing with 4.

They can be productive.

So nurses school, we're talking 2 to 4 years and then a year for them to learn in organization.

So you're talking 2 to 5 years before nurses productive.

That's a pipeline.

>> Right.

Because it's not going to answer the immediate crisis and concerning Iran definitely will not.

There's nothing in Senate bill that helps us to address the immediate nursing shortage crises.

A few months ago.

I had Chancellor Chris Williams of the Kentucky Community and Technical College system and she was talking about with Lakeesha Miller of the Kentucky Chamber of Commerce about a way to help shore up interest in the nursing field and to get more professionals online.

What can you talk to us about what's being done in the educational, the post-secondary educational space to answer this, even if lawmakers don't do it as adequately as you'd like.

Well, we I think that the educators are doing the best they can do with what they And I think that the efforts to increase the brand image of nursing is something that we must do and it's not up to educators to do that.

That was one of the things that we asked legislators for in that is funding to do a brand image campaign.

So one of the suggestions that the Kentucky Nurses Association has is to partner with public companies and private companies to help us to develop this nursing image campaign.

So I will be visiting if you're listening on coming to ask for funding for that because one of the things we have to do is lift up the image of nurses.

What you think the image is tarnished?

Almost definitely Thomas tarnished.

I mean, why do you think that spit on while right?

Right.

And then why do you that nurses are not wanting to only because they're tired because they're not being hacked.

You know, so we have to do something to make.

Nursing.

One of those prefer fashions that children want to be when they grow up as much as they want to be a professional name.

Your type of ball player, right?

Exactly to make it cool to make it cool.

And but that's going to take funding to in order to do that.

Yeah.

Hero pay.

We heard about at the start of the legislative session in January.

The governor had proposed taking some of the federal COVID relief money to the tune of 400 million dollars and using it not just for nurses and other frontline workers.

Those who had been there on the front lines risking their lives are health or health of they're the ones who they the share a home with to give them a been a little hero, pay exactly what it sounds.

>> That didn't make it.

But you also had a financial request to that did not make it what?

Would you have wanted to have seen happen during the session, but didn't?

Well, first of all, I want to say I am not opposed to but what we asked for was a small.

>> Retention bonus for nurses who stayed in their communities and worked.

And it was $1000 for every nurse for every are in and $750 for every L P and we were not calling it hero pay because we can't pay them what they deserve, but we could give them something that says thank you for staying.

Do you think that would have made a Why do most definitely I cannot tell you how many nurses said to me.

We don't want any more donuts.

No more We want to be at the table where the decisions are being made.

We want to thank you a genuine.

Thank you for being here and doing what you do to make a safe and taken care of?

>> Well, it sounds like there needs to be and those continuing education courses that the health care provider community is supposed to have primary care physicians and others that there needs to be in administrators is what it sounds like.

There needs to be social emotional class.

If they go through to help nurture the spirits of those that are and their total is right that they're in charge of.

I mean, it really does sound like there's a disconnect between those on the ground doing the work and those who might be in a higher office with a big window.

Well, I tell you one of the things that is a challenge is that.

>> You need to ask nurses, for be American Nurses Foundation, which is the foundation for the American Nurses Association, has done a lot of surveys of nurses across the asking them, what do you need?

What do you want?

We also did a survey that you mentioned in October, even though we were reading what the ANF came up with, even though we were hearing anecdotally from nurses here and there we did our own survey.

We have 850 nurses to tell us this is what we want.

This is what we need.

And so for legislators and for administrators asked the nurses when you need what would make this better for you?

And they need to be part of that conversation and part of the solution.

It's like I mentioned the legislators.

We know they meant well, but nurses were not consulted before SB 10 was drafted.

Ask us we will give you the answers.

We are health care experts.

We'll have to keep around.

Maybe what happens next session.

But his next session too late.

>> And and and is it, you know, we talk about there being a child care crisis in this country.

Everything is at a crisis point, says the nursing industry at a crisis point.

We definitely are.

>> The American Nurses Association wrote a letter I'm recommending to that health and Human services to declare the nursing shortage, a crisis situation if we don't have enough nurses to work in all the places where nurses work.

When you get sick.

When I get sick, there won't be nurses there to take care of And so it is a crisis.

If we're going to.

Shore up that crisis.

We need short-term solutions as well as the pipeline longer term solutions.

And there are some short-term solutions that we could employ today, such as I'm so glad to haha.

>> That's my Haha questions.

One of the things that I mentioned earlier, it's about clinical We have seen in nursing students who could be employed.

>> By healthcare organizations while they're in their last year of school, that would help tremendously.

I also there up nurse Emerich Imrie this program that could be piloted the news.

And this is bringing back retired nurses.

We have about 5,000 retired and I think we can convince them if we could make 3rd jobs.

Not 12 hour shifts and they had jobs that would support novice nurses as well.

Is the nursing shortage in different areas and you would tailor their jobs to be a support.

I think we can get some of those nurses to come I'm in fact, I enticed one nurse to come back and she came back.

She renewed her license so that she could help us with the clinics.

Might that the testing in the vaccine?

They want to help.

And if we can make it so they could help.

I think we could get them back.

So those are some of the things that we can do immediately.

One of the provisions of SB 10 and this is just one is to allow nurses who work out of state to be able to work in Kentucky.

Would that help?

We already did that.

It was already in place.

So that doesn't really effectuate any change.

Absolutely not.

The Kentucky Board of has worked on a number of things, too help with the nursing shortage and that where there's a compact with other states and then there are other nurses who were coming into Kentucky to work the Kentucky Board of Nursing was accepting to do.

Are you hopeful that you're under Stree will rebound?

I am very hopeful.

Our industry will rebound.

And I think that with the planned that the Kentucky Nurses Association had the one that was presented to the presented to legislators is a doable plan.

We don't have the money.

We didn't get the 100 million dollars.

But guess what?

We're not done yet.

We cannot afford.

So let down Kentuckians.

We have 2 bring your says to the profession we have to retain the nurses that we have and we have to maintain their wellness so that they can stay.

Dona Manson.

Thank you for educating us all on what we've done, where Don already twenty-something minutes.

28 minutes flies by.

And it's been a pleasure to be with you.

And we'll keep on top of this issue and keep in touch with you, Elaine.

Well, thank you very much.

I appreciate you inviting me and allowing me to talk about the nursing shortage.

>> Absolutely anytime.

Thank you.

You can keep up with is going on in this state by watching Kentucky addition each night, 6.30, eastern time, 5.30, central.

We're going to talk about this issue and much, much, much more.

That really does affect to.

I hope you'll join us every night 6.30, and you can still watch our connections programs online.

Listen to podcast all that.