State eases licensing for Ohio nurses

COLUMBUS — As the state looks to physically build out the health-care infrastructure of beds and intensive care units in anticipation of a surge in coronavirus infections, the system is also trying to address critical shortages of medical professionals on the front lines of the pandemic.

“When we talk about capacity, some of it is physical, but it involves the doctors and nurses and the folks that wrap around that, and it’s also the equipment that they need to do their jobs,” Ohio’s health director, Dr. Amy Acton, said. “There are many components to up our ability to treat someone.”

State lawmakers have temporarily relaxed licensing requirements to get newly graduated nursing students on the job immediately. They’ve permanently expanded the duties of certified registered nurse anesthetists to include ordering and administering drugs and IV fluids, ordering diagnostic tests, and directing nurses to administer drugs.

Hospitals and nursing homes have looked at trying to get retired doctors and nurses to return, and there’s talk of loosening restrictions on physician assistants so they may perform more duties with less direct supervision from a doctor.

Dr. Acton noted hospitals are doing online training for nurses working in one sector of the health-care industry to prepare them for new jobs. That’s true as well for surgeons who suddenly have time on their hands as elective procedures have been postponed. They may perform nursing functions.

All of this is being done knowing that medical professionals are at higher risk of coming down with the infection and may be forced to quarantine themselves if exposed. Some could face burnout as the crisis goes on, and many are dealing with the same strains that other Ohioans face in terms of child care and other problems as schools and businesses remained closed.

“We’re also graduating classes early in some areas of the state ... so that those folks can be deployed on the front line,” Dr. Acton said. “So there’s a lot of moving pieces to the people problem. It’s not just for hospitals. We are actually working with earlier-year med students and nursing students to get them to be amateur disease detectives. We are actually building a curriculum for them to be trained in.”

These “disease detectives” would involve tracing patient contacts to learn more about the disease and how it spreads.

Some governors have waived their states’ restrictions on what an advanced practice registered nurse can do outside their specialties.

Michigan Gov. Gretchen Whitmer issued an executive order to allow medical professionals to renew their licenses regardless of whether they’ve met their continuing education obligations.

Ohio has tried to build up daycare facilities specifically geared to caring for the children of health-care providers.

House Bill 197, Ohio’s recently signed law dealing with tax changes that was hijacked to serve as a coronavirus crisis response, allows recently graduated nurses to skip the current license examination for now. Instead, graduates could get temporary licenses that would expire 90 days after the official end of the crisis or Dec. 1, whichever is sooner.

New nursing graduates, armed with temporary licenses from the Ohio Board of Nursing, will soon be able to enter the workforce just as coronavirus infections are expected to surge and peak. They will essentially experience baptism by fire.

“Just as they were trained,” said Gregory Guzman, Maumee campus president of Hondros College of Nursing. Statewide at its five campuses, the school graduates more practical and registered nurses annually than any other Ohio school.

The Maumee campus enrolls about 500 a year and graduates about 400 licensed practical nurses, a 12-month program, and associate-degree nurses, a 15-month program. Statewide, the school produces about 2,000 graduates annually.

The temporary license is particularly timely given that the national examination process itself has been put on hold by the precautions taken to slow the spread of cononavirus.

“We couldn’t get nurses in the pipelines because they couldn’t test,” Mr. Guzman said.

The skills of those nurses, however, are the same, regardless of whether they have the letters RN or LPN behind their names, he said.

Trish Pacheco of Newport, Mich., in Monroe County, has been working 14 years as a licensed practical nurse, currently at a local long-term care facility. She is part of Hondros’ Maumee graduating RN class.

“Graduates are eager to get into hospitals,” she said. “They need all the help they can get right now.”

Waiving that test requirement is the right thing to do, she said.

“The test is like a right of passage,” Ms. Pacheco said. “It’s kind of a shame that I can’t take the test right now, but I’d be more upset if I couldn’t work as an RN. ... Having that restriction lifted right now is a great idea, so I can finally do what my heart told me to do all this time.”

She is in the process of getting her temporary license from the Board of Nursing.

“I feel prepared,” she said. “Everybody was you at some point... You truly learn everything you know from experienced nurses. I’m confident in the nursing profession. They will take me under their wing.”

The state’s efforts to expand the physical infrastructure of hospitals is kicking into high gear with the Ohio National Guard’s assisting in transforming convention centers in Columbus and Cincinnati into hospital wards.

Although the plans have been created by hospital regions inside Ohio, they can anticipate a crossing of state lines, Dr. Acton said.

“Absolutely we know that the virus does not know borders,” she said. “Hospitals have containment zones that cross borders where they work with smaller hospitals leading into larger whenever there is a surge or accident or a trauma. That is most notable in the Toledo area across the border with Michigan, but it’s also very common in the Cincinnati area with Kentucky.”

Contact Jim Provance at

jprovance@theblade.com

or 614-221-0496.