By Mara O'Malley / Broadcast version by Farah Siddiqi reporting for the Kent State-Ohio News Connection Collaboration.

The Ohio Nurses Association has undertaken a so-called Code Red campaign to call attention to the shortage of nurses in Ohio hospitals, which could lead to a patient care crisis.

The campaign focuses on five areas, including staffing levels, working conditions, the nursing workforce pipeline, corporate trends and trust and agency within the profession. They hope to encourage employers and lawmakers to implement the staffing ratios their nurses need.

"That is our sounding the alarm and putting forward real workable strategies to address the nurse staffing crisis in Ohio," said Rick Lucas, president and executive director of the Ohio Nurses Association and himself a registered nurse.

The ONA conducted a survey in 2023 that received over 11,000 responses from licensed nurses in Ohio, seeking to find out why nurses are leaving bedside care positions.

They found:

• 58% of nurses who left bedside roles did so because of their patient care load.


• 70% of direct care nurses are currently considering leaving bedside roles because of their patient care load.


• 88% of nurses would consider staying in bedside roles if Ohio had legally enforceable minimum staffing standards.

"Nurses need help. We needed help before the pandemic," Lucas said. "After enduring that and dealing with the exacerbated staffing shortage, we really need help. And we need for people to know what's happening in our hospitals so that they can help fight for the change that they need as well."


Ohio House Bill 285, the Nurse Workforce and Safe Patient Care Act, was introduced in September 2023. If enacted, the bill would establish minimum staffing standards in Ohio hospitals, create a loan-to-grant program to support nurses in training, ensure accountability in hospital compliance, establish nurse staffing committees with direct caregivers, and create whistleblower protections for patients, nurses and hospital staff.


The Ohio Nurses Association supports H.B. 285.


"It's a way for us to attract and retain those nurses here," said Rep. Elgin Rogers (D-Toledo), a co-sponsor of the bill. "We want to make sure that we have nurses who are qualified. Nurses are in high demand, but we want to make sure that they are trained properly and they remain in Ohio."


The nursing shortage around Ohio hospitals started before the COVID-19 and is expected to get worse, peaking in early 2027, Lucas said. Nurses now have more responsibilities than ever, ranging from caring for patients to taking out the trash and changing the linens.


"There were barely enough nurses scheduled already, and then when COVID hit, things only got worse, with stressing an already broken system," Lucas said.


Beyond that, Lucas said hospitals are relying heavily on travel nurses - nurses who aren't based in any one location, but instead work for several months at hospitals in need of staff before moving on.


The $20 million loan-to-grant in H.B. 285 is designed to help encourage nurses to stay in Ohio. Nurses could be eligible for up to $12,000 in forgivable loans if they stay in Ohio for at least five years of work.


"In this particular item, there is significantly a higher value than some of those other programs," said Dr. Wendy Batch-Wilson, Dean of Nursing Cuyahoga Community College. "With the $5,000 that's available, but then also the ability for that to turn into a grant for the full amount."


Rogers, a Democrat, and his Republican co-sponsor hope the bill will go to the floor for a vote before the General Assembly session ends.


"They went to college, they went to school, they sacrificed," said Rogers. "So we want to make sure we're creating an atmosphere where they can do what they were called to do in this great state."




This collaboration is produced in association with Media in the Public Interest and funded in part by the George Gund Foundation.


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As summer kicks into full gear, North Carolina dentists stressed the importance of maintaining children's dental health.

Dr. Miranda Kalaskey, a dentist in Raleigh and member of the North Carolina Dental Society, said with more outdoor activities and changing routines, dental care can often be neglected, leading to cavities and dental trauma. Her advice is for parents to keep up with preventive care and encourage healthier eating habits.

"Try to pick a healthy summer snack. That can be fruit. That can be vegetables. Just not something dry, not something processed," Kalaskey outlined. "And the more processed you have, the more dried it is, the more likely it is to stick to their teeth."

She pointed out left-behind food can cause cavities. Tooth decay is the most common chronic disease among children in the U.S., with more than half of eight-year-olds having had at least one cavity in their baby teeth, according to the Centers for Disease Control and Prevention.

Warmer weather also means more outdoor play. Kalaskey highlighted the rise in dental trauma cases during the summer because of increased outdoor play and sports activities.

"Oftentimes, kids are going and playing basketball, and sometimes high schools are really good about, 'Hey, here's a mouth guard,' or 'You need to get a mouth guard for practice,'" Kalaskey noted. "But during the summer, a lot of times kids will play with other kids, which is great, but making sure they're aware that tooth trauma is a thing."

If a tooth gets knocked out, contact your dentist immediately. If it is after hours, she suggested the ToothSOS app for guidance.

She added another major key to dental hygiene for kids over the summer is a consistent schedule.

"Summer oftentimes is going to change that routine but your brushing, flossing routine does not need a change," Kalaskey recommended. "You still want to do brushing twice a day, flossing at least once a day. So kind of making sure we incorporate that, even though the kids might be waking up at 10 o'clock."

Kalaskey emphasized routine is also important for dental visits. She advised children should be seen by a dentist when they get their first tooth and then every six months afterward. In addition to keeping teeth healthy, she stressed it also builds a good relationship with dental visits in the long term.


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A Virginia community health center is part of a program addressing food scarcity.

The National Association of Community Health Centers' 2024 Innovation Incubator creates ways to expand healthy food access. Tri-Area Community Health Center's Laurel Fork location will have funding and guidance from experts to help them design and test community-based solutions.

Merrill Warschoff Press, senior vice president of partnership, development and innovation for the National Association of Community Health Centers, said the centers are uniquely suited to address local food issues.

"Health centers are highly effective and innovated with integrated models of care," Press explained. "They reach far beyond the walls of the traditional exam room, not only to prevent illness and treat it but to really address the social drivers that may cause poor health."

Food insecurity has grown since pandemic-era programs ended in 2023. Emergency allotments provided SNAP recipients with an added $95 per month for 470,000 families statewide. However, some people are above or below SNAP's qualifying threshold.

Other issues stem from food prices. The Consumer Price Index shows food prices grew between 2022 and 2023 but in recent months, prices have been declining.

A primary goal of the Innovation Incubator is to discover best practices for providing care for millions of people and share them with health centers nationwide. Press noted the methods being worked out can help varying populations.

"There are many health centers who have large populations of patients who come from other countries and are used to certain foods, and have different preferences," Press observed. "Being able to work with them in their own language with the foods that they like and trust is really valuable to improving access to food that'll make a difference in their lives."

Food pantries have been key to reducing food insecurity wherever possible. Virginia food banks saw a 5% to 10% increase in demand at the end of 2022, which is problematic since food banks nationwide are seeing donations decline and reduced commodities from the Emergency Food Assistance Program.

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A southeast Arkansas healthcare system is using grant money to help increase its patients' access to healthy foods.

Mainline Health Systems will use the funds to focus on healthy eating habits for people who are expecting.

Work will include showing families how to grow their own fruits and vegetables, and establishing farmers markets that cater specifically to the needs of pregnant women and new mothers.

Health System Registered Dietitian Jane Pelkki said they will teach new moms the basics of eating healthy.

"Eating healthy doesn't have to cost a lot, that it's doable and that there are food assistance programs such as WIC and SNAP, food stamps," said Pelkki. "And we're also going to provide some food to help moms understand what a healthy meal looks like."

Mainline is one of eight health systems nationwide to participate in the National Innovation Incubator program.

It's sponsored by the National Association of Community Health Centers and the global healthcare company, Abbott.

Research shows almost 13% of U.S. households experience food insecurity - or don't have access to an affordable, nutritious diet.

Merrill Warschoff-Press - senior vice president at NACHC - said the facilities play an integral part in improving the overall health of patients, and address social issues that may cause illnesses.

"They reach far beyond the walls of the traditional exam room, not only to prevent illness and treat it, but also to really address the social drivers that may cause poor health," said Warschoff-Press, "so whether it's food insecurity and poor nutrition or even housing, joblessness, mental illness, substance use disorders."

At the end of the six-month pilot program, results will be shared with 1,400 health centers nationwide. That could impact the overall health of more than 31 million patients across the country.

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