Providence nurses across Oregon are going on strike on Tuesday. It could be one of the biggest nurse strikes in state history.

More than 3,000 nurses represented by the Oregon Nurses Association will conduct a three-day work stoppage at six Providence hospitals.

Whitney Evans, operating room charge nurse at Providence Medford, said the strike is not just about wages, but the hospital system's failure on the state's new Safe Staffing Law, the need for more paid time off and increasing costs for health care.

"All of those things put together create a comprehensive package that will be able to not only bring in new or even experienced nurses but help to retain them," Evans pointed out. "So that we're not having this ad nauseam train and release cycle."

Nurses are striking at Providence hospitals in Hood River, Medford, Milwaukie, Newberg, Oregon City and Saint Vincent in Portland. Providence said it offered wage increases of 10% in the first year of the contract across the six hospitals. The health system noted it has replacement workers and it will not negotiate during the strike.

Denise Arnold, an intensive care unit staff nurse at Providence Newberg, said health care costs for her and her daughter mean she has sent $1,000 back to Providence every month this year to pay for care. She also has concerns about the plans Providence has set up under the new Safe Staffing Law, which went into effect June 1.

Arnold explained nurse-to-patient ratios in the medical-surgical unit at her hospital were one to four for day shift nurses, but Providence's new plan makes it one to five, both day and night.

"What used to be once in a blue moon, maybe once a month you would have five patients and go home totally exhausted, dripping sweat, you didn't get any breaks because it's just too much is now becoming common, near daily experience," Arnold asserted.

Nurses want the ability to fight staffing ratio changes included in their contracts but Providence has rejected it. Arnold added nurses deserve more respect than they're getting, especially because their job is so crucial.

"We're that final safety line," Arnold stressed. "It is so important that we have the time to look at the chart, review and make sure we are that last safety line for the patient."

Virginia doctors are reminding people how important it is to stay heart healthy in extreme heat.

Temperatures across the U.S. have skyrocketed, and climatologists estimate 2024 will surpass 2023 as the hottest year on record. Virginia's average temperature has gone up almost 3 degrees in the last 20 years.

Dr. Deepak Talreja, clinical chief of cardiology at Sentara Health in Norfolk, said rising temperatures can be hard on your heart.

"The heart muscle is really susceptible to problems from heat, especially when a person gets dehydrated, or when they're not drinking enough fluid and they get their electrolytes off," Talreja explained. "That can cause rhythm problems, changes in blood pressure, and an increase in the risk of passing out."

Enough stress on the body ultimately leads to heart attack and stroke. Drinking water often is key to maintaining good heart health in the heat. While doctors said people should drink eight glasses of water daily, Talreja thinks people should drink 1.5 times that during extreme heat to stay hydrated.

Other drinks high in electrolytes are helpful for hydration but Talreja noted you should check the sugar content. High blood sugar with or without heat is harmful to the heart. He added there are misconceptions about caffeinated drinks in intense heat.

"Drinks with caffeine in them actually act as diuretics, they make you pee more and so, you have to be careful about heavily caffeinated beverages," Talreja advised. "Also, you have to be careful because you want to avoid beverages with a lot of sugar; sodas that cause excess weight, excess blood sugar."

Talreja noted another problem is not planning ahead and being in more heat than you may realize. He recommended anytime you go out, you should grab some water and know where to find a cool, shady spot.


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A critical shortage of direct care workers in Maine is leaving residents without needed health services, according to a new report.

It showed more than 23,000 hours of approved home care for older adults go undelivered each week, while waitlists for behavioral health care have grown into the thousands.

Arthur Phillips, analyst at the Maine Center for Economic Policy, said low pay and poor benefits make it tough to retain enough workers to meet demand.

"Even if you feel really dedicated to the work that you do and the people who you serve, if it's having negative impacts on your own life, then you're faced with a tough choice," Phillips pointed out. "I think a lot of people are leaving."

It is estimated the state needs to hire more than 2,300 direct-care workers just to meet existing needs. Phillips argued the state should raise its median wage for workers to at least 140% of the minimum wage to remain competitive or just under $20 an hour.

Maine already has the oldest population in the U.S. and the share of people age 65 or older is projected to grow to nearly 30% by 2050. AARP Maine estimates more than 160,000 unpaid caregivers, including family and friends, are currently filling the state's health care gap for the age group.

Phillips noted it can lead to greater stress on everyone and a loss of economic activity for the state.

"While we think that this will require significant resources and that this group of workers should be prioritized, I think it's also true that the costs of inaction are far greater," Phillips emphasized.

Phillips added the legislature raised the reimbursement rate for direct care workers in 2021, allocating some $120 million for recruitment and longevity bonuses, and needs to take action again. He recommended the state improve its data systems to get a clearer picture of Maine's health care needs, including both direct care workers and those they serve in the process of policy changes to ensure all needs are met.

West Virginia healthcare advocates are applauding a recent proposed rule by the Consumer Financial Protection Bureau to remove medical bills from credit reports.

As of last summer, about 5% of Americans had unpaid medical bills on their credit reports.

Healthcare Organizer with West Virginia Citizen Action Group Mindy Salango said more West Virginians are being forced to find ways to pay out of pocket, relying on credit cards and crowdfunding websites.

She added patients often receive unexpected medical bills and struggle to understand costs, making it difficult to compare medical debt to other loans.

"When you're going for an emergency surgery, they don't give you an outline of all the charges that you're going to be hit with," said Salango. "They do the surgery, and then you get the bill. If you go in to buy a car, they give you paperwork; you know exactly what you're signing on the dotted line for."

The proposed rule would close a regulatory loophole that has kept vast amounts of medical debt information in the credit reporting system, and would help prevent debt collectors from coercing payments for inaccurate or false medical bills, according to the Bureau.

Medical debt can lead to missed rent or mortgage payments, denied rental applications, and eviction. One study found 27% of Americans with medical debt have experienced housing-related problems.

Salango said erasing medical debt from credit reports will help more West Virginians stay in their homes.

"If you take these this off of a credit report," said Salango, "it's going to allow people to move into more stable situations."

She added there's been a significant spike in health insurance companies denying coverage, leaving consumers saddled with hefty bills.

"We're really fighting both federally and at a state level to stop these insurance companies from using predatory denials," said Salango. "Many of them are currently using AI to do initial denials."

West Virginia Citizen Action Group is hosting a town hall on June 25 in Huntington to help empower residents to dispute denials and understand how changes to Medicaid may affect their coverage.

More information about the event is online at wvcag.org.