Some New York hospitals are not adequately staffing nurses, according to a new report.
The New York State Nurses Association report showed between January and October 2024, hospitals failed to staff intensive care units and critical care patients at the state-mandated ratio more than 50% of the time. The report also said most hospitals do not publicly post staffing ratios as state law requires.
Margret Franks, a registered nurse at Vassar Hospital in Poughkeepsie, said it greatly affects patient care.
"We were regularly coming into a shift where we had eight patients when we were only supposed to have five, with one nurse at six on a 36-bed unit," Franks outlined. "Eight patients means out of every hour that you're there you can only give seven and a half minutes worth of care to that patient in your shift."
She argued it is impossible to provide good patient care and do everything a nurse has to in a given shift. While one recommendation is hiring more and retaining nurses, it is not so simple. Reports have shown labor expenses at New York hospitals grew 36% since 2019. While 2024 is the second year they declined, it is still double what they were in 2019.
Other report recommendations included the Department of Health increasing transparency so people see a hospital's actual staffing levels, enforcing safe staffing levels and expanding nurse recruitment and retention.
Franks stressed the issues outlined in the report exist beyond her workplace.
"This is not a problem that's exclusive to the Hudson Valley where I work," Franks pointed out. "It's not a problem that's even exclusive to New York State, it's nationwide. The reason for this is because you have these corporations coming in, taking over health care systems, and they're all using the same playbook."
Many studies have shown the ongoing nursing shortage is only set to continue due to many factors. Chief among them is the high stress nurses face in their work. Franks feels the shortage is not about people not wanting to enter the profession. Instead, she said it is about nurses wanting better work environments.
"Each facility has to create the kind of work environment somebody would want to willingly go into and work," Franks asserted. "It's not that the nurses who are not at the bedside right now don't want to work, it's just that they don't want to work in the situations that have been created by the facilities."
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Solving North Dakota's child-care crisis is taking another turn, with adoption of a new tax credit.
The incentive is geared for employers who make contributions toward their employee's child-care costs.
Gov. Kelly Armstrong has signed a bill that allows employers to claim a tax credit of 50%, for child-care stipends they might offer as part of a benefits package.
Bill supporters say it might convince more businesses to meet the needs of staff members with young kids.
Bill Bauman, CEO of the Missouri Valley Family YMCA in Bismarck, said he hopes it'll be effective in removing stress on the child-care system by keeping parents in the workforce.
"It's so vital to our economy," said Bauman, "our community, our workforce and our families."
The YMCAs are collectively the largest provider of child-care services in North Dakota, and Bauman said they've seen progress in closing gaps based on 2023 investments from the state.
Other organizations such as the Chamber of Commerce agree that previous steps have helped.
But officials note some solutions have limitations, pointing to age and income eligibility levels under the Working Parents Child Care Relief Program.
Bauman credited policymakers for continuing to monitor how these efforts are playing out, and whether they need to try something new.
He suggested it's going to take additional time to measure the effectiveness of new programs and incentives.
"Some are highly utilized and others maybe not as utilized," said Bauman, "so you have to be able to adjust."
According to a 2024 North Dakota business survey from the Chamber of Commerce, 69% of respondents indicated that child care was an issue for their organization.
A similar percentage indicated support for this type of incentive to help recruit and retain workers.
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Thousands are expected to rally in Harrisburg on Monday for a "Raise the Wage and Immigrant Rights Day of Action."
More than 47,000 Pennsylvania workers earn the minimum wage of $7.25 an hour or less.
Jarrett Smith, legislative director for the Service Employees International Union, said Pennsylvania hasn't raised its minimum wage in more than 15 years, while more than 30 other states and Washington, D.C., have all moved toward $15 an hour.
Smith said this makes it harder for the state to stay competitive.
"We are demanding that we raise the wage in Pennsylvania to $15 an hour," he said, and "that we include a cost-of-living adjustment so that we don't have to keep coming back, year after year."
Smith said the coalition Pennsylvania Stands Up is leading the protest, backed by labor and community groups and some lawmakers.
Two years ago, the House passed a bill to raise the state minimum wage to $15 by 2026, but the Senate hasn't acted. Smith said Gov. Josh Shapiro has pointed out it could bring in up to $60 million a year in tax revenue.
Smith said it's key to distinguish low-wage from minimum-wage workers. Nearly 1.2 million Pennsylvanians earn wages less than $15 an hour, and many are single moms. He added that these workers often support families, pushing the state to cover gaps with programs such as SNAP and Medicaid.
"When we talk about how do we actually lift workers out of poverty," he said, "one of the things that you can do is raise that floor and give families the financial independence to actually earn a wage that's going to allow them to not have to make decisions between paying a grocery bill or getting health care."
Smith noted that Pennsylvania is losing workers to neighboring states with higher minimum wages, making it hard to keep a strong workforce.
"We are one of the fastest-shrinking states in the Northeast," he said. "New Jersey, across the border, they have a $15 minimum wage to start, and they're already increasing it for certain workforces, like health care and education."
He added that SEIU represents around 80,000 service workers in the state, across industries such as government, health care and food service. The union is also negotiating its first national Starbucks contract.
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New national rankings out this week show South Dakota jumped a few spots higher in teacher pay for each state. However, there are questions about whether the shift will be temporary.
The National Education Association puts South Dakota at 46th in the U.S. for compensation offered to educators around the state. The current rank is the highest South Dakota has achieved since reporting began. Teachers in the state now earn an average salary of more than $56,000.
Loren Paul, president of the South Dakota Education Association, credits higher bumps in state aid the past few years.
"That extra effort from our state gets us out of the bottom rankings," Paul explained. "It also is supportive in recruiting teachers and also retaining teachers in the profession."
In this year's legislative session, education got a smaller funding increase of 1.25%, falling behind inflation. Paul cautioned it could mean South Dakota will slide back in future rankings. The smaller bump came as part of a "belt tightening" mood at the State Capitol this year, with uncertainty over federal funding and declines in sales tax revenue.
Educators said they understand the budget challenges facing South Dakota but Paul contended taking the foot off the accelerator only puts the state in a troubling pattern it has been trying to shake off.
"It has to be year after year," Paul stressed. "It's not a, 'Oh, we're going to address this for a year or two, and then we're going to fall back into very small increases,' or no increases, or actually going backwards."
He added when shrinking investments cause a state to tumble in rankings, public pressure goes back up because no state wants to be seen as holding the last spot.
The union noted when adjusted for inflation, teachers in many parts of the country still make less than they did a decade ago, and if they cannot afford to cover basic expenses, some will choose to leave the profession.
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