Column: Let’s make Michigan a nurse-friendly state

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This year, communities across the state will recognize nurses’ week, May 6 to May 12. During the darkest days of the COVID-19 pandemic, we saw lawn signs and car parades to thank nurses for their selfless efforts to care for our loved ones and serve our communities. This year, the signs are more sparse, but the strain remains.

In early March, my research team reported alarming results from over 10,000 registered nurses in Michigan: nearly 4 nurses out of 10 plan to leave their job and younger nurses were the most likely to leave. This shortfall threatens the health and safety of all Michiganders and may trigger a revolving door of departures as working conditions deteriorate.

Why are so many Michigan nurses planning to leave and what can be done about it? We have some of the least-friendly nurse policies in the country. By tackling four outdated policies, we can make Michigan a great place for nurses to work and allow them to deliver outstanding care to patients and communities.

Improve nurse staffing levels 

Over 75% of nurses in our study cited unsafe staffing levels as their primary concern. Nurses in Michigan often care for more patients than experts recommend to assure safety. Executives criticize improved staffing as a one-size-fits all plan that deprives them of flexibility. But California, Chile and Queensland, Australia, have implemented minimum staffing guidance that allowed smaller hospitals time to adjust. In these regions, nurse staffing has stabilized and some patient outcomes have improved. 

Republicans and Democrats in Lansing agreed and in 2021, proposed similar bipartisan legislation. But we don’t even need to wait for legislation. Like planning for a new building, executives could commit tomorrow to multi-year plans to improve staffing and maintain consistently safe patient assignments. 

Prevent violence against health care workers

Verbal, physical and sexual abuse is on the rise against health care workers, and nursing is often the primary target. In our study, nearly half of surveyed nurses reported some form of abuse in the past year and abusive events were linked to recently leaving the nursing workforce. Bipartisan legislation to strengthen protections against violence and require health care facilities to implement safety plans has stalled, despite similar protections being in place for policy, fire, and emergency service personnel. 

Airlines have enforceable minimum staffing standards and strong protections against workplace violence. Why wouldn’t we provide the same protections to Michigan’s essential health care workers?

Remove outdated advanced practice restrictions

Each year, hundreds of Michigan nurses study to become nurse practitioners, nurse anesthetists and midwives. These advanced practice nurses deliver safe, high-quality, and cost-effective care. Yet, Michigan ranks dead last in allowing them to practice independently, unlike 28 other states. Updating the law to allow advanced practice nurses to deliver more care independently is good for Michigan’s residents and will keep more nurses in the state for their training and subsequent career.

Allow nurses from other states to practice easily in Michigan

Currently, nurses can practice through one unified licensure compact across 39 states and territories. Michigan temporarily allowed nurses from other states to practice here during the pandemic. Yet Gov. Gretchen Whitmer vetoed legislation to join this compact, despite doctors having a similar arrangement. Joining the compact would reduce nurses’ burden and expense and attract more nurses to work in Michigan.

Despite the challenges, I tell my students that nursing is the best hope for patients and communities. Yet I worry how they will fare in a broken system, despite solutions near at hand. Will employers create safer and supportive working conditions? Will elected officials enact policies to protect patients and nurses? 

Nurses saved countless Michiganders during a deadly pandemic. Every day, they serve our communities in hospitals, clinics, nursing homes and schools. Enacting these four strategies are crucial to making Michigan a nurse-friendly state.


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Christopher R. Friese
Christopher R. Friese

Christopher R. Friese is a practicing registered nurse and professor at the University of Michigan, Ann Arbor.