The crisis in nursing: New reports highlight some vexing problems and why there may still be cause for optimism


Add a new series of reports from the good people at Higher Ed Works to your list of “must reads” (and “must watches” — there are some videos included) in the coming days. As we learn in the introductory installment to “Help Wanted: Nurses,” North Carolina was already facing a worsening nursing shortage prior to the pandemic and the last year and a half has only added to the problem.

As we climb out of a global pandemic, we’ve seen nurses take incredible risks to themselves and their families. We’ve seen them hold the hands of patients as they die. We’ve seen them hold tablets for patients to see and hear goodbyes from their loved ones.

Yet even before the pandemic, we didn’t have enough nurses. And the shortage is only expected to get worse.

The Cecil G. Sheps Center for Health Services Research at UNC Chapel Hill will soon release a model that projects North Carolina could face a shortage of 10,000 registered nurses – almost 10% of the current RN workforce – by 2033.

According to that model, the state could also face a shortage of 5,000 licensed practical nurses – more than 20% of the LPN workforce – by the same year.

Happily the reports are about more than merely documenting the problem. In an installment that looks at the situation at UNC Greensboro’s School of Nursing, there are notes of optimism from new dean, Deborah Barksdale, who says that, despite the current slump, “We really have the opportunity to increase the supply, at least in our own way. And more importantly, the supply we produce is going to be even better-prepared.”

Meanwhile, in the latest installment, which profiles a true hero of the profession who came to be known as the “Mother Teresa of Durham,” the series highlights someone who has inspired scores of nurses down through the years.

Going forward, Higher Ed Works promises to examine, among other things:

  • how some institutions are confronting the state’s longstanding nursing shortage,
  • the frustrations of battling the job market to hire enough instructors to train nurses,
  • how burnout among nurses is real – and increased during the pandemic,
  • the critical need for nurses in rural settings, and
  • how the demand for nurses is shifting.

Be sure to stay tuned.

New report documents the plight of NC hourly workers (and how to make things better)

If you missed it last week, be sure to check out the latest report from the progressive nonprofit group, Carolina Forward. In Our Daily Bread: The Hourly Workers Package, authors Blair Reeves and Alex Jones provide a sobering assessment of the economy that millions of hourly workers in our state inhabit (an economy that was, of course, grievously injured by the COVID-19 pandemic) and a detailed prescription of policy choices that could make things markedly better. This is from the executive summary:

Image: https://www.carolinaforward.org/blog/our-daily-bread

As North Carolina looks beyond the COVID pandemic, it faces a number of big, fundamental choices for its economic future. The uneven and unequally shared post-2008 recovery is a cautionary tale. Then, far too much of the post-crash growth wound up making the comfortable and affluent even more so, without really changing the economic fortunes of the bottom half – or, worse, pulling up the ladder of opportunity even higher out of reach.

Today, nearly half of North Carolina’s workers are hourly workers, most of them earning very low wages. The COVID pandemic wiped out hundreds of thousands of hourly jobs, leaving behind not just a path of illness and death, but economic dislocation too.

Emerging from the global pandemic, we now face a period of potentially significant economic expansion.

To do this, we propose six specific policy areas where state leaders can have a tremendous positive impact on the economic future for the state’s hourly workers. North Carolina’s economy has been dominated by low-wage, hourly, and politically powerless labor for generations. Entrenched big business interests have been highly successful in steering the political agenda during that time, in close cooperation with leadership from both parties. The old, traditional approaches, lurching between austerity, trickle-down economics and wishful thinking, have always left our state’s hourly workers last. It’s time to reverse that order. We must harness the transformative power of strong markets and free enterprise to even the economic playing field.

Work is ennobling. In the best of cases, it can give purpose to our days and our lives. But it is, first and foremost, a matter of sustenance; a way that each person and family keeps themselves housed, fed and clothed, and hopefully, in at least some small way, can look forward to something better tomorrow. This is what a job should deliver: not a gamble, but some small measure of stability. A guarantee not of wealth, but of at least getting by, with the hope of another day to come. Our daily bread.

The six policy priorities identified in the report are:

  1. Raise the minimum wage to $15 per hour.
  2. End the practice of “wage theft” whereby employers use all manner of tactics (like requiring workers to go “off the clock”) to lower their wages.
  3. Allow workers to reasonable breaks, time off and fair work schedules.
  4. Fix the state’s stingiest-in-the-nation unemployment insurance system.
  5. Allow workers to pursue better opportunities by banning anti-worker tools like ‘non-compete’ clauses.
  6. Allow workers to organize by repealing the state’s “right to work” law.

Obviously, this ambitious agenda is not something that’s going to be embraced right away by the state’s current GOP-dominated legislature and the authors understand that fact. But several items on the list have been gaining traction across the nation in recent years and it’s extremely helpful and encouraging to have them all succinctly compiled in one handy and persuasive package for North Carolinians and future state leaders.

Click here to check out and share this fine report.

Dem control of Virginia government, progressive policies bad for business? Not.

The oft-propagated notion (at least by those on the political right) that progressive policies are somehow bad for business and economic development received another thorough debunking last week in a new national assessment from CNBC. This is from a story by reporters Graham Moomaw and Ned Oliver of the Virginia Mercury entitled “Virginia Republicans have been warning Democratic control is bad for business. CNBC disagrees.”

Virginia Capitol – Photo, Ned Oliver

After Democrats took control of the General Assembly in 2020, a common refrain emerged among Republicans who opposed legislation that raised the minimum wage and added new anti-discrimination protections for employees.

“The Democrat majority has done much to diminish Virginia’s reputation for being America’s ‘best state for business,’” said Senate Minority Leader Tommy Norment, R-James City, as Democrats’ first legislative session in power in more than two decades came to a close, invoking a ranking bestowed annually by the cable news network CNBC.

Two years later, it looks like at least some of those Democratic priorities actually helped the state’s business reputation.

For the second time in a row, Virginia was named the “best state for business” by CNBC, which this year began factoring things like anti-discrimination laws and voting rights protections into its rankings under the heading of inclusivity.

Of course, none of this should come as any particular surprise. Here in North Carolina (which came in second in the new rankings), the state regularly topped an array of “best states for business” lists throughout the 1990s and early 2000s during a period in which Democrats dominated state politics. Add this to the fact that low taxes and deregulation — two criteria regularly touted by GOP politicians and conservative think tanks as the supposed keys to a healthy economy — are regularly ranked near the bottom in survey after survey of real world businesses (behind things like having an educated workforce, easy access to good transportation, and a high quality of life for employees) and it’s actually a wonder that so many politicos still get away with propagating the myth.

Of course, it’s true that North Carolina’s high ranking comes at a time in which Republicans and their conservative tax-cutting policies have dominated state politics for the past decade. If nothing else, however, it would seem that the new rankings offer compelling evidence that: a) North Carolina taxes are already plenty low, and b) current GOP efforts to further slash taxes in the new state budget at the obvious expense of core quality-of-life services and structures like education and the environment make no sense at all.

Click here to read the entire Mercury story and here to explore the CNBC rankings and criteria.

Weekend humor from Celia Rivenbark: Circus clothes and the middle-aged woman

I’m not sure when it happened but fashion has decided we women of a certain age need to dress like clowns. Billowy, technicolor, ruffled things that seem designed to make everyone stare when we walk into a room. And then look away awkwardly because nobody wants to see Nana wearing what appears to be a psychedelic wedding cake. With leggings.

At our age, maybe any attention is positive. As the middle-aged Kathy Bates character lamented in “Fried Green Tomatoes,” women who are menopausal and beyond become invisible. It’s why so many of my friends leave restaurants with wine glasses in their oversized Scout totes. No one ever sees them. It’s a game they play. One particularly daring sister wife emerged with a complete table setting and a couple of candle holders. Allegedly.

I’ve been pondering the over 50 circus clothes phenomenon and the only thing I can figure is we said one too many times we were tired of being invisible, ignored. The designers must have been listening…while eating highly questionable mushrooms scraped from the bark of trees. And now here we sit, in the waiting room at the eye doctor surrounded by a dazzling assortment of animal prints embellished with crystals and, God help us, plumage.

We want to be noticed, and listened to, for sure. This doesn’t mean we want to dress like we have lost our damn minds. I get more than a dozen unwanted clothes catalogs in my mailbox every month and many times that number in my social media feed and here’s what they seem to be saying about me: “You are deranged so let’s tell the whole world!” I would describe the fashion catalogues as “Escaped Mental Patient Monthly” but some of you would say I was making light of mental health issues which are very serious indeed and you’d be right. Humor-impaired but right.

Now this is not to say we should dress like the Marthas in The Handmaid’s Tale. Gray on gray with a saucy side of … no, more gray. Animal prints? Sure, in moderation, I’m a big fan, but what’s with the proliferation of zebra striped tops with giant fluorescent hibiscuses dancing across the top and bottom that are less “I’m fun!” and more “I was completely hammered when I ordered these from the QVC.”

Yes, yes, I hear you. You should wear what makes you feel good about yourself, happy, carefree, young. Why is that anyone’s business? To which I say, have we met? What’s next? Neon elf shoes with bells on the toes? Only the venerable style icon Iris Apfel can get away with such tomfoolery and, sacrilege alert, I’m not sure she does more than half the time. Yeah, I said it. Mostly she just looks weird.

Paradoxically, I’m oddly proud of the tanned granny who wears a teeny bikini at the beach. That’s a kind of confidence that has nothing to do with a catalogue or website that makes you look like you’re wearing a pinata from Dollar General.

Tanned granny does not give a …hoot. And it shows. She laughs too loud, still applies baby oil and iodine as “sunscreen” and smokes on the beach. IN FRONT OF CHILDREN. This is a woman who is crazy comfortable in her own tortured beef jerky skin and doesn’t waste a moment worrying about what you think of her exposed upper arms or muddied-by-time tatts. I love her.

The late Nora Ephron’s blockbuster bestseller, “I Feel Funny About My Neck” dealt with themes of the American woman growing older with her trademark humor. If Ephron were alive today, I’d request a sequel: “That Olay Serum Helps My Neck But What Are We Going to Do About These Awful Upper Arms?”

Oh, wait. I get it now. Plumage!!!

Celia Rivenbark is a NYT-bestselling author and columnist. Write her at [email protected].

Veteran educator: We’ll keep teaching the truth about America’s racial history

Image: AdobeStock

As you’re no doubt aware, the political right’s ongoing effort to whitewash American history through legislative efforts to micromanage public school history curricula continues apace.

Here in North Carolina, Senate President Pro Tem Phil Berger and Lt. Gov. Mark Robinson joined in the effort this week by trumpeting their opposition to a once obscure academic concept that’s never been taught in North Carolina public schools called Critical Race Theory.

Berger even went to the trouble of giving a big speech on the topic that was, sadly, chock full of wildly inaccurate claims and frightening ideas – including a proposal to amend the state constitution.

Happily even as this cynical, Trump-inspired campaign at manipulating white voters in anticipation of the 2022 elections persists, educators across the country are forcefully pushing back.

Gabe Hart

For a great example, check out the fine essay that appeared earlier this week in the Tennessee Lookout by veteran public school teacher Gabe Hart. As Hart explains to his state’s conservative Republican governor, Bill Lee, in “Educators will continue to teach the truth of America’s racial history,” the campaign against Critical Race Theory, will ultimately fail — both because it’s a solution in search of a nonexistent problem and, more importantly, because teachers will keep telling the truth about American history. Here’s Hart:

While no conservative lawmaker could explain exactly what CRT was or how exactly it was being taught in Tennessee classrooms (spoiler alert: it wasn’t being taught in Tennessee classrooms), the basis of CRT deals with the inherent racism of many of our social constructs such the criminal justice system and policies put into place by lawmakers who have been predominantly Caucasian males.  To see the modern day effects of CRT at play, one needs to look no further than the recent voting laws enacted in many southern states.  

By the time CRT had made it through the wash cycle of conservative media, the banning of teaching CRT was brought to the floor for a vote in Tennessee and other red states like Texas, Arkansas, and Florida even though no one seemed to be able to provide examples of how or where it was being taught.  It passed in each state.  

The problem with banning the teaching of CRT, however, is that CRT was never taught directly in classrooms to begin with. There are no Tennessee State Academic Standards requiring the teaching of CRT or standards pointing out inherent racism within societal structures in our state or country.  Those ideas are illuminated naturally if a teacher is teaching students to think critically based on the facts that are provided.  It doesn’t take a lot of searching to see that bias and racism are intertwined in most of our societal structures.  

When asked for a reason for banning the teaching  of CRT, Gov. Lee responded, “We need to make sure that our kids recognize that this country is moving toward a more perfect union, that we should teach the exceptionalism of our nation and how people can live together and work together to make a greater nation, and to not teach things that inherently divide or pit either Americans against Americans or people groups against people groups.”

But, Gov. Lee, are we “moving toward a more perfect union”?  Our criminal justice system is still heavily slanted against African-Americans.  We are only two generations removed from the Civil Rights movement.  In my town of Jackson, Tennessee, there has essentially been legal resegregation of our local education system due to the inordinate amount of private schools and white flight to the county north of Jackson.  These are precisely the examples of collateral damage from our systems of inherent racism that CRT highlights.  Asking public educators to turn a blind eye to those truths is like asking a firefighter to drive past a burning building – we, as educators, must address the inequities of our societal structure to keep them from continuing to occur.  We don’t have time to cradle your white fragility.  

As Hart concluded: Read more