[Congressional Record Volume 147, Number 178 (Thursday, December 20, 2001)]
[Senate]
[Pages S13946-S13950]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. MIKULSKI (for herself, Mr. Hutchinson, Mr. Kerry, Mr. 
        Jeffords, Mr. Gregg, Mr. Daschle, Mr. Frist, Mr. Kennedy, Ms. 
        Collins, Mr. Lieberman, Mr. Enzi, Mrs. Clinton, Mr. Warner, Mr. 
        Johnson, Mr. Roberts, Mrs. Lincoln, Mrs. Hutchison, Mrs. 
        Murray, Mr. Smith of Oregon, Mr. Sarbanes, Mr. Hagel, Mr. 
        Torricelli, Mr. Cochran, Mr. Dayton, Mr. Chafee, Mr. Graham, 
        Mr. Lugar, Ms. Cantwell, Mr. Hatch, Mr. Leahy, Mrs. Carnahan, 
        Mr. Rockefeller, Ms. Stabenow, Mr. Corzine, Mr. Schumer, Mr. 
        Inouye, Mr. Miller, Mr. Wellstone, Mr. Harkin, Mr. Santorum, 
        Mr. Reed, and Mr. Bond):
  S. 1864. A bill to amend the Public Health Service Act to establish a 
Nurse Corps and recruitment and retention strategies to address the 
nursing shortage, and for other purposes; considered and passed.
  Ms. MIKULSKI. Mr. President, I rise to introduce the Nurse 
Reinvestment Act. This bill is a down payment to help address the 
nursing shortage in this country by bringing more people into the 
nursing profession and by retaining nurses. This bill combines the 
Nursing Employment and Education Development Act, S. 721, introduced by 
Senator Tim Hutchinson and myself and the Nurse Reinvestment Act, (S. 
1597), introduced by Senators Kerry and Jeffords. We have all worked 
together to bring this important legislation before the Senate today.
  This bill is sorely needed, because we have a nursing shortage. In 
Maryland, 15 percent of the nursing jobs are vacant. Last year, it took 
an average of 68 days to fill a nurse vacancy, and we need about 1,600 
more full-time nurses to fill those vacancies. There were 2,000 fewer 
nurses in Maryland in 1999 than there were in 1998. The shortage exists 
across the United States, and will get worse in the future. Nationwide, 
we need 1.7 million nurses by the year 2020, but only about 600,000 
will be available. The need for this bill was clear at the Subcommittee 
on Aging's hearing on the nursing shortgage earlier this year.
  We depend on nurses every day to care for millions of Americans, 
whether in a hospital, nursing home, community health center, hospice, 
or through home health. They are the backbone of our health care 
system. If we don't effectively address the crisis in nursing, those 
hospitals, nursing homes and clinics will soon be on life support.
  This bill is a down payment. It doesn't address the fact that nurses 
are underpaid, overworked, and undervalued, but it does focus on 
education and other important areas. This bill seeks to help bring men 
and women into the nursing profession, and help them to advance within 
it. The bill does this under five major approaches:

[[Page S13947]]

  Creates a National Nurse Service Corps Scholarship Program, which 
provides scholarships in exchange for at least two years of service in 
a critical nursing shortage area or facility
  Provides grants for outreach at primary and secondary schools; 
scholarships or stipends to nursing students from disadvantaged 
backgrounds, education programs for students who need assistance with 
math, science, or other areas; dependent care and transportation 
assistance; establishment of partnerships between schools of nursing 
and health care facilities to improve access to care in underserved 
areas
  Creates state and national public awareness and education campaigns 
to enhance the image of nursing, promote diversity in the nursing 
workforce, and encourage people to enter the nursing profession
  Creates ``career ladder'' programs with schools of nursing and health 
care facilities to encourage individuals to pursue additional education 
and training to enter and advance within the nursing profession
  Enables Area Health Education Centers, AHECs, to expand their junior 
and senior high school mentoring programs for nurses and develop 
``models of excellence'' for community-based nurses
  Trains individuals to provide long-term care to the elderly and 
expands educational opportunities in gerontological nursing
  Creates internship and residency programs that encourage mentoring 
and the development of specialties
  Provides grants to improve workplace conditions, reduce workplace 
injuries, promote continuing nursing education and career development, 
and establish nurse retention programs
  Provides scholarships, loans, and stipends for graduate-
level education in nursing in exchange for teaching at an accredited 
school of nursing, to help ensure that we have enough teachers at our 
nursing schools.

  Creates a National Commission on the Recruitment and Retention of 
Nurses to study and make recommendations to the health care community 
and Congress on how to address: the nursing shortage in the long-term, 
nursing recruitment and retention, career advancement within the 
profession and attracting individuals into the profession.
  This bill is about nursing education, but it's also about 
empowerment. We can empower people to have a better life and go into a 
career to save lives.
  The bill will empower the single mom who has been working in a 
minimum wage job to forge a better life for herself and her family. It 
will help her get a scholarship to help pay for tuition, books, and lab 
fees, and by funding child care programs to help her balance work and 
family.
  The bill will empower the nurse who has a baccalaureate degree, but 
wants to get a Master's degree so she can teach nursing at a community 
college. It will help her get loans or scholarships and living stipends 
to pursue that degree.
  This bill will also fund partnerships between schools of nursing and 
health care facilities to train individuals who will provide long-term 
care for the elderly. Our population is aging, more than 70 million 
Americans will be over age 65 by 2030. This means more people will need 
care provided by nurses and other individuals specifically trained to 
care for the unique health needs of older Americans.
  I look forward to the Senate's speedy passage of this important 
legislation and to working with our colleagues in the House of 
Representatives to enact a strong bill that gets behind our Nation's 
nurses. I also want to thank Senators Kennedy, Gregg, and Frist for 
their hard work in moving this legislation forward, as well as Senators 
Lieberman and Clinton for their important contributions to this bill.
  Mr. HUTCHINSON. Mr. President, I am proud to be a lead cosponsor of 
the legislation we are introducing today to address the critical 
shortage of nurses in our country. After holding two hearings earlier 
this year to examine the nurse shortage and its impact on our health 
care delivery system. I introduced S. 721, the Nurse Employment and 
Education Development Act, NEED Act. This bipartisan legislation seeks 
to encourage individuals to enter the nursing profession, provide 
continued education and opportunities for advancement within the 
profession, and to bolster the number of nurse faculty to teach at our 
nursing schools. Most importantly, its legislation would establish a 
Nurse Service Corps, which would provide financial assistance to 
individuals for nurse education in exchange for 2 years of service in a 
nurse shortage area.
  The NEED Act won unanimous approval by the Senate Health, Education, 
Labor and Pensions Committee on November 1, and I am pleased that it 
has served as the basis for the legislation we are introducing today.
  The nursing profession is suffering from a serious decline in 
practicing nurses due to a shrinking pipeline. The nursing profession 
as a whole is aging, the average age of Registered Nurses is 43.3 
years, while nurses under age 30 comprise less than 10 percent of 
today's nurse workforce. Large numbers of nurses are retiring or 
leaving the profession, and only a small number of nurses and nurse 
educators are taking their place. By the year 2020, when millions of 
Baby Boomers will retire, it is projected that nursing needs will be 
unmet by at least 20 percent. For this reason, we need to employ 
innovative recruitment techniques, including a Nurse Service Corps, 
public service announcements, and outreach efforts at elementary and 
secondary schools to promote nursing as a viable, fulfilling career 
option. To address the needs of the elderly, the bill will provide 
grants for gerontological education and training.
  Hospitals, nursing homes, community health centers and other health 
care facilities are desperately seeking nurses to fill vacant positions 
so they can continue to provide safe, quality health care. In Arkansas, 
hospitals have reported over 750 nursing vacancies. To encourage nurses 
to stay and advance within the profession, the nursing bill provides 
for a career ladder program and encourages hospitals and other 
employers to develop innovative retention strategies. The bill also 
encourages speciality training and mentors through an internship and 
residency program, in order to fill the void created by experienced 
nurses leaving the profession.
  Finally, the bill addresses the critical need for nurse educators. 
The number of nursing school graduates in Arkansas is at its lowest in 
a decade, and nursing students have been turned away because of the 
lack of faculty to teach them. There are approximately four hundred 
nurse faculty vacancies in nursing schools nationwide. Therefore we 
include two provisions, a nurse faculty fast-track loan repayment 
program and a stipend and scholarship program, both of which provide 
financial assistance to masters and doctoral students who will teach at 
an accredited school of nursing for each year of assistance.
  This has been a team effort. I want to thank Senators Mikulski, 
Kerry, and Jeffords for their contributions to this important 
legislation, and I urge my colleagues to support its passage.
  Mr. KERRY. Mr. President, I am pleased to join my colleagues Senators 
Jeffords, Hutchinson and Mikulski in re-introducing the Nurse 
Reinvestment Act. This legislation will increase the number of nurses 
in our country, and also ensure that every nurse in the field has the 
skills he or she needs to provide the quality care patients deserve.
  We are in the midst of a serious nursing workforce shortage. Every 
type of community, urban, suburban and rural, is touched by it. No 
sector of our health care system is immune to it. Across the country, 
hospitals, nursing homes, home health care agencies and hospices are 
struggling to find nurses to care for their patients. Patients in 
search of care have been denied admission to facilities and told that 
there were ``no beds'' for them. Often there are beds, just not the 
nurses to care for the patients who would occupy them.
  Our Naiton has suffered from nursing shortages in the past. However, 
this shortage is particularly severe because we are losing nurses at 
both ends of the pipeline. Over the past five years, enrollment in 
entry-level nursing programs has declined by 20 percent. Lured to the 
lucartive jobs of the new economy, high school graduates are not 
pursuing careers in nursing in the numbers they once had. Consequently, 
nurses under the age of 30 represent only 10 percent of the current 
workforce. By 2010, 40 percent of the nursing

[[Page S13948]]

workforce will be over the age of 50, and nearing retirement. If these 
trends are not reversed, we stand to lose vast numbers of nurses at the 
same time that they will be needed to care for the millions of baby 
boomers enrolling in Medicare.
  The Nurse Reinvestment Act will support the recruitment of new 
students into our Nation's nursing programs. The bill will fund 
national and local public service announcements to enhance the profile 
of the nursing profession and encourage students to commit to a career 
in nursing. Our legislation will also expand school-to-career 
partnerships between health care facilities, nursing colleges, middle 
schools and high schools to show our youth the value of a nursing 
degree.
  Our legislation will ensure that barriers to higher education do not 
dissuade Americans who are interested in nursing from pursuing a degree 
in the field. The Nurse Reinvestment Act will support education for 
students who need help getting-up to speed on math, science and medical 
English. Our legislation will also ensure that there is support for 
single moms and dads with children who need a hand in daycare or a lift 
in getting to their classroom because they are without transportation.
  Still, is it not enough to simply encourage more individuals to enter 
the nursing profession, we must also ensure that our schools of nursing 
have enough professors to teach them. The Nurse Reinvestment Act 
provides for a fast-track facility development program, which 
encourages master's and doctoral students to rapidly complete their 
studies through loans and scholarships. Individuals receiving financial 
assistance through the fast-track faculty program must agree to teach 
at an ascredited school of nursing in exchange for this assistance.
  In addition to recruiting new nurses, our legislation will reinvest 
in nurses who are already practicing by providing them with education 
and training at every step of the career ladder and at every health 
care facility in which they work. It will ensure that nurses can obtain 
advanced degrees, from a B.S. in Nursing to a PhD in Nursing. It will 
enable nurses to access the specialty training they require to learn 
how to treat a specific disease or utilize a new piece of technology. 
Our bill will also help colleges and universities develop curriculum in 
gerontology and long-term care so that nursing students can pursue 
concentrations, minors and majors in this growing field of health care 
and be ready to apply their knowledge to the current and future senior 
population.
  To assist institutions in providing advanced education and training 
for nurses across the career ladder, our bill will strengthen the 
partnerships between colleges of nursing and health care facilities. 
Grants will be available to support such initiatives as the teaching of 
a course in gerontology in the conference rooms of a hospital or 
nurusing home. Grants will also support the use of distance learning 
technology to extend education and training to rural areas, and 
specialty education and training to all areas.
  The Nurse Reinvestment Act will authorize, for the first time in 
history, a National Nurse Service Corps. Separate from, though modeled 
after, the National Health Service Corps, the NNSC will administer 
scholarships to students who commit to working in a health care 
facility that is experiencing a shortage of nurses. In urban, suburban 
and rural communities across the country, where facilities turn away 
patients due to staff shortages, the NNSC will send qualified nurses to 
serve and provide the care that patients deserve.
  Our country boasts the best health care system in the world. But, 
that health care system is being jeopardized by the shortage plaguing 
our nursing workforce. Indeed, state-of-the-art medical facilities are 
of no use if their beds go unfilled and their floors remain empty 
because the nurses needed to staff them are not available. The Nurse 
Reinvestment Act not only seeks to increase the numbers of new nurses 
in our country, but also ensures that all nurses have the skills they 
need to provide the high quality care that makes our health care system 
the best in the world.
  Mr. JEFFORDS. Mr. President, I am especially pleased that the Senate 
is scheduled to consider and vote on the Nurse Reinvestment Act. When 
we pass this measure, it will represent a good day for the future of 
nursing in America and a good day for the future for patient-care. I 
want to take this opportunity to tell our colleagues a little about 
this legislation and to congratulate and complement my fellow Senators 
who worked so hard to see this effort through. My good friend from 
Massachusetts, Senator Kerry, was the original sponsor of the Nurse 
Reinvestment Act and with me crafted an innovative set of solutions to 
the nursing shortage problem. Since then, this bill has been 
strengthened significantly by the inclusion of a complimentary measure 
authored by my colleagues on the HELP Committee, Senator Hutchinson and 
Senator Mikulski. The measure we are considering today has been 
benefited by this collaboration.
  As I have stated before, we are facing a looming crisis in this 
country. The size of our nursing workforce remains stagnant, while the 
average age of the American nurse is on the rise. Over the past five 
years, enrollment in entry-level nursing programs has declined by 20 
percent. Nurses under the age of 30 represent only 10 percent of the 
current workforce. By 2010, 40 percent of the nursing workforce will be 
over the age of 50, and nearing retirement. In Vermont we are facing an 
even greater crisis because these numbers are worse. Only 28 percent of 
nurses are under the age of 40 and Vermont schools and colleges are 
producing 31 percent fewer nurses today than they did just five years 
ago.
  We have a compelling need to encourage more Americans to enter the 
nursing profession and to strengthen it so that more nurses choose to 
stay in the profession. All facets of the health care system will have 
a role to play in ensuring a strong nursing workforce. Nurses, 
physicians, hospitals, nursing homes, academia, community organizations 
and state and federal governments all must accept responsibility and 
work towards a solution. Part of the responsibility to launch that 
effort begins with us today as we make a decision on the vote for the 
Nurse Reinvestment Act.
  The Nurse Reinvestment Act expands and improves the federal 
government's support of ``pipeline'' programs, which will maintain a 
strong talent pool and develop a nursing workforce that can address the 
increasingly diverse needs of America's population. The Nurse 
Reinvestment Act provides for a comprehensive public awareness and 
education campaign on a national, state and local level that will 
bolster the image of the profession, encourage diversity, attract more 
nurses to the workforce, and lead current nurses to take advantage of 
career development opportunities.
  The legislation creates a National Nursing Service Corps Scholarship 
Program authorized at $40 million that will provide scholarships to 
individuals to attend nursing schools in exchange for a commitment to 
serve two years in a health facility determined to have a critical 
shortage of nurses. This scholarship program is designed to greatly 
help the recruitment of nursing students by providing them tuition, 
other reasonable and necessary educational fees and a monthly stipend 
paid to the student.
  The Act also authorizes the ``Nurse Recruitment Grant Program'' to 
support outreach efforts by nursing schools and other eligible 
healthcare facilities to inform students in primary, junior and 
secondary schools of nursing educational opportunities and to attract 
them to the nursing profession. The grant program provides appropriate 
student support services to individuals from disadvantaged backgrounds 
and creates community-based partnerships to recruit nurses in medically 
underserved rural and urban areas. Further, the ``Area Health Education 
Centers Program'' will award grants to nursing schools that work in 
partnership in the community to develop models of excellence.
  The ``Career Ladder Programs'' will assist schools of nursing, health 
care facilities or partnerships of the two to develop programs that 
will encourage current nursing students in active nurses alike, to 
pursue further education and training. This will be achieved through 
scholarships, stipends, career counseling, direct training and distance 
learning programs.

[[Page S13949]]

And, in light of our aging baby-boomer generation, specific grants are 
offered to schools and health care facilities so that they might place 
a further emphasis upon encouraging students to study long-term care 
for the elderly.
  In addition to the provisions that were included in the original bill 
I co-sponsored with my colleague Senator Kerry, there are provisions 
added by our colleagues which, I am happy to have included in this 
final piece of legislation. Those provisions will provide for the 
development of internship and residency programs to encourage the 
development of specialties and student, loan, stipend and scholarship 
programs for those who would like to seek a masters or doctorate degree 
at a school of nursing. The final bill was also strengthened by 
provisions added through the efforts of Senator Lieberman and Senator 
Clinton.
  Once again, I want to applaud my colleagues Senator Kerry, Senator 
Mikulski and Senator Hutchinson for their tireless work on the Nurse 
Reinvestment Act and for the work of their staffs. In particular, I 
want to recognize the efforts of Kelly Bovio in Senator Kerry,'s 
office, Kate Hull in Senator Hutchinson's office and Rhonda Richards 
with Senator Mikulski. This effort was also advanced with the help of 
Sarah Bianchi and Jackie Gran who are members of Senator Kennedy's 
staff, Steve Irizarry with Senator Gregg and Shana Christrup with 
Senator Frist. Finally, in my own office, I want to note the efforts of 
Philo Hall, Angela Mattie, Eric Silva and Sean Donohue.
  Adequate health care services cannot survive any further diminishing 
of the nursing workforce. All patients depend on the professional care 
of nurses, and we must make sure it will be there for them. I urged my 
colleagues to join me and the bill's cosponsors in support of this 
measure.
  Mr. FRIST. Mr. President, I rise today to discuss the introduction of 
a very important bill to address the nursing workforce shortage. At the 
beginning of November, we reported two different bills from the Senate 
HELP Committee designed to address the nursing shortage in this 
country, the Hutchinson-Mikulski ``Nursing Employment and Education 
Development Act'' and the Kerry-Jeffords ``Nursing Reinvestment Act.'' 
I was an original cosponsor of the Hutchinson legislation and a strong 
supporter of that bill. At that time, I voiced my concern that we are 
marking up two rather similar proposals to deal with the nursing 
shortage, and I requested that the differences be worked out before the 
bill was discussed on the Senate floor. I am happy today to report the 
the final reconciliation is complete, and we have a consensus bill that 
firmly addresses the nursing workforce shortage issue. I thank Senator 
Hutchinson for his hard work in ensuring that we could reach this 
point.
  We are in the midst of a direct care workforce shortage. Not only are 
fewer people entering and staying in the nursing profession, but we are 
losing experienced nurses at a time of growing need. Today, nurses are 
needed in a greater number of settings, such as nursing homes, extended 
care facilities, community and public health centers, professional 
education, and ambulatory care facilities. Nationwide, health care 
providers, ranging from hospitals and nursing homes to home health 
agencies and public health departments, are struggling to find 
qualified nurses to provide safe, efficient, quality care for their 
patients. That's why it is important to have a new Nursing Corps, which 
will provide scholarships to qualified individuals in exchange for 
direct care service in a variety of settings as well as to allow others 
to know about the numerous possibilities within the profession by 
authorizing public service announcements.
  Though we have faced nursing shortages in the past, this looming 
shortage is particularly troublesome because it reflects two trends 
that are occurring simultaneously: 1. A shortage of people entering the 
profession; and 2. The retirement of nurses who have been working in 
the profession for many years. Over the past five years, enrollment in 
entry-level nursing programs has declined by twenty percent, mirroring 
the declining awareness of the nursing profession among high school 
graduates. Consequently, nurses under the age of thirty represent only 
ten percent of the current workforce. By 2010, forty percent of the 
nursing workforce will be older than fifty years old and nearing 
retirement. If these trends continue, we stand to lost vast numbers of 
nurses at the very time that they will be needed to care for the 
millions of baby boomers reaching retirement age. To deal with the 
increased need for nurses to care for the elderly, this bill has a 
provision to assist with both the necessary training and educational 
development of gerontological nurses as well as to strengthen the 
ability of nurses to obtain additional training and certification 
through the career ladders program.
  Further, greater efforts must be made to recruit more men and 
minorities to this noble profession. Currently, only ten percent of the 
registered nurses in the United States are from racial or ethnic 
minority backgrounds, even though these individuals comprise twenty-
eight percent of the total United States population. In 2000, less than 
six percent of the registered nurses were men. We must work to promote 
diversity in the workforce, not only to increase the number of 
individuals within the profession, but also to promote culturally 
competent and relevant care. Within the combined nursing shortage bill, 
one grant program directly addresses the need to increase funding for 
the training of minority and disadvantaged students to make it easier 
for individuals to enter the nursing profession.
  Even if nursing schools could recruit more students to deal with the 
shortage, many schools could not accommodate higher enrollments because 
of faculty shortages. There are nearly four hundred faculty vacancies 
at nursing schools in this country. And, an even greater faculty 
shortage looms in the next ten to fifteen years as many current nursing 
faculty approach retirement and fewer nursing students pursue academic 
careers. Therefore, I strongly support the two provisions to assist 
with faculty development and training, the fast track nursing faculty 
loan program and the stipend and scholarship program.
  In addressing these direct care staffing shortages, we must work 
together to develop innovative solutions to address this growing issue. 
As reported in the Memphis Commercial Appeal on May 10, there are steps 
that Congress can take to increase funding for specific programs and 
reduce regulatory requirements. However, a comprehensive strategy must 
also include other sectors of the health care system, hospitals, health 
care professionals, educators, and the general public, to successfully 
deal with this looming shortage. That's why it is important to also 
include a provision to deal with developing retention strategies and 
best practices in nursing staff management.
  I am extremely supportive of this legislation, and I want to thank 
Senator Hutchinson again for his hard work in addressing this critical 
issue. I also want to commend my other colleagues, including Senator 
Mikulski, for her efforts. Senator Hutchinson clearly has shown 
tremendous leadership in this area. He understands the need to address 
the nursing shortage issue, and he is largely responsible for getting 
us to this point today.
  Mr. KENNEDY. Mr. President, it is a privilege to join my colleagues 
in introducing the Nurse Reinvestment Act. Our goal in this bipartisan 
legislation is to do as much as we can to alleviate the nursing 
shortage experienced by health care facilities across the United 
States. Increasing the number of nurses is an essential part of the 
ongoing effort to reduce medical errors, improve patient outcomes, and 
encourage more Americans to become and remain nurses.
  The Nation's nurses provide care for Americans at the most vulnerable 
times in the lives. We must act now to halt the decline in the number 
of nurses. Enrollment in schools of nursing is falling, and the average 
age of the nursing workforce is rising. Across the country, communities 
are losing vast numbers of nurses, just as we need more to care for the 
millions of aging baby boomers and deal with the many medical 
challenges facing our hospitals.
  The current shortage means that too many nurses now have to care for 
too many patients at once, undermining the high quality of care that 
nurses want to give, and patients deserve. A

[[Page S13950]]

recent survey by the American Nurses Association showed that 75 percent 
of nurses believe that the quality of nursing care at their facility 
has declined. More than half of those surveyed said that the time they 
can spend with patients has decreased. A nurse in Massachusetts said 
that she would not go the hospital where she worked, if she needed 
care.
  Nationally, the shortfall is expected to rise to 20 percent in the 
coming years. Yet nurses themselves are already seriously questioning 
the quality of bedside treatments now being provided on intensive care 
units, in emergency rooms, and at the bedsides of patients where they 
work.
  Their questions are call for help. This legislation can be 
significant in strengthening the nursing profession, and responding to 
the urgent need.
  The Nurse Reinvestment Act will recruit new students into schools of 
nursing through outreach programs, public awareness and education 
campaigns, and area health education centers. It establishes a national 
nurse service corps, which will offer scholarships to bring individuals 
into the profession and place them in medically under-served areas and 
facilities. The Act expands school-to-career partnerships to show 
youths the high value and importance of a nursing degree. It invests in 
today's nurses by providing education and training at every step of the 
career ladder, and by helping them obtain advanced degrees, from a B.S. 
in Nursing to a Ph.D. in Nursing. It includes provisions developed by 
Senator Lieberman and Senator Clinton to help health care facilities 
retain nurses.
  Our country has the best health care system in the world. But that 
system is being jeopardized today by the shortages plaguing the nursing 
workforce. Even our best medical facilities are in deep trouble if 
their beds go unfilled and their floors remain empty because there are 
no nurses to staff them.
  I commend Senator Mikulski, Senator Kerry, Senator Hutchinson, and 
Senator Jeffords for their leadership in this initiative. Bringing more 
nurses into the profession will help to ensure that nurses are ready 
and able to provide the highest quality of care to their patients. The 
Nurse Reinvestment Act is a significant step that Congress can take to 
support the Nation's nurses, and I urge my colleagues to support it.
  Mr. LIEBERMAN. Mr. President, I am proud to be an original cosponsor 
of the Nurse Reinvestment Act of 2001. I want to congratulate my 
colleagues, particularly Senators Mikulski, Hutchinson, Kerry and 
Jeffords, for their extraordinary efforts to put together this 
excellent bill. I also want to thank the Committee for including the 
provisions of the Lieberman-Ensign ``Hospital Based Nursing Initiative 
Act of 2001'' in the bill.
  By now, everyone knows that the nation faces a critical shortage of 
nurses. The shortage has already severely impacted states in many areas 
of the country, including Connecticut, and I fear it will jeopardize 
our ability to provide quality health care to patients. A recent report 
by the Government Accounting Office projected that the growing national 
nursing shortage will hit a peak in ten years.
  While pay is a major factor cited in the report, it is not the 
primary reason nurses are leaving the profession. The study also cites 
poor or unsafe working conditions, lack of respect from physicians and 
patients, barriers to participation in the hospital administration 
decision-making process, lack of opportunity to continue their 
education, and lack of recognition for accomplishments. We must do more 
to attract new people to the nursing profession and retain the quality 
nurses who currently provide us care. The Nurse Reinvestment Act will 
do just that.
  I want to take just a minute to talk about the specific provisions 
that were part of the ``Hospital Based Nursing Initiative Act.'' This 
legislation contained two proposals to help retain nurses in the 
hospital setting: a competitive grant program that would provide 
funding to hospitals that actively work to retain their nurses and a 
scholarship program for registered nurses who hold an associates or 
diploma degree who wish to obtain a bachelor's degree in nursing.
  As part of the Nurse Reinvestment Act, these incentives have been 
broadened to apply to the nursing workforce in all health care 
facilities, providing a critical stimulus for these facilities to 
retain their nurses.
  While the ominous projections about the growing nursing shortage 
looms over the health care industry, it is clear that now is the time 
to act. I am encouraged that Congress is acting quickly and decisively 
to actively add to the nurse workforce and to provide critical 
incentives to keep nurses on the job.
                                 ______