Situation: On March 25, 2020 the Ohio legislature passed Substitute House Bill 197, allowing newly graduated nurses to obtain a temporary license prior to passing the NCLEX to enter the workforce to assist with workforce shortages that may occur due to COVID-19.
Background: On March 9, 2020 Governor Mike DeWine declared a state of emergency through an executive order due to the COVID-19 pandemic. A series of events occurred over the next few weeks, including the closing of NCLEX testing centers in the state of Ohio on March 18, 2020. With testing centers remaining closed during the state of emergency, it became apparent that new nursing graduates would be unable to take the licensing exam, and therefore would not be able to help in the capacity as a licensed nurse during the pandemic. The Governor requested that the legislature return to Columbus, Ohio during the week of March 24, 2020 to pass emergency COVID-19 legislation. Included in the emergency legislation was language that allows the Ohio Board of Nursing to grant a temporary license to practice nursing as a registered nurse or as a licensed practical nurse to new nursing graduates. This temporary license shall only be valid until ninety days after the duration of the period of the emergency declared on March 9, 2020 or ninety days after December 1, 2020, whichever comes first. The Board of Nursing will still require completion letters from all approved graduating students, as well as full background checks. This language passed both the Ohio House of Representatives and the Ohio Senate on March 25, 2020, with full bipartisan support from the Governor’s office and both Chambers. The legislature had one day to pass Substitute House Bill 197 as an amended piece of legislation that included COVID-19 emergency language. Public input was not offered and/or taken due to a very strict timeline and circumstances beyond the state’s control.
Assessment: Despite comprehensive preparation of our newly graduated nurses, the temporary licensure legislation in Ohio has caused concern among both licensed nurses and student nurses alike. Students are concerned about entering the workforce in such unstable conditions, and experienced nurses understand the critical importance of proper orientation and preceptorship for new graduates to ensure safe, competent practice. During these unprecedented times filled with great uncertainty, the safety of all nurses and all Ohioans remains the priority. Ohio has many experienced nurses displaced from their current roles due to the cancellation of elective surgeries and other non-emergent care. These experienced nurses are invaluable during this pandemic and should be utilized to the fullest extent of their licensure, including precepting and mentoring our newly licensed nurses. ONA understands the magnitude of this global pandemic and joins other lead organizations in advocating for the temporary actions that are needed to protect nurses, patients, and the community in times of crisis as the needs of healthcare organizations change and demand for healthcare providers rise.
Recommendation
• Explore opportunities with the Ohio Board of Nursing to re-open NCLEX testing sites within the framework of the Governor’s executive orders
• Thorough assessment of each region of the number of current nursing personnel and use of modeling to accurately project how many staff will be needed
• Recruitment of current staff from displaced areas to voluntarily accept other roles with as much of the proper orientation and education as possible to provide safe patient care
• Recruitment and professional development of licensed retired nurses and other nurses who are not currently in primary/acute care roles
• Recruitment of newly graduated, temporarily licensed nurses should occur as needed to support a safe balanced work force.
• Each newly graduated, temporarily licensed nurse to have:
o Precepted orientation and evidence-based training to prepare to work in a clinically appropriate setting
o Support of a mentor
o Access to emotional support services to assist with coping of transitioning to practice in such an uncertain and stressful time
o Guarantee of assistance in transitioning to their professional nursing career once the crisis is over upon passing of NCLEX and obtaining their active nursing license