By Mara O'Malley / Broadcast version by Farah Siddiqi reporting for the Kent State-Ohio News Connection Collaboration.

The Ohio Nurses Association has undertaken a so-called Code Red campaign to call attention to the shortage of nurses in Ohio hospitals, which could lead to a patient care crisis.

The campaign focuses on five areas, including staffing levels, working conditions, the nursing workforce pipeline, corporate trends and trust and agency within the profession. They hope to encourage employers and lawmakers to implement the staffing ratios their nurses need.

"That is our sounding the alarm and putting forward real workable strategies to address the nurse staffing crisis in Ohio," said Rick Lucas, president and executive director of the Ohio Nurses Association and himself a registered nurse.

The ONA conducted a survey in 2023 that received over 11,000 responses from licensed nurses in Ohio, seeking to find out why nurses are leaving bedside care positions.

They found:

• 58% of nurses who left bedside roles did so because of their patient care load.


• 70% of direct care nurses are currently considering leaving bedside roles because of their patient care load.


• 88% of nurses would consider staying in bedside roles if Ohio had legally enforceable minimum staffing standards.

"Nurses need help. We needed help before the pandemic," Lucas said. "After enduring that and dealing with the exacerbated staffing shortage, we really need help. And we need for people to know what's happening in our hospitals so that they can help fight for the change that they need as well."


Ohio House Bill 285, the Nurse Workforce and Safe Patient Care Act, was introduced in September 2023. If enacted, the bill would establish minimum staffing standards in Ohio hospitals, create a loan-to-grant program to support nurses in training, ensure accountability in hospital compliance, establish nurse staffing committees with direct caregivers, and create whistleblower protections for patients, nurses and hospital staff.


The Ohio Nurses Association supports H.B. 285.


"It's a way for us to attract and retain those nurses here," said Rep. Elgin Rogers (D-Toledo), a co-sponsor of the bill. "We want to make sure that we have nurses who are qualified. Nurses are in high demand, but we want to make sure that they are trained properly and they remain in Ohio."


The nursing shortage around Ohio hospitals started before the COVID-19 and is expected to get worse, peaking in early 2027, Lucas said. Nurses now have more responsibilities than ever, ranging from caring for patients to taking out the trash and changing the linens.


"There were barely enough nurses scheduled already, and then when COVID hit, things only got worse, with stressing an already broken system," Lucas said.


Beyond that, Lucas said hospitals are relying heavily on travel nurses - nurses who aren't based in any one location, but instead work for several months at hospitals in need of staff before moving on.


The $20 million loan-to-grant in H.B. 285 is designed to help encourage nurses to stay in Ohio. Nurses could be eligible for up to $12,000 in forgivable loans if they stay in Ohio for at least five years of work.


"In this particular item, there is significantly a higher value than some of those other programs," said Dr. Wendy Batch-Wilson, Dean of Nursing Cuyahoga Community College. "With the $5,000 that's available, but then also the ability for that to turn into a grant for the full amount."


Rogers, a Democrat, and his Republican co-sponsor hope the bill will go to the floor for a vote before the General Assembly session ends.


"They went to college, they went to school, they sacrificed," said Rogers. "So we want to make sure we're creating an atmosphere where they can do what they were called to do in this great state."




This collaboration is produced in association with Media in the Public Interest and funded in part by the George Gund Foundation.


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About 1.3 million Missourians are currently enrolled in Medicaid and nonprofits around the state have warned proposed federal cuts would be devastating.

In Missouri, children are the largest group served by Medicaid, with 61% enrolled. States could face more than $800 billion in Medicaid cuts and more than $200 billion in the Supplemental Nutrition Assistance Program, known as SNAP or food stamps.

McClain Bryant Macklin, vice president of policy and impact for the Kansas City nonprofit Health Forward Foundation, emphasized how important Medicaid is to the organization.

"From a policy perspective as well as where we tend to lend our funding support is squarely in that direction, and Medicaid access has been our primary policy issue, really since our inception," Bryant Macklin explained. "It's just our number one priority."

Supporters of the cuts argued Medicaid is inefficient because of waste and fraud, and restructuring or reducing funding could improve sustainability.

Bryant Macklin noted the Health Forward Foundation played a key role in advocating for Medicaid expansion in Missouri, contributing to policy changes which extended coverage to thousands of low-income residents. She stressed as a Medicaid expansion state, Missouri will need to find funding from other critical sources, which could result in further challenges.

"State legislators are going to be forced to -- and administrators forced to -- find those dollars elsewhere," Bryant Macklin pointed out. "That elsewhere will be from other key social services that folks are relying upon and that the state has grown accustomed to receiving that federal support."

Those in favor of the cuts said they would give states greater control over Medicaid through block grants, which are fixed amounts of federal funding states can use with more flexibility, to tailor programs to local needs and priorities.

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Indiana is losing millions in public health funding as the federal government cuts grants for state and local programs.

In Marion County, officials confirmed the immediate loss of a $450,000 immunization grant, leaving employees searching for ways to continue vaccination efforts amid ongoing disease outbreaks.

Dr. Virginia Caine, director and chief medical officer for the Marion County Health Department, highlighted the cuts during a town hall hosted by Rep. André Carson, D-Ind.

"We are now seeing that they've cut all state and local health departments budgets," Caine explained. "We have to be very concerned about our ability to protect the public."

Caine noted the federal government eliminated $13.1 billion in funding for state and local health departments, part of a broader rollback of pandemic-era grants. Indiana Department of Health legislative director Rachel Swartwood recently commented the state's goal is to ensure no direct services to Hoosiers are interrupted.

State health officials estimate Indiana will lose about $40 million because of the cuts. Additionally, the U.S. Department of Health and Human Services recently announced plans to eliminate 10,000 full-time jobs. The totality of the cuts is very concerning for Caine.

"When we had this fentanyl epidemic with overdoes -- we have the bird flu taking place across this country -- we have to be concerned," Caine emphasized. "Do we have the workforce to come out and meet these demands?"

Marion County officials are evaluating how to fill the funding gap. Caine added the department has 300 positions supported by grants and expressed concern job losses and service reductions could follow if no alternative funding emerges.


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Oregon does not have enough health care workers and the need continues to grow.

Service Employees International Union Local 49 members said retention is a key cause of the shortage and they are lobbying for two bills in Salem to improve job quality across the industry. Over the next 10 years, health care and social services will need to bring in nearly 225,000 workers, according to the Oregon Employment Department.

Matt Swanson, political strategist for SEIU Local 49, said meeting the growing demand will take every possible intervention.

"I heard from many workers about how tired they are," Swanson reported. "How difficult it is to provide quality patient care when there just aren't enough people working."

One bill at the top of the union's priority list would address unchecked workplace violence, which health care workers experience at a higher rate than any other industry. Another would expand funding to allow providers to continue to work while going to school for advanced training.

Felipa Nesta, a licensed practical nurse at Kaiser Permanente, is using existing funding to get a nursing degree while working. She said Senate Bill 27 would help meet the growing demand for health care providers by increasing funding for such programs as well as providing wage replacement, child care, and transportation.

"It would help so more people can get into health care jobs without being buried in debt," Nesta emphasized.

Rachel Dennis, a certified nursing assistant at PeaceHealth Sacred Heart Medical Center, said Senate Bill 537 mandates de-escalation training as well as systems to notify providers of potentially violent patients. It also guarantees counseling and paycheck protection for injured employees. She noted nearly all her coworkers have faced verbal or physical assault on the job.

"I'm tired of seeing my coworkers leave because they're scared to go to work," Dennis stressed.

Both bills have had public hearings and are scheduled for work sessions in Salem.

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