LAS VEGAS (KLAS) — A union that represents more than 8,000 nurses and health care professionals in Nevada remains staunchly opposed to legislation that would put the state into a national agreement on nurse licenses.

Lawmakers listened to opinions for and against Assembly Bill 108 (AB108) on Friday in Carson City and by video conference with people in attendance in Las Vegas. Under AB108, Nevada would participate in the Nurse Licensure Compact, a national agreement that 37 states have signed since it was created two decades ago.

“AB108 will not address the nurse understaffing crisis as we continue to see shortages throughout the country including current compact states,” according to Grace Vergara-Mactal, executive director of Service Employees International Union (SEIU) Local 1107. “The bill will force Nevada to enter a binding nurse license compact that would be extremely difficult to make changes to in the future, undermining our state’s sovereignty.”

Grace Vergara-Mactal, executive director of SEIU Local 1107.

The bill would eliminate barriers to hiring nurses from other states, removing requirements for nurses to hold a Nevada license before they could work here.

Republican Assemblyman P.K. O’Neill asked questions about past opposition to the legislation, including suspicions that it would be used to break hospital strikes.

Patrick Kelly, president and CEO of the Nevada Hospital Association (NHA), answered those questions. “We’ve heard the bill described as a union-busting bill and I don’t understand that. Thirty-seven states have adopted the Nurse Licensure Compact and nursing unions exist in compact states. I’ve heard the bill described as a strike-breaker bill. Again, I don’t understand. Federal law requires a union to give a health care provider 10 days notice of a strike. Currently, the Nevada Board of Nursing will issue a temporary license to a nurse in about three days.”

In December, NHA argued for the state to join the compact as hospitals struggled during a “tripledemic” of RSV, flu and COVID-19 cases that taxed pediatric care and nursing care.

During the pandemic, emergency provisions signed by Gov. Steve Sisolak opened the door to allowing out-of-state nurses — including traveling nurses — to work in Nevada. But that emergency has expired and the state is likely to see emergencies in the future that will strain resources again.

“The compact’s not needed for strikes,” Kelly said. “The compact is needed for patient surges and emergencies. God forbid we have another 1 October shooting. However, if we do, we can bring help into the state within hours.”

Union opposition turned to working conditions and hospital profits, as well.

“If we are going to address the nurse staffing shortage we are seeing here in Nevada and across the country we need to be discussing working conditions, Vergara-Mactal said. “Right now, the grueling working conditions of nurses is the number one barrier to addressing the nursing shortage. Often, our health care members are working 12 to 14 hours a day and seeing up to 10 patients an hour. When hospitals like HCA are bringing in yearly profits of $5.6 billion — with a ‘b’ — there’s no reason that HCA should be staffing 34% below the national average in Nevada. Policies like compact will not address this problem and only serve to help the bottom line for for-profit hospitals.”

Assemblywoman Sandra Jauregui (D-Las Vegas) speaks on AB108 in Carson City on Friday.

Democratic Assemblywoman Sandra Jauregui, who sponsored the bill, made a gesture to unions on Friday, introducing an amendment that would facilitate union contact with new hospital hires. But unions were unmoved, and the AFL-CIO put out a press release following the hearing.

“This bill is not only an affront to Nevada’s nurses, but also to the labor movement as a whole. Our state’s nurses have always worked on the front lines to ensure that our families receive the health care that they deserve, especially during the pandemic. The idea of outsourcing labor to workers in other states that do not have the same knowledge of our health care system is offensive to our nursing workforce and the Nevadans to which they provide care,” AFL-CIO Executive Secretary-Treasurer Susie Martinez said.

Jauregui acknowledged in closing testimony that the compact would not solve the problem by itself. She said the bill was not meant to interfere with unions. AB108 is just a part of helping to fill 2,300 vacant nursing positions in the state, she said.

Renee Ruiz, legislative advocate for National Nurses United, National Nurses Organizing Committee of Nevada, was among the union members in opposition.

“We have had these arguments for 10 years, and you know why? Because this is bad legislation.
I keep hearing this 5,000 nursing licenses. ‘We’re going to need them, we’re going to need them.’ We have them. We have nurses who do not want to go back to the bedside because of conditions set up by their employers that make it impossible for them to be a healthy nurse in Nevada,” Ruiz said.

The Nevada Hospital Association (NHA) identified the need to join the compact as a priority in December. The COVID-19 pandemic and the RSV outbreak in November exposed nursing licenses as a major reason it was difficult to bring in emergency help from out-of-state nurses.

Nevada, California, Oregon, Connecticut and Hawaii are not participants in the nursing compact.

Jauregui said that Washington’s state legislature passed the compact on Thursday, sending it to the governor’s desk.

Pediatric nurses were in short supply as RSV filled hospital wards in November and into December. An NHA request to suspend licensing requirements in late November was denied by the state. Instead, the Governor’s Office worked with NHA and the Nevada State Board of Nursing to fast-track nursing licenses for pediatric nurses.

NHA said at the time, “Nevada should become part of the National Nurse Compact to avoid the need for these patches in the future and afford Nevada nurses to be part of disaster response in other states.”

The Nevada Nurses Association supports the nursing compact.