Nursing shortage and pay at heart of debate among senators



By Eric Rosario

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Senators refused to debate a bill by Sen. Mary Torres that would have allowed qualified nurses from throughout the country to be hired without the cumbersome licensure requirements. Her Bill No. 239, would have brought Guam into the Nursing Licensure Compact - a multi-state agreement allowing nurses from within the compact to have mutli-state licensure.


Ms. Torres wanted the bill to pass into law prior to the Coronavirus pandemic to address Guam's age-old nursing shortage, which has hampered even critical care at Guam Memorial Hospital and the island's other health providers.


Speaking openly to nurses and COVID-19 front liners, Ms. Torres said, "This is a bill that many of you have personally requested and overwhelmingly supported. A bill that would have opened our island to 2 million nurses in 34 member states, enable telehealth opportunities, and establish a level of security in the vetting process that we presently do not have. But perhaps more importantly—Bill 239 would have helped solve the perennial nursing shortage our community faces. I know this shortage affects each of you on a daily basis—that it hurt you long before this pandemic even began. I know that COVID-19 has increased the demand on our already- strained healthcare system—so strained that this government has been forced to contract traveling nurses to help fill the gaps."

Sen. Therese Terlaje, who chairs the legislature's health committee, said she is concerned the bill will have the opposite effect - that nurses will leave Guam to work in another state, where the pay is better.


"Since this bill was introduced, the committee continues to work to reconcile the very real threat of an increased loss of nurses and nurse graduates to higher paying jurisdictions," Ms. Terlaje wrote in response to her colleague's open letter. "The adoption of the Nurse Compact into law would enable Guam nurses to hold a multi-state license, allowing them to more easily migrate to work in other Compact jurisdictions. This ability is a major benefit of Compact membership that may have the unintended consequence of compounding the chronic nursing shortage in Guam."

The bill was sent to Ms. Terlaje's committee, where it remained for a year. Her committee did not report the bill out to the full legislature. Ms. Torres tried to have senators debate the bill, but not enough senators supported her motion to do so.


"It was our sincere hope that this bill would help relieve the workload you for too long have had to bear," Ms. Torres continued in her open message to nurses and front liners. "Despite your statements, testimonies, and near 4,000 signatures petitioning to add Guam to the Compact, we could not convince the Health Chair to respect your voices. As a result, Bill 239 will die in the Committee where it has languished for over a year. I have always believed in the principle that government should work just as hard for the powerless as it does for the powerful. I’m sorry to say that too many of those with power would not yield theirs yesterday to help you."

The two senators agreed that a necessary part of the public policy discussion on this issue is the pay nurses receive on Guam. Ms. Torres said, "I don't believe anyone here disagrees with the need to increase local salaries." To remedy that problem, she introduced Bill No. 415, which funds a nurse pay study using $50,000 in savings from Ms. Torres's office budget.


If the bill does not pass before the next legislature takes office, it will die with this current legislature in January.


In her open letter, which was co signed by Bill No. 239's co-sponsor, Speaker Tina Muna Barnes, Ms. Torres expressed profound dismay that Ms. Terlaje prevented the bill from reaching the session floor, and said she will re-introduce the bill in the next legislature.


"While this is a sad day for Guam’s front liners, I commit to you that this is not the end for me or Speaker Muña Barnes. Efforts to add Guam to the Compact will live again—not in this term, but in the next—where we will introduce a bill at the soonest opportunity. You’ve fought at the front lines for us—we won’t stop fighting for you." - Sen. Mary Torres

In response, Ms. Terlaje wrote: "I continue to work with the stakeholders to ensure Guam’s nursing needs are met, including expanding the use of workforce development funds towards healthcare, and increasing the allocation of scholarship money towards nursing programs. I had informed the sponsor of the bill repeatedly that we must work together to resolve retention issues as well, as was recommended by the University of Guam, Guam Memorial Hospital, and many others."

Ms. Torres replied: "I don't claim that Bill 239 is perfect or that it will solve all our problems--I just don't pretend to know better than the front liners who asked for it."

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