By David Lubofsky
As a consumer of health care and an advocate to protect all of Guam’s health care consumers, one must ask what is going on with Bill 13-36. This Bill appears to be a special interest Bill that will have eventual detrimental impact on the poorest on Guam and the Guam Memorial Hospital.
The fluff of the Bill, authored by Senator Mary Camacho Torres, and co-sponsored by Vice Speaker Tina Rose Muña Barnes and Senator Amanda L. Shelton, would add Guam to the Nurse Licensure Compact (NLC)—making it easier for nurses in other NLC states to practice on Guam.
Sounds great right? Hold on. What they do not say is that our nurses can leave easier as well. Why wasn’t this Bill introduced by Speaker Terlaje who is the Chair of the Health Committee? She also introduced the same Bill during the 35th Guam Legislature and had hearings on it etc. Why was it taken away from her? Is this a special interest Bill? Did she not support it? What is being hidden?
In my opinion, this Bill will put the poorest people on Guam in more jeopardy and at risk for more negligent medical care than they are already in at GMH. GMH administrator, Ms. Lillian Posadas, in her testimony during the 35th legislature clearly stated that Nurse retention is already a big issue for GMH. She stated many leave Guam for a better salary.
I personally see Bill 13 as a special interest piece of legislation, having a long-term negative impact on health care on Guam, especially since it was removed from the Health Committee and then supported by the Guam Board of Nursing Examiners, The Guam Association of Nurses and by nurses and others either not realizing what it will do or hope to reap the benefits of easily being able to leave Guam.
In other words, the Bill benefits one group of professionals on Guam, under the guise of using a challenged health care nursing system as the justification and of course saying we need it due to the Pandemic without addressing the real issues of nurse retention.
This Bill is being used to fix problems or to appease nurses that the legislature has blatantly ignored for decades. Do we need this Bill if they just pay the nurses what they deserve at GMH? Other medical facilities will follow with increases in pay. The Guam legislatures have been told this for years. Instead of responding to that cry and need they come up with this Bill which will not pay nurses on Guam more, will not attract nurses from off island or the compact states, but will make it easy for our nurses to either leave or be recruited for the “Big Salary” in other places. The Guam health care industry has a vested interest to keep nurse salaries low and no doubt that is one reason that nurses are not paid more. This is the same group that do not think that doctors should pay malpractice insurance rates to protect patients. Its all about keeping costs lower for them, compromising medical care.
When I looked at the 34 compact states, Guam pays nurses the lowest of all, actually the lowest in the country with one of the highest costs of living. Our nurses, the biggest asset to our medical system, have not been respected in the past, up to the present by how they have been underpaid for years. Our nurses should be earning at GMH around $75,000 per year and that will put them in the middle of what nurses in the compact states earn.
Does anyone really think that nurses from other states will say, “my gosh, let’s go to Guam, it’s so beautiful” and be poor, as that is what nurse salaries look like here. Or will they say, “It’s a beautiful place but we will have to work two jobs.” Or will our nurses, with this Bill if turned into a law, especially at GMH say, let’s move to the states and not have to work two jobs, have more time together as a family with better working conditions? It is a no Brainer. Ask the GMH Hospital administrator the answer as she has experienced departing nurses often. Bill 13 is a Nurse drain Bill, and every nurse knows that. Ms. Posadas stated that nurses were leaving already for financial reasons. It cannot be clearer.
The nurses only average around $25 per hour at GMH, the lowest salary in the nation for nurses and work under extremely difficult and at times hostile conditions. Nurses can leave at any time they want by applying to other jurisdictions, but this law makes it so we will lose and not replace nurses, who will be potentially recruited by other states.
Working conditions for nurses also need to improve on Guam. In my research, and discussions, I have learned bullying of nurses at GMH is NOT uncommon. I have reported this to the legislative Health Committee, to the Guam Board of Nurse Examiners and to the Guam Association of Nurses to no avail. No one responds or maybe prefers NOT to see this as an issue, but here we are talking about giving NURSES an exit off Guam to lose nurses, rather than fixing problems nurses face.
Bill 13 provides for what I project as a one-way street for losing nurses at GMH and on Guam in general and not being able to replace them unless with more foreign H1 nurses. There is nothing wrong with H1 nurses, except for one thing. It is said that they fear losing their jobs and being sent back home and not being able to support their families. That fear and concern raises serious questions about their ability to step up and assert themselves in a medical crisis. This is a large concern. I have witnessed this firsthand. We need to keep local hire nurses and pay them well. USING THE PANDEMIC TO SELL THE COMPACT IS INAPPROPRIATE AS THESE ISSUES HAVE BEEN HERE FOR YEARS.
Think of it for a minute. Will nurses from compact states want to come to Guam, be paid an exceptionally low salary, the lowest in the country, with a very high cost of living and work at GMH with all its problems or would they work at GRMC or a private clinic if they did decide to come to Guam? The answer is obvious to me. Our public hospital will get the short end of the stick and the poorest on Guam will continue to be put at risk with less nurses who are overworked or frozen in fear of being sent home if they make mistakes.
If this Bill was about Guam, not including GMH, I may feel differently, but as written, it will impact patient care for the most vulnerable on Guam at GMH where care is a challenge now. I do not want to see another patient go thru the chaos of confused nurses and lack of care that is now present at GMH that I personally witnessed and was documented by THE CMS FEDS report and that will only be made worse by this Bill and the potential loss of nurses.
It is also my opinion, if this Bill was passed, that the GUAM BOARD OF NURSE EXAMINERS should screen all nurses coming to Guam, even if members of the Compact states to protect the people of Guam. The medical examiners Board does that with compact doctors. Please do not rely on others to protect our loved ones on Guam.
I think the concentration should be on getting Guam nurses pay raised to a rate closer to the national average, $75,000, to attract more good nurses and pay them for their worth, rather than coming up with this special interest legislation that will not pay our nurses an equitable rate, who work so extremely hard on Guam.
Guam needs to attract good nurses by paying our valued nurses more and improving working conditions at GMH. It is almost embarrassing or even laughable to look at the compact list of states and see that we will be at the bottom for nurses’ salaries. It says volumes as to how we value health care on Guam, beyond talk and special interest legislation.
Doesn't that tell you something?
David Lubofsky is a resident of Tamuning, and the proud father of the late Asher Dean Lubofsky.