Among the more controversial bills that Gov. Dannel Malloy recently signed into law is one that allows advanced practice registered nurses to practice independently after collaborating for three years with a licensed Connecticut physician. The measure had been at the center of a clash between healthcare professional groups.
The Connecticut State Medical Society rallied against the bill, claiming that it opens the door to potentially inadequate care for patients.
“It is fundamentally an issue of patient safety and health-care transparency,” said CSMS President Michael Saffir, MD in a statement. He asserted that patients would be better served by a physician-APRN team approach to care.
“Studies have shown that the team-based model, where physicians and APRNs collaborated to provide coordinated patient care, is the most effective approach to quality patient care,” Saffir said. “This bill moves in the opposite direction, by removing collaboration and fragmenting the care team. It is difficult to see how this change will improve patient care, and it does nothing to address the need for health-care transparency in Connecticut.”
Of primary concern among CSMS members were nurse-practitioner educational training, practice oversight and how the three-year collaboration with a physician would be structured.
The bill, titled “An Act Concerning the Governor’s Recommendations to Improve Access to Health Care” (SB 36) passed both the House and the Senate in April. CSMS called on Malloy to veto the measure when it got to his desk. However, the governor signed it in late May.
That was good news for Laima Karosas, health policy chair of the Connecticut Advanced Practice Registered Nurses Society (APRNS).
“It’s a wonderful thing that happened,” says Karosas. “We are exuberant because this is a long time in coming. I think there was an overwhelming cry out there where [people said] ‘You know what? We do need all hands on deck.’”
Karosas, who is director of the nurse practitioner program at Quinnipiac University’s School of Nursing and is a clinical associate professor of nursing there, believes fear of competition might be a contributing factor for at least some resistance to the bill.
“The scope of practice remains the same, so I think their fear is unfounded,” she says. “I think the places where we work and the services we provide are just to a different clientele.”
Plus, nurse practitioners who are independent will continue to work in concert with a physician, Karosas says.
“I want to have someone I can go to [to consult with],” she says. “I see us as very complementary. I think we need to support each other. It’s a very fragmented system we have, and nurse practitioners are part of the solution.”
Karosas adds that the training and educational requirements for nurse practitioners at Quinnipiac are substantial and she does not foresee any changes because of the bill.
“No, I don’t think we’ll change at all,” she says, adding that “the world has changed tremendously” in terms of healthcare delivery needs. Through the Quinnipiac nurse practitioner program, she says, “I also think we’re keeping up with the times.”
Connecticut residents seeking work might want to consider a job as a retail salesperson, operations manager or customer-service representative. Those are among occupations in the state with the greatest number of positions, according to the Department of Labor’s Office of Research. The top-rated job, retail salesperson, boasts more than 50,000 positions, and maintains 1,936 job openings each year, according to DOL. The average annual wage is $27,453. Annual pay is much higher for accountants and auditors: $75,185. However, there are far fewer yearly job openings in this field, 528. State residents might want to reconsider starting a career in fields in which the number of jobs is expected to decline. This category includes U.S. Postal Service workers, word processors and typists, and architectural and civil drafters. For more information visit the DOL website at ctdol.state.ct.us.
Over the past 26 years, about one-fifth of Connecticut’s working population has held a part-time job, according to the Connecticut Economic Digest. In a May article, author and Department of Labor Economist Matthew Krzyzek notes that reasons for securing part-time work vary from inability to find full-time work to medical limitations to school enrollment to family/child-care obligations. Data from 2012 show that 69.5 percent (266,000) of the state’s 383,000 part-time workers were female. Part-time was defined as less than 35 work hours per week. Krzyzek writes that the lowest number of part-time hours worked were in the following sectors: leisure and hospitality, other services and education and health services.
NEW HAVEN — Elm City workers far surpass their peers wide nation when it comes to biking to their jobs, according to the U.S. Census Bureau. Locally, 2.7 percent of commuters ride a bicycle to work, compared with 0.6 percent of workers nationally, the bureau. While commuting via car, van or truck remains the most popular choices of transportation, a substantial proportion of workers get to and from their jobs either by taking public transportation (13.1 percent) or walking (12.4 percent). The average travel time to work locally is 22.4 minutes, according to the report.
“Through efforts to increase local transportation options may U.S. cities have contributed to the increase [in] the number of people who bike to work,” states Brian McKenzie, a Census Bureau sociologist who specializes in commuting, in a bureau release. “This information shapes our understanding of how people get to work, and how this may change across cities in the coming years.”
Employment in Connecticut small businesses with less than 20 employees increased by 0.06 percent in May, according to Intuit’s May Small Business Indexes. That’s about one-third of the employment rise nationwide, which was 0.17 percent, according to the report. The report also shows that the average monthly pay of hourly employees rose in May by $17, or 0.6 percent, over the previous month. They were compensated the equivalent of $2,804, according to the report. But small-business employees also worked more hours in May, up 0.8 percent, or about 48 minutes, for an average annual equivalent of 112.3 hours.
A dwindling labor force and decreased economic expansion indicate “slower growth” in 2014 and 2015, according to Daniel W. Kennedy, senior economist with the Connecticut Economic Digest. In an article for the June issue, Kennedy writes that what initially appear to be positive economic directions in fact could be the result of negative occurrences.
“[A]fter increasing in March, 806,000 left the labor force in April, making a shrinking labor force the principal reason for the declining [unemployment rate],” writes Kennedy. “And the first estimate of U.S. GDP for 2014 Q1 showed that U.S. economic growth rapidly decelerated.” He goes on to blame “the bursting of the housing bubble” and its “persistent drag on the economy” for the sluggish economic recovery. Hartford and Bridgeport were hit especially hard, he notes. Kennedy also believes that as the economy recuperates, the greatest job gains will be in the education-health care and social assistance sector and the leisure-hospitality sector.
WETHERSFIELD — “[A] pattern of continuing job growth for Connecticut” is what the Department of Labor’s Office of Research says the latest labor-situation numbers show for April. Nonfarm jobs increased by 2,200 for the month, and unemployment dropped slightly to 6.9 percent. “Both the establishment and household employment surveys are pointing to an improving labor market going forward for the state after extreme winter volatility,” said Andy Condon, director of the Office of Research.
Sectors that gained positions in April included transportation and public utilities (800), education and health services (700), leisure and hospitality (700), financial activities (500), construction (500) and government (400). Those sectors that lost jobs in April included professional and business services (-600), other services (-400), manufacturing (-200) and information (-100).
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