Could apprentices help solve shortage of CNAs locally?

This article was originally published by Michaela Ramm on The Gazette on Nov, 2021.

The staff shortage within the health care industry — exacerbated by factors from the ongoing coronavirus pandemic — has hospitals and other health care organizations using new methods to recruit and retain medical professionals.

In some cases, that includes hiring candidates before they’ve even completed their medical training.

In an effort to alleviate the strain of workforce shortages within their facilities, dozens of Eastern Iowan employers have used an apprenticeship program through Kirkwood Community College in Cedar Rapids to hire certified nursing assistants.

CNAs hold a necessary role in hospitals, nursing homes and other health care settings by providing direct care to patients. But even as the demand for these workers balloons with the growing population of aging residents statewide, these professionals are hard to come by for many facilities.

Since the inception of Kirkwood apprenticeship program in late 2019, 16 health care employers across five counties have hired students as they complete their CNA certification.

That includes five employers in Johnson County and six in Linn County.

How the apprenticeship program works

Throughout the one-year program, these apprentices are not just paid salaries for their work on-site but the employer also financially supports the cost of their books, materials and state testing fees.

Salaries for CNA apprentices in Iowa range from $10.74 an hour to $17.99 an hour, according to Kirkwood.

“We’re finding people who want to get the skills, they just don’t have the means right away,” said Becky Weininger, workforce initiatives project manager at Kirkwood. “When you take that barrier away, you find people who want to grow in their careers.”

It’s individuals such as Jazmine Reynolds whom local employers are aiming to capture through this program. By hiring them even before they complete training, employers hope Reynolds and other apprentices translate into long-term employees.

Jazmine Reynolds was the first CNA apprentice hired at Mercy Medical Center in Cedar Rapids this past February.

After obtaining a degree in actuarial science and mathematics from Mount Mercy University, the 24-year-old from Cedar Rapids was working an office job with the intent to study for her actuarial accreditation. However, she found her desire for the work lacking, and decided to pursue a new career.

But with a young daughter at home, going back to school full-time was not a feasible option.

“I thought about going back to school to go into the health care field, but with my daughter I needed a job,” she said. “That’s when I found the Hallmar apprenticeship program.”

For the past nine months, Mercy has hired CNA apprentices to staff the Hallmar nursing home, the long-term care facility within the Cedar Rapids hospital.

CNA certification requirements

Requirements to receive CNA certification include 30 hours of online learning, 25 hours of labs at Kirkwood and 30 hours of clinical experience at the apprentice’s employer.

The program also provides courses to certify apprentices as geriatric specialists about three to six months following their CNA certification, providing a necessary skill set for long-term care facilities. Apprentices must complete 70 hours of online coursework to be certified.

Reynolds officially became certified as a CNA in early May and has worked at Hallmar since.

“It’s been amazing so far,” she said.

Reynolds plans to stay in health care for the foreseeable future. She is planning to apply for the Mount Mercy University nursing program for this upcoming fall semester.

More employers turning to apprentices nationally

The state Workforce Development job board has hundreds of local health care jobs posted, including dozens of openings for nursing assistants and nearly a hundred openings for a registered nurse in the Cedar Rapids area alone.

Workforce challenges have plagued Iowa’s health care organizations for years, but the ongoing pandemic has created a new hurdle in that effort. Turnover rates are at the highest ever, both in Iowa and nationwide, experts say.

“We can’t take care of people without nursing assistance and dining services and housekeeping,” said Kim Bergen-Jackson, administrator for Oaknoll Retirement Community in Iowa City. “Across the board, we need all of those front line positions.”

More industries have been turning to apprenticeship programs to fill gaps in staffing. Even with the 12 percent decline in new apprentices compared to fiscal year 2019, the U.S. Department of Labor says fiscal year 2020 is the third-highest enrollment for registered apprenticeship programs nationwide.

The federal agency estimates there are roughly 26,000 registered apprenticeships across the country, with more than 636,000 apprentices obtaining skills through these programs.

However, the positions in construction, manufacturing, transportation and warehousing vastly outweigh other industries, according to data from the federal Department of Labor. There are about 6,800 apprenticeship positions in health care and social assistance for fiscal year 2020, with nursing assistants representing the top share nationally.

In Iowa, there are about 7,700 active apprentices across 807 programs, according to the Department of Labor. In addition, more than 1,500 Iowans have completed an apprenticeship program.

About 100 applicants have been accepted since Kirkwood’s CNA apprenticeship program launched in late 2019. Of those, roughly 50 students are “active” in the program, according to the college’s Weininger, with 10 completing course requirements and receiving their CNA certification.

Mercy Medical began hiring apprentices earlier this year when it received a $183,560 grant through the Coronavirus Relief Registered Apprenticeship Incentive Program for Healthcare Employers, a state-funded program through Iowa Workforce Development.

So far, 10 apprentices are enrolled in the program through Mercy Medical, with seven completing their certification. Each apprentice is required to work two years at the facility as part of the program.

“It’s been exciting for us,” said Tawnya Salsbery, Mercy Medical senior director of post-acute services who oversees the CNA apprenticeship program. “We’ve had more applicants in the last six months than had in the last year.”

The demographics of applicants range from high school students to individuals pursuing a second career. A number of apprentices also have been those who worked in health care in other countries before immigrating to the United States.

Apprentices hired at Meth-Wick Community, the senior living center in Cedar Rapids that began collaboration with Kirkwood last year, have been high school students who plan to pursue other degrees once they graduate, said Samantha Ryan, an administration nurse.

“We’re looking for someone who’s willing to learn, and who’s willing to learn the right way to do things,” Ryan said.

“We found these high schoolers who were willing to work a lot of hours that we were struggling to fill, such as nights and weekends.”

The facility currently has two apprentices. Former apprentices who since have moved on from the program often come back during breaks or over the summer to work shifts at Meth-Wick, Ryan said.

Not the only step in addressing workforce shortages

But finding viable candidates has been difficult, according to Bergen-Jackson, administrator for Oaknoll in Iowa City. She and administrators with six other nursing homes received a grant to hire 50 CNA apprentices across Johnson County — but so far have only managed to hire 26 candidates.

Of those, Bergen-Jackson said 12 have completed the apprenticeship program.

“It’s really been a struggle to figure out how to create the pipeline of people interested in and capable to be seen” as candidates, Bergen-Jackson said.

Bergen-Jackson theorizes the pandemic also has discouraged potential candidates from pursuing health care careers, particularly as more medical professionals grapple with the mental and emotional strain from responding to the ongoing coronavirus pandemic.

An April 2021 Kaiser Family Foundation survey found that 55 percent of front-line health care workers reported burnout, with the highest rate — 69 percent — reported among younger staff between the ages of 18 to 29.

The poll also learned that 29 percent of health care workers have considered leaving the medical field.

Still, officials with local long-term care facilities involved with the Kirkwood apprenticeship program are hopeful. According to the Labor Department, 94 percent of workers who complete an apprenticeship are retained in employment six months after completion.

“I think the apprenticeship program is a great step toward helping with the workforce shortage,” Bergen-Jackson said. “I don’t think it’s the only step.”

Kirkwood officials are exploring the next iteration of medical apprenticeships and determining the feasibility of opening the program up to other positions, such as surgical technicians and licensed practical nurses. Weininger said they are speaking with employers to identify their needs before moving forward with new programs.

“At Kirkwood, we’re thinking there will be a long-term need for this type of program to help keep the pipeline going,” Weininger said.

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