Health care training abounds post-COVID

LACONIA — Today, Lakes Region Community College will hold a health care open house and express admissions event from 4 to 6 p.m. for anyone interested in becoming a medical assistant or a licensed nursing assistant — two careers in demand to meet the region’s burgeoning health care needs.

In the wake of COVID-19, “health care facilities are getting close to crisis mode with a lack of skilled workers,” said Marty Pasquali, chair of the nursing department at LRCC. “Unfortunately, we hear every day from hospitals, assisted living facilities and other health care providers in dire need of skilled professionals,” Pasquali said last week in a press release.

The open house, which highlights LRCC’s expedited training that leads to expedited licensure, comes not a moment too soon.

For public and private nursing homes across the state, the shortage of direct care workers, including all levels of nurses, has reached critical proportions, curtailing admissions and shutting down hallways and wings in some facilities, according to nursing home advocates and administrators. Within the last month, three nursing homes in Maine have closed because of lack of staff.

Belknap County Nursing Home has closed hallways to consolidate and better serve 66 residents in a facility that ordinarily serves 94. The primary reason is lack of staff. St. Francis Skilled Nursing and Rehabilitation Center, which is run by New Hampshire Catholic Charities, did not respond to phone calls or emails.

Across the country, the coronavirus led to an adjunct pandemic in health care. Nurses retired or quit because of burnout or fears of contagion. Some questioned the safety of quickly-developed vaccines and did not want to put themselves or patients in harm’s way, according to nursing experts. At nursing homes nationwide, the rate of “voluntary quits” rocketed to a 20-year-high during COVID, said Brendan Williams, president of the New Hampshire Health Care Association, which represents New Hampshire nursing homes.

Hospital nurses are exiting to become school nurses, he said. Nursing homes can’t find enough full- or part-time licensed staff, and have been forced to pay exorbitant rates for traveling RNs, LPNs and LNAs, he added. While medical schools have witnessed an 18 percent uptick in applications nationwide, people are leaving the nursing profession faster than trainees are becoming available to replace them, health care workforce surveys show. The number of new LNAs licensed in New Hampshire varies greatly and unpredictably from month to month, according to workforce experts and the New Hampshire Board of Nursing.

The shortage of health care workers casts a worrisome shadow in New Hampshire, the nation’s second oldest state. Nursing homes, assisted living facilities, and hospitals are competing for all levels of staff in pool that has shrunk dramatically since the onset of COVID. Bidding wars have resulted to retain or attract nurses and nurse’s aides who can bargain or take better offers elsewhere. Nursing assistants are in demand at the same time there are fewer to go around.

“A lot of people are getting out of this field because it’s a lot of hard work, or because they’d rather sit at a computer and run stats” or work remotely from home, said Debra Poire, an LNA at Belknap County Nursing Home.

According to a Sept. 2021 survey of 1,183 nursing home and assisted living providers by the American Health Care Association and the National Center for Assisted Living, 86 percent of nursing homes and 77 percent of assisted living providers say their workforce situation has worsened in the past three months. Nearly every U.S. nursing home and assisted living facility (99 percent and 96 percent) are facing staffing shortages, and 58 percentage of nursing homes are limiting new admissions because of it. More than 70 percent of long-term care facilities report that lack of qualified candidates and unemployment benefits discouraging job seekers continue to be the main obstacles in hiring new staff.

Medical assistant and LNA training can be “a stepping stone to a career pathway. That’s the message that has to get out,” said Roxie Severance, a former New Hampshire nursing home administrator who now works in health care workforce development. 

The good news is that the Huot Technical Education Center, which offers career education to high school students in the Lakes Region, had a record number of students graduate in spring 2021 from its LNA training program — 17 compared to the usual eight to 12 during the past eight years, said Carol Brody, LNA coordinator at the center. COVID made on-site training a hybrid of working at facilities that weren’t under quarantine, and learning the same hands-on tasks at Huot, in accordance with requirements set by the NH Board of Nursing.

“We had a 100 percent pass rate” when it came to written and practical exams required for licensing, said Brody. Most went to work in hospitals, while one went to long-term care. Brody said the specter of COVID didn’t appear to discourage the newly-minting LNAs, who were “very excited and driven to get into nursing” and didn’t feel particularly vulnerable. Many were hired upon graduation by their job sites or through connections made at job fairs, she said.

Huot Center director David Warrender said health sciences remains the center’s largest program by enrollment, with current participation at 60 students compared to 66 in 2019. This year, 12 LNAs are completing the second leg of the two-year program, while 18 are in the second year of allied health, which includes medical assistant training. The medical assistant track has comparatively greater interest this year, he said.

At Lakes Region Community College, the fast-track LNA training is an extension of the program at Claremont’s River Valley Community College, which has been approved by the board of nursing. Upon passing written and practical exams, graduates receive temporary licenses that enable them to work right away.

Another option for newcomers to health care is the temporary health partner, or THP program which enables graduates of condensed online training to work under the supervision of LNAs and LPNs. THPs do much of the menial work involved in routine patient care, such as delivering food trays, changing sheets and transporting nursing home residents to activities. Started in June 2020 as an emergency measure, the state legislature recently passed a law making it a permanent program in New Hampshire.

Last week the state announced plans to hire a national recruiting firm to address New Hampshire’s critical health care staffing needs by encouraging licensed workers across the country to relocate here. Recruiters intend to comb college fairs and call on health care professionals directly to encourage them to practice in New Hampshire, which can offer paths for advancement, outdoor recreation and overall quality of life. American Rescue Plan funds will be used to help find doctors, nurses, social workers, nursing assistants and other direct service providers, said Lori Shibinette, commissioner of the New Hampshire Department of Health and Human Services.