Training Health Care Workers in a Crisis

Marjie Laizure, “Covid Nightingale”, 2020, oil on panel, 16”x12”

The pandemic has decimated Minnesota’s health care system in many ways. There are now 40,000 unfilled positions across the state for mostly entry-level health care assistants. In the short term, state agencies are offering educational incentives to quickly train new workers.

In a January virtual conversation with Minnesota commissioners of employment and economic development, higher education, and secondary education, discussion centered around how to provide free training to people seeking entry-level work in health care. The goal is to make it easier for youth, and adults seeking new opportunities, to train at little or no cost — whether or not students see it as a long-term career choice.

The state’s Office of Higher Education is launching a grant program to provide a tuition-free pathway for students at public institutions pursuing a credential or diploma in high- need career areas — health care is a top priority. A second initiative provides free training to become a Certified Nursing Assistant (CNA), including funding for books, tuition, and uniforms. One thousand nursing assistants will be trained in the next few months.

Several women from the Mayo Clinic Health System were on the January call. “On a daily basis I see the intense need for health care workers, as well as for pipelines to attract more nurses for training and employment,” says Renae Wolf, Nursing Placement Coordinator for Mayo. “We need to be innovative and creative with our collaborative partnerships to build the nursing and health care pipeline for the future.”

The Mayo Clinic’s Bridges to Health Care partnership brings together adult education centers, community colleges, and health care employers to offer basic skills education as well as career-specific training and support services.

Laura Bowman, regional director of strategic partnerships and community relations for Mayo, adds: “We also need to continue focusing on diversifying our workforce, eliminating racism, and achieving health equity. We especially need to recruit talent that is reflective of the people we serve, and we are deeply committed to that process.”

Heather Mueller, commissioner of the Minnesota Department of Education (MDE), indicated the MDE has started to build health care career preparation into school days. Apprenticeships are available with doctors, nurses, and hospital administration. Starting in ninth grade, students have the opportunity to begin earning a CNA certification.

Members of the National Guard have been also trained as certified nursing assistants and temporary nursing aids since November to fill some of the needs.

Low Pay Meets Burnout

Bowman noted that it is positions at the lower wage levels that have the greatest gap. According to Minnesota Housing Partnership, home health and personal care aid jobs have an expected demand growth rate of 32 percent, yet they earn on average $28,562 annually, meaning home ownership is out of reach.

An affordable average rent requires an annual salary of about $3,000 higher. With transportation and child-care needs, these low-wage jobs are unsustainable — especially for single parents.

In a second related group conversation in January, Jodi Harpstead, commissioner of the Minnesota Department of Human Services, pointed out that caring professions represent 15 percent of the Minnesota workforce, serve 30 percent of the population, and earn wages that are 27 percent below the average Minnesota wage.

Sue Schettle, of the Association of Residential Resources MN, says that disability services had high turnover rates before the pandemic, and it has gotten worse. “It is beyond a crisis. We are turning away people who need services. We simply don’t have enough staff.” The pay for professionals who support people with disabilities is $14–16 per hour on the high end.

Mary Turner, president of the Minnesota Nurses Association, says, “We need to make [the caring professions] a great place to start your career. We cannot do that when they are making the amount of money they are now.”

The intensive care unit at North Memorial Hospital in Robbinsdale, where Turner works, has lost 37 percent of its nursing staff. The smaller the staff levels, the more burnout and fatigue sets in, leading to additional departures.

As one way to retain workers, Turner advocates for creative staffing methods. “Rotating shifts are killing young nurses [because of burnout]. There are so many holes; the ship is sinking,” she says. “[Health care companies] need to go to each individual nurse and say ‘What can we do to make a difference?’ We need to do whatever we can to make them successful at their schedule[s].”

In some regions of Minnesota, Turner says nurses have been scolded by their communities. “[They are being told they] need to do better.” That is the opposite of the attitude people should have, she says.

“One of the best ways we can show gratitude to health care workers right now is to limit the transmission of Covid-19 by getting vaccinated, masking, and staying home when you’re sick,” adds Diane Rydrych, acting assistant commissioner of the Minnesota Department of Health. “Support them by keeping yourself out of the hospital.”

Editor’s Note: In mid-January, Governor Walz announced an expedited $83 million in Medicaid funding to help keep staff at nursing homes and care services for people with disabilities, and that he would direct $40 million in federal relief toward hiring 350 health care workers (if available) for two months. At the time, more than 1,000 workers at HealthPartners and more than 800 workers at CentraCare were out sick with Covid.

At the end of January, various state commissioners signed their names to a news release that indicated:

Almost 400,000 Minnesotans work in the health care sector. “However, the industry faces a crisis: an unprecedented health care workforce shortage that’s impacting thousands of Minnesotans at a critical point in our fight against the pandemic. Some emergency room patients can’t be moved to a hospital room because there aren’t enough employees available to open more beds. Older Minnesotans struggle finding long-term care because there aren’t enough staff to take care of them. The same shortage is affecting people with disabilities living in the community.”

  • With nearly 40,000 vacancies, unfilled health care positions account for nearly one in every five job vacancies in Minnesota.
  • Minnesota is projected to add 60,000 new health care jobs over the next decade.
  • To find out more about working in health care, call 651-259-7500.
  • An emergency fund of $50 million is being distributed by the Minnesota Department of Human Services as retention/hiring bonuses for thousands of nursing home workers, increased payment rates for personal care assistants who help individuals in their homes, and higher Medicaid reimbursements to providers.
  • Partner organizations are offering free CNA training. Thus far, 558 Minnesotans had enrolled in this training.
  • 400 Minnesota National Guard members are assisting at skilled-nursing facilities experiencing severe staffing shortages; 200 registered nurses and respiratory therapists are working 60-hour weeks for two months to support hospitals overwhelmed by COVID patients.