Anyone who has spent even a little time in a nursing home or hospital has seen whose hands do the essential feeding, dressing, cleaning and comforting. Most often, those hands belong to a certified nursing assistant, or CNA.
The number of CNAs working in Rhode Island nursing homes and hospitals has plummeted in recent years to “crisis levels,” in the words of one nursing home owner.
The reasons are familiar: fear and illness from COVID-19, an open job market, competitive wages elsewhere, preference for online work and shortage of public money to help pay for nursing care.
Along with other states, Rhode Island is fighting to retain and train CNAs, whose numbers dropped from about 10,000 before the pandemic to about 8,000 now, said John Gage, CEO of the Rhode Island Health Care Association, an advocacy group for the industry.
The problem is serious. The state has about 75 nursing homes now – down from more than 100 just two decades ago – and some have been closing wings or beds because of a shortage of staffing. Five nursing homes have closed in the state since the pandemic began.
At the same time, the lead edge of America’s baby boom cohort needs long-term care, creating a “silver tsunami” that could swamp these facilities, said Shaun Cournoyer, administrator of the The Friendly Home in Woonsocket.
CNAs are the “backbone of this facility,” said Cournoyer. “When a family is distraught about a loved one, we tell them, ‘You are one person doing this job; we have 165 of us.’ ”
Among them is Kylie Deguire, 23, who started working at Friendly Home in 2016 as a housekeeper, then a unit assistant – making beds and taking meal orders. She took her training and began working as a certified CNA this year. Next February, Deguire will begin her studies for a degree in nursing.
“I’ve gotten to love a lot of the residents over the years,” Deguire said. That included a “little, old guy” who once worked as a drummer and loved music. The two of them connected over their love of music, and Deguire at one point gave the man a CD player, Elvis CDs and headphones.
“He had a huge impact on my wanting to be a nurse,” Deguire said, as did supportive co-workers. “I would go home at the end of the day and know I had done something that helped make their day a little more special.”
Still, the $14- to $20-an-hour wages paid to CNAs in Rhode Island compete with other service industries that require much less training and outlays for uniforms and equipment.
[caption id="attachment_448991" align="alignleft" width="425"]
CHECKUP: Aracelys Colon, right, a certified nursing assistant, checks the pulse and blood pressure on Gail Dubeau, a seven-year resident at The Friendly Home, a nursing and long-term care facility in Woonsocket.
PBN PHOTO/MICHAEL SALERNO[/caption]
Healthcentric Advisors LLC in Providence is a nonprofit consulting organization for health care providers. It was approved in January to begin operating a Work As You Learn program using a federal grant, administered through the state under the Nursing Home & Long-Term Care Facility Strike Team and Infrastructure Project. Rhode Island got $298,000 in federal funds this year, says Gail Patry, chief program officer.
Concurrent with the federal grant was the approval in Rhode Island to use CNA Online, an online course that offers the classroom portion of a CNA’s training.
Traditionally, the required 80 hours of classroom training and 40 hours of clinical training were done by registered nurses in nursing homes or other businesses, such as community colleges. Many nursing homes have had their own training programs up and running for a long time, but these programs are costly in staff time and money.
Moving the classroom training online is an enormous cost saving; it also eases the problem of a shortage of registered nurses to do the teaching. Using CNA Online, nursing homes typically hire a new employee who takes the course at no charge while also doing clinical training and performing backup work at the nursing home until training and certification are completed. A newly trained CNA is usually expected to give a year’s service to the nursing home.
Using the federal grant, Healthcentric pitches in $700 per CNA trainee to every approved facility doing training, whether or not the training uses the online component, Patry said. The company also uses grant money to help CNA trainees pay for uniforms, equipment, the certification exam and, in some cases, vouchers for travel to work and for child care.
Patry said Healthcentric hopes to support the training of 155 new CNAs with the initial round of the Strike Team grant. Patry isn’t sure if the grant will renew, but if the results are positive, her organization will go to the R.I. Department of Health and make a pitch for more funding.
Community College of Rhode Island offers a 12-week course of online and in-person training with day, evening and hybrid time frames in a number of locations. CCRI also works with entities such as Eleanor Slater Hospital, the Rhode Island Veterans Home in Bristol, Real Jobs RI, the Rhode Island Health Care Association, Care New England Health System, and Lifespan Corp. to offer employer-sponsored, full-time jobs. Tuition is free for all those who qualify. Once licensed, full-time positions with benefits begin.
The work to recruit new CNAs is ongoing at many nursing homes. Cheryl Picard, administrator at the South Kingstown Nursing & Rehabilitation Center, said she and her assistant sometimes feel like their “whole lives are spent trying to get bodies” into the jobs.
