Overcoming the workforce shortage is a factor in maintaining quality. Overall employment of nursing assistants and orderlies is projected to grow 11 percent from 2016 to 2026, which is faster than the average for all occupations. As the baby-boom population ages, more nursing assistants and orderlies will be needed to assist and care for elderly patients.
Nursing assistants are the major occupation responsible for providing patient care of a paraprofessional nature to chronically ill, disabled, and elderly persons in nursing centers, assisted living or community-based settings as well as at home. Faced with an aging population and a material shift of patient care to non-hospital venues, the Nation is experiencing an unprecedented demand for individuals with the training and experience needed to provide such care. There is a high turnover rate associated with these occupations, the result of a variety of factors relating to job satisfaction such as low pay, lack of a career ladder, and burn out. Consequently, the supply of these individuals, while continuing to grow, has been slipping relative to demand, a situation likely to continue well into the future.
Because of the importance of this segment of the health workforce in meeting the care needs of an increasing percentage of the population, the National Center for Health Workforce Analysis (NCHWA) in the Health Resources and Services Administration’s (HRSA) Bureau of Health Professions (BHPr) has commissioned and directed a study on the shortage. The study concludes that informed workforce planning is needed to document the extent of existing shortages in these occupations and thereby assist providers in addressing them, as well as to assess the impact of present and future initiatives to balance supply and demand.
With the projected shortages and the immediate need, what can a provider do now to fill the vacancies? FHCA member centers can start a two-week Test Prep class so that the participants can challenge the CNA test and become certified. The facility must send the RN instructor to one of the CNA Train-the-Trainer classes to become qualified to teach the participants.
It is important that when the facility recruits class participants, they focus on candidates that have had some type of caregiving experience such as working at an assisted living center or taking care of a relative. The facility should develop their plan, such as pay scale on hire, and be able to answer questions such as; will the person be allowed to take the test more than once, what will the employee do while waiting for the results and what will the pay be once the candidate becomes certified. It is important that the candidate’s duties while waiting for the test and certification do not include anything that requires hands-on interaction with the resident. The candidate will have to be “hands-off” until they are certified. They can act as hospitality aides making beds, delivering meal trays, welcoming new residents and performing other duties that will free of time for CNAs.
Once the facility is ready to host their first class, there are some important tips for the successful timing of the candidate’s test. Here are the tips:
- The nursing center should process the test application during the first couple of days of the Test Prep class so that the test date will be assigned shortly after the end of class.
- The employee in the Test Prep class must be background screened prior to entering resident care areas. When signing up the employee up for the CNA test, it is important on the Prometric application that the applicant marks the attestation box regarding live scan. This enables the entities involved to release information. Otherwise, they will be instructed to have ANOTHER live scan performed which will delay the test.
- If the center files a paper application, DO NOT make multiple copies from a photocopy machine. Instead, try printing multiple blank applications directly from the website. The applications have barcodes, so if you print one copy out and go to the copy machine to make multiples, this will dilute the barcode and delay Prometric in processing the test request.
- If the center completes the online application, print it out once completed and keep a copy.
- Make sure you are using the MOST recent application. The newest version has the required health questions. If an applicant answers “yes” to any of the health questions, then an explanation letter needs to be sent to the Board of Nursing for review along with recent supporting documentation from a health care provider. For example, if an applicant has bipolar disorder, depression, ADHD or any other mental health diagnosis that requires medication, then the applicant needs to obtain from their health care provider on letterhead so BON can verify legitimate health care provider. The Board also needs a statement from both the health care provider and the applicant that the applicant is stable, competent, and compliant with a treatment plan and they are safe to practice or work as a CNA. So, for any “yes” answer in the health field portion of the application, these two components will need to be completed and included. The application and health care provider statement will need to be reviewed by the Board of Nursing to determine eligibility for CNA testing. The facility will need to explain this to the applicants before they complete the application so they can obtain the needed health care statements and prevent a delay in the application.
- If the nursing center is submitting a check for payment for multiple applicants, please include the names of the candidates in the memo section so that Prometric can cross-reference payment to clear the applicant.
Skilled nursing centers can make a big impact in the nursing assistant shortage. Once the center has successfully taught the materials and trained the applicant on the proper clinical skills so that the candidate can pass the CNA test, it’s time to move to the next tip for success. It is important that the nursing center continues to nurture the new caregiver and give them the support to continue to grow in skills and confidence. Team them up with a seasoned, quality mentor so that they can advance in their knowledge and skillset. Celebrate the win with the new CNA! Make sure they understand that they have entered a gratifying career where they can make a difference…and that it is NOT “just a job!”