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CNA Shortage Spurs Creativity in Waterville

Lakewood hums with activity as residents gather in the common room to enjoy a guest musician, meet in the communal kitchen to bake cookies and share a laugh, or take a short stroll down the hall to freshen their “hair-do” at the in-house salon. Lakewood is a continuing care center affiliated with EMHS member, Inland Hospital. Both facilities are located just steps from one another in the heart of Waterville. This continuing care center provides Alzheimer’s and dementia care, long-term care and skilled nursing care, and rehabilitation services—each clinical unit uniquely addresses the needs of an aging population.  
 
“We call them ‘neighborhoods’ rather than units,” explains Megan Stiles, a Lakewood administrator. The term neighborhood more accurately describes the personal, familial atmosphere at this award-winning facility, which boasts a five-star rating with the Centers for Medicare and Medicaid Services.
 
Hiring and keeping qualified, passionate staff is a top priority for Megan and co-administrator, Shannon Lockwood. Unfortunately, certified nursing assistants (CNAs) and other clinical staff are getting harder to come by in Maine. CNAs are caregivers who provide assistance with patients’ basic needs and activities of daily living under the direction of a registered nurse. Duties include everything from bathing a patient, brushing their teeth, and applying makeup if requested, to simply listening to a patient’s concerns—the job is as tough as it is rewarding. At Lakewood, it has become increasingly difficult to offer workers wages that are competitive with other healthcare settings or even with other entry-level positions offered at retail and fast food chains.
 
The first Lakewood graduating class of CNAs pictured at their August 2016 ceremony.As a result of the statewide staffing shortages, Megan says Lakewood has been forced to turn to expensive solutions. “We use agency temporary staffing to keep up with our patient demand—it’s become a real financial burden.” As time went on, it became clear Lakewood needed to get creative and design a new way to cultivate their own workforce. In early 2016, Lakewood, the Maine Department of Labor, and Mid-Maine Regional Adult Education created a program together that would connect job seekers, through the Department of Labor’s Career Center, to Lakewood’s new 12-week CNA training program. Candidates are pre-screened and trained on the soft skills that are needed in any work environment and given an opportunity to set out on this new career path. Attracting young and experienced workers alike, the program’s inaugural class of 12 graduated in August of 2016. The audience at this formal graduation was filled with family members, Lakewood staff, and even Lakewood residents in attendance, cheering on the new members of their Lakewood family. They expect to graduate a third class this coming June.
 
Lakewood’s second graduating class of CNAs, and proud audience members, listen to a guest speaker as they are being honored at their January, 2017 ceremony.Megan is hopeful that Lakewood’s culture and career growth opportunities are enough to retain these freshly minted CNAs. “We provide a CNA career ladder,” she explains. “Employees are able to take a CNA II course and are eligible for a raise. Six months after that, they can apply to be a CNA level III and again, see another rate increase. With tuition reimbursement available, we encourage staff to continue on their educational journey. Some seek careers as registered nurses or x-ray technicians—there are so many possibilities.”
 
Word of this training program reached Brittany Gould, inpatient and emergency department nurse manager at EMHS’ Greenville member hospital, Charles A. Dean Memorial Hospital (CA Dean). Brittany said the idea for a training program actually came from members of the community asking about a potential CNA class. Brittany sat in on Lakewood’s CNA classroom portion of the training program taught by Chris Miller, Lakewood staff development coordinator, to learn their approach. Brittany shares, “We’re now partnering with Greenville Adult Education to teach our first class, which began in February. We expect them to take their final exam the last week in April.” With a modest class size of two, Brittany is happy with the candidates selected for the program. “One of the women is a unit helper and is interested in directly caring for patients. The other worked in marketing and took this opportunity to start a whole a new career. They are wonderful and our patients love them.”
 
The Lakewood administrators and John Dalton, Inland Hospital president and EMHS senior vice president, recognize their CNA program is meaningful, yet a small drop in the bucket in terms of solving Maine’s clinical workforce shortages. “At a time when we are all competing for the same workforce, it’s more important than ever to live up to the promise of being an employer of choice. As a system, we are working together with our community partners, universities, community colleges, and the Maine Department of Labor to bring a long-term solution to clinical staffing shortages throughout the state.”
 
The rise in clinical workforce shortages is a culmination of a declining state population, an aging clinical workforce, and a scarcity of instructors at our educational institutions to meet the enrollment demands, among other factors. Leaders in Maine continue to actively work on finding sustainable solutions to this urgent problem. In the meantime, EMHS members have taken to doing what Mainers do when faced with a challenge—they innovate.