Even in the current COVID-19 crisis, we still have options to boost America’s health and allied health workforce. This means during the infections and after it.
That means having people on the front line or supporting it doing their training at the same time. And yes, they’d need appropriate personal protective clothing and gear and risk mitigation training.
That’s what work-based learning systems have been doing for a long time. Formalizing the effort using the apprenticeship model works best as you earn while you learn in the workplace and all without being lugged with a colossal college tuition debt. It’s hands-on training and work experience to gain valuable skills specific to the workplace and certifications to document them. Plus, apprentice grads earn very respectable and liveable salaries.
Before the current crisis, more than 71 million active U.S. workers lacked college degrees, according to a new report from Opportunity@Work and Accenture. They’d gained their skills through alternative routes, that is a flexible training model. In health care, it’s not just doctors and nurses who learn much by doing. Plenty of other health roles can be learned mostly on the job, again best through a formal apprenticeship program.
The Accenture report shows that workers in personal care and services are skilled enough to transition to the healthcare and support job group. New apprenticeships are helping make that happen. Apprenticeships in health care were among the 700 programs in “newer fields” created in the past two years.
Much groundwork has already been laid on marrying apprenticeship programs up with skills needs in the health care sector. The Urban Institute in D.C. has developed a full competency-based framework for a range of health care occupations for registered apprenticeships. They included community health worker, medical assistant, medical records and health information technicians and medical coders, phlebotomists (they take blood samples for tests, transfusions, donations or research), sterile supply technicians, and surgical technologists. The U.S. Department of Labor funded the work.
And increasingly, we’re seeing a range of healthcare apprenticeships harnessed by not only school leavers, but also those yet to graduate.
A health care apprenticeship program has been launched by Trilogy Health Services in Kentucky. The company provides nursing and residential care services. Trilogy takes on high school students each year into new jobs they’ve created. Trilogy will pay the students and cover the costs of training so they can get their industry-recognized credentials. What sort of jobs are they training for? It’s what the company wants - nurse aides, dietary aides, environmental services helpers, guest relations associates, life enrichment associates and maintenance assistants. Training and growing these employees from high school onward leads to increased job satisfaction, which translates into lower turnover and better care for Trilogy’s residents.
I’ve been aware of the skills shortfalls and mismatches in nursing-related health care employment for much longer. An Urban Institute report on that very subject was completed for the U.S. Department of Labor, Employment and Training Administration. In its executive summary, the report said even back then concerns about a nursing shortage had existed for decades. It forecasted the situation would get more severe by 2012 thanks to an older population in the U.S. It’s not any better now.
The report said there wasn’t a single silver bullet, but it’s cheaper and faster to return a trained nurse to the profession rather than train novices. The Urban Institute recommended tapping into the current pool of health care workers to train them for nursing profession roles. Those roles include registered nurses, licensed practical nurses (one-year trained) and nurse aides.
We’ve seen some great work in pockets throughout the U.S. I point to Alaska’s three health-aide training programs, for example, which help remote communities with medical, dental, or behavioural health services. Trainees learn by distance education and have specialists oversee and mentor their work through telehealth video technologies. The infrastructure is there now to leverage to boost healthcare and related positions in these regions, some of which only have boat or small aircraft access.
And as NPR reports, across the U.S., this country is getting creative to seek out and hire more health workers to tackle the COVID-19 crisis. It’s all about surge staffing. The Federation of State Medical Boards is letting hospitals peek at its database, particularly to vet retired and out-of-state physicians who may wish to volunteer. As well, the federation may fast track senior medical students’ graduation.
What can the US learn from International efforts?
Overseas, the Australian Health Practitioners Regulation Agency is also working on fast-tracking registration for medical practitioners, nurses, midwives, paramedics and pharmacists. The Australian Government also pledged $2.4 billion to help do that and pay for telehealth, among other things. A report by global consultancy firm, PWC, suggests workforce re-allocation should also be considered to boost numbers in healthcare. And the Prime Minister, Scott Morrison, has just lifted restrictions on 20,000 international nursing students so they can now work 40+ hours per fortnight in the health system. Australia put out a whole-of-government emergency response plan for the health sector back in February, too. And to sure up their workforce, they announced on 31 March a plan to merge public and private hospitals, bringing 100,000 healthcare professionals into the public system. Meanwhile, in the U.K., more than 7,500 former nurses and midwives have joined an emergency register for work, thanks to the Nursing & Midwifery Council.
Get the sense there’s a lot of roles at play here? Just like doctors and nurses, healthcare workers get the satisfaction of supporting people every day - sometimes even saving lives, which is something very few of us will ever experience. The message came home to me when my then-toddler son couldn’t breathe without difficulty as my family and I were staying in a Pennsylvania hotel. The paramedics stabilized my son, before taking him to a hospital where he recovered in a few days. It was croup, which can constrict airways and threaten life.
In my later interviews with two members of an air medical ‘strike team,’ I learned that paramedics do everything that emergency medical technicians do. The paramedics didn’t learn their life-saving skills at a traditional nursing school but through on-the-job experience and many hours of certificate training.
The health care sector is multi-faceted and complex. Let’s pivot off tried-and-true training models such as apprenticeships to ensure there’s a pipeline for this workforce to tackle the COVID-19 health crisis and beyond.