WHITE BEAR LAKE, Minn. — At the bedside of life-size mannequins, small groups of Minnesota National Guard members took turns asking their faux patients how they were doing, if they could get them a cup of coffee or help them to use the bathroom.
One by one the trainees at Century College practiced carefully turning the patients on their side, changing their bedpans and helping them to sit up.
The 10 are among hundreds of Minnesota National Guard members this week taking 75-hour training to become certified nursing assistants and temporary nursing aides. At 16 Minnesota State College campuses around the state, the Guard members learned about care protocols and practiced the techniques on mannequins and fellow guardsmen.
They'll need to harken back to the lessons starting on Dec. 5, as Guard members swap their fatigues for scrubs and take their training into the field to relieve staff at dozens of long-term care facilities that have requested help as they manage a caregiver shortage.
“We are at crisis levels," said Kari Thurlow, LeadingAge Minnesota senior vice president for advocacy. "We have open positions and our staff is exhausted so having the ability to have the National Guard come in to provide relief for two, potentially up to three weeks will provide much-needed time as providers try to work each and every day for permanent workforce solutions."
State health officials last month announced that they would activate 400 Minnesota National Guard members to fill gaps in long-term care facilities around Minnesota. The move came as the long-term care industry reported a 23,000-person shortage in its caregiver workforce, that's about 20% of the workforce at full capacity.
The gap prevented more than 70% of Minnesota nursing homes from admitting new residents, industry leaders said.
Being short a caregiver or two is a headache enough for a facility. It means others work longer shifts and more of them and noncaregiver staff may get pulled in to help with jobs that are not their own.
"We’re in the business of taking care of seniors and you don’t get to limit hours, you don’t get to cut back on services, you can’t close for a day," Thurlow said. "And so the choices that we make under this particular circumstance, it means we are not caring for, we’re not accepting admissions for as many seniors as need help right now."
The shortage causes bigger bottlenecks, too. Without enough places to discharge patients who no longer need intensive or emergency care, hospitals had to keep the patients in those highly sought-after beds and turn away others in need of care.
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With a crush of COVID-19 patients requiring intensive care, in addition to those with severe illnesses or injuries, Minnesota hospitals called for backup.
And early last month, the Walz administration started alternative care settings to alleviate pressure on the hospitals. Department of Defense medical teams last week also came in to supplement emergency care services at Hennepin Healthcare in Minneapolis and St. Cloud Hospital. And the Walz administration on Thursday said a third team would deploy to M Health Fairview Southdale in Edina.
“This is pretty unprecedented," Health Commissioner Jan Malcolm said as federal doctors, nurses and respiratory therapists started their Minnesota rotation on Tuesday, Nov. 23. "There’s just never been a time where we've had this many fully tapped-out hospitals and this few medical-surgical beds or ICU beds open on any given surgical day for these transfers."
The unprecedented situation called for a rapid and unprecedented response, state health officials, Minnesota National Guard leaders and Minnesota State University system trainers involved in standing up the program in a little more than a week said.
“In the same way the Guard was called to action by the governor, our staff was called to action,” Century College Angelia Millender said on Tuesday, Nov. 30. A group of 10 National Guard members started their intensive training there on Sunday, Nov. 28.
The concise timeline posed challenges, Millender said. But teachers were willing to shorten or skip their Thanksgiving plans to prepare. Campus leaders made arrangements to free up a skills lab, keep classrooms open on a Sunday and provide training equipment to help the guardsmen and women prepare.
Century College typically saw 500 students go through its non-certified nursing assistant training program in a given semester prior to COVID-19 and 1,000 enroll in the certified program, said Lynnette Lancor, Century's Health Careers Program manager. But the pandemic, health care worker burnout and low wages in some places have shrunk the school's candidate pool, she said, along with the broader caregiver workforce.
"We've always seen really strong enrollments with all the campuses but when you sit down and watch what's going on with COVID and you can earn $15 an hour at Target, what would you do?" Lancor said.
Lancor said she was hopeful that bringing in hundreds of new people through the program could motivate some to stay in nursing positions or motivate them to pursue other careers in health care.
“They aren’t just coming in and supplementing long-term care, but they’re being introduced to a career and a possible career path. They’re leaving with something in hand,” Lancor said. “So what a great investment at a time that we need it so much more.”
Lt. Col. Brian Douty runs the Guard's mission responding to COVID-19 and he said most of the guardsmen involved in the caregiver staffing mission volunteered. And Guard officials made a point of checking that those working health care jobs in their civilian lives wouldn't get pulled away to staff the nursing assistant posts.
"There’s really no need to rob Peter to pay Paul, so if we’re going to take them out of the hospital to put them into the long-term care facility, we’re not really solving the problem at all," Douty said. "So we tried to leave them alone as much as possible."
For trainees who were new to the health care field, the mission proved exciting, even if they didn't think they'd stick to nursing for the long haul.
“The training is really good so it has me really excited to put it to the test in the real world," Josinio Andrew, 25, said. "I’m really looking forward to meeting those who need us."