Nationwide staffing shortages have required weary nurses across America to do everything from CPR and dressing wounds to making beds and taking out the trash.
At Novant Health, help is on the way. A newly created entry-level position — care associate — aims to make sure nurses aren't saddled with tasks that take them away from skilled patient care.
"It will give nurses more time to spend with their patients, more time to complete their assessments and documentation, more time to pass meds," said Richard Coffy, interim nurse manager on the stroke and neuroscience unit at Novant Health Presbyterian Medical Center in Charlotte.
With specific duties built into their job description, care associates should decrease the burden on registered nurses and help prevent burnout.
"Early in the pandemic, we would send nonclinical team members up to the nursing units to say, 'I'm here to help; I know you guys are struggling,' but the nurses often didn't know how to use them, so it became almost burdensome," said Daria Kring, vice president of the Novant Health Center for Professional Practice and Development.
A foot in the door
It’s why Novant Health plans to hire 250 care associates across the system by summer's end. The first 50 reported to work in late June.
Among them is Manazha Miller, 22, who just graduated from UNC Greensboro with a degree in kinesiology and plans to one day get a master’s in physical therapy. Instead of waiting tables for another summer, Miller is getting a head start on her career.
“I think it was a great decision,” Miller said. “It seemed like a great way to get my foot in the door at Novant Health.” Just days into the job she was doing just that. She began asking around Presbyterian Medical Center about physical therapy options and quickly connected with a manager who is interested in getting her hours in the department.
Supporting nurses' professional role is essential at a time when more are leaving the field than are coming in, intensifying competition for top candidates. The U.S. Bureau of Labor Statistics forecasts 194,500 openings a year for RNs, on average, through 2030.
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Filling the new, entry-level care associates' jobs should be far easier. Candidates only need a high school diploma.
Kring said the care associate role is ideal for men and women who want to find out what working in a hospital is like, with an eye to exploring career opportunities, and for students in health-related fields whose program requirements include spending time in a clinical setting.
"We can get them trained and ready to go in a week," she said. "We're hopeful that by the end of the summer, we'll be in a much better place."
Keep in mind, certified nursing assistants have similar responsibilities, but becoming a CNA requires additional schooling and certification.
A juggling act
By Kring's estimate, as much as a quarter of a nurse's day is devoted to tasks such as stocking supply closets and removing meal trays from patient rooms. A 2021 study in the Journal of Nursing Management put the percentage even higher, making an already challenging job even more so.
"The first year of the pandemic it was all hands on deck — ‘This is a temporary situation, we're health care heroes,’" Kring said. "Then into the second year, people started getting exhausted. The amount of death, the sheer physicality of the work, we just had so many (nurses) get burned out and start to leave the profession."
During the pandemic, Novant Health's new graduate RN retention rate slipped from about 90%+ into the mid-80s. Team surveys revealed that demanding workloads and stress — well-documented issues throughout health care during the pandemic — contributed to the problem.
At the same time, surveys found there was much to celebrate, too, Kring said. More than 90% of nurses said their work gives them purpose and meaning. And almost as many — 88% — praised a culture built on strong teamwork even in the face of challenges such as a heavy workload.
"We think the care associates will be able to fill in some skills on the unit so the nurses will be happier," Kring said.
‘They got us help’
As he prepared to welcome the first care associate to his unit, Coffy said the new position is tangible evidence that Novant Health pays attention to employees. He's happy nurses have been heard.
"This brings some satisfaction," he said. "We raised concerns, and leadership listened. They got us help. So it's a good place to work."
Another new care assistant, Breona Bennett, took the job to gain clinical experience. A senior at UNC- Charlotte, she is double majoring in health care management and public health. In previous summers, she sold clothes at Express, a national chain. “I like this a lot better because of the career advancement,” Bennett said.
Miller, the UNC Greensboro graduate, is pursuing a career as well, of course. But working as a care associate is also a step toward fulfilling her dream. She was a dancer from age 7 to 17, when a bad foot injury brought her under the care of a physical therapist who was so good at her job Miller realized that’s what she wanted to do, too.
“I want to be that person who can help someone get back to what they want to do,” Miller said, a smile blooming across her face.