Doctors and nurses gather outside of a COVID-19 patient's room at the medical ICU at St. Mary's Hospital at the Mayo Clinic in Rochester, Minnesota. Credit: Evan Frost | MPR News 2020

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Faustina Mintah loves her job as a nursing assistant, but she’s afraid to pick up one of the extra shifts she’s constantly being offered.

If she does, she may be the only assistant helping roughly eight nurses care for as many as 33 patients at St. John’s Hospital in Maplewood*. Sometimes, she said, this has happened in the last five months as the hospital has been short staffed. Mintah, who works as a float aide, meaning she rotates in different areas of the hospital, said that ideally, two more nursing assistants would be on the shift with her. 

Mintah performs tasks such as checking patients’ vitals, assisting them in the bathroom, and checking their blood sugar levels. With a lack of other nursing assistants to help, she must scramble between patients. Sometimes this means leaving a patient in the bathroom and instructing them to hit the assist button when they’re done. This is particularly problematic for patients with conditions like dementia, which may prevent them from knowing how to properly call for help. 

“It’s unsafe for me, and it’s unsafe for the patient, because I am rushing,” Mintah said. 

And it’s getting worse, despite efforts from her workplace to lure workers with bonus pay.

“What I’m experiencing is, they hire new nursing assistants, they come and see the workload is too much, and they do not come to work again,” she said. 

In the health care and social assistance industry, employment is currently down more than 18,000 people compared to March 2020, just when the pandemic hit. But overall health care vacancies are even higher, currently sitting at nearly 40,000 unfilled jobs, 

The biggest job losses in health care came during April, May, and June 2020, according to the Minnesota Department of Employment and Economic Development. At that time, the industry saw as many as 40,000 previously employed people no longer working.

Temporary furloughs made up many of these initial job losses as the state suspended elective procedures during COVID-19 economic shutdowns. As shutdowns lifted, more than half of this lost healthcare workforce recovered by August 2020. But since then, the number of people working in health care has stagnated.

At the same time, the number of job vacancies in the healthcare field skyrocketed, as employers also created new jobs to fill growing care needs during the pandemic. 

This comes as the state experiences workforce shortages across nearly all sectors of the economy. While the state’s unemployment rate currently sits at a low 3.5 percent, job vacancies across all industries are at a record high 205,000, according to DEED

Workers like Mintah, the labor unions that represent them, and their employers all say that the job shortage problem got worse this year around the time the Delta variant of COVID-19 took off. They say a variety of factors are causing the shortage to persist, including worker burnout, people taking retirement as soon as they become eligible, and newly trained employees lasting only a couple of days or shifts on the job. 

Aimee Jordan, a spokesperson for M Health Fairview, which operates St. John’s Hospital, said that across all clinics and hospitals, the care provider is seeing a high volume of patients. This is “driven primarily by an increase in COVID hospitalizations and significant staffing shortages,” she added. 

To prevent situations like Mintah working as the only nurse assistant on a ward, Jordan said Fairview is postponing some surgeries and procedures that “can be delayed without prolonged negative consequence to patients.” Fairview is also “aggressively recruiting” for its open positions by offering sign-on bonuses, making on-the-spot offers at job fairs, and speeding up the hiring and training process, Jordan said. 

“We are extremely grateful to all of our staff as they continue to deliver exceptional care to our patients under stress and multiple limitations,” Jordan said. 

In another sign of urgency, the federal Department of Defense agreed to send 44 emergency medical workers to Minnesota next week to work at Hennepin Healthcare’s downtown Minneapolis hospital and CentraCare’s hospital in St. Cloud.

Jamie Gulley, president of Service Employees International Union Healthcare Minnesota, said his union currently counts 45,000 members in the state who are medical workers, a 10 percent decrease from before the pandemic. Roughly 30 percent of these workers are people of color, exceeding the state’s overall population average of 20 percent. 

During the first COVID-19 vaccine rollouts at the end of 2020 and beginning of 2021, many health workers in SEIU’s bargaining units felt a sense of optimism that people who left or went on unemployment would return to the industry as the pandemic began to ease, Gulley said. That all changed this past summer as Delta surged. Several health care employers are attempting to lure new employees and reduce the shortage with pay increases and bonus sign-ons. 

The St. Mary’s Campus of the Mayo Clinic Hospital in Rochester is offering $6,000-a-year raises for housekeeping workers. Methodist Hospital in St. Louis Park last week announced a 5 percent pay increase for nursing assistants. North Memorial Health Hospital in Robbinsdale matched this raise for its nursing assistants earlier this week, Gulley said. 

In negotiations with SEIU, Cuyuna Regional Medical Center, a nursing home in Crosby, Minnesota, just agreed to pay no less than $17 an hour plus a 2 percent bonus for its nursing assistant, dietary aides, and housekeeping workers. Such a move underscores the turn of events since the pandemic, Gulley said. Just two years ago, the union, which represents roughly 600 employees at Cuyuna, almost went on strike to push for a $15 minimum wage for the same positions. 

“Pretty much every workplace is trying to find ways to keep staff and find new ways to recruit staff,” Gulley said. 

At Hennepin Healthcare, that includes recruiting people with no health care experience and placing them in a six-week training program with the Red Cross to get certified as a health care assistant. Tony Campisi, a talent acquisition director at Hennepin Healthcare, characterized the Red Cross training program as a bright spot in recruiting new employees. 

But the overall situation has been rough. Healthcare systems across Minnesota currently have a total of 700 medical assistant openings. Across all professions, Hennepin Healthcare has 625 job openings. Normally, job openings range between 350-400. 

Another point of concern: Campisi said he gets about five applications for every registered nurse opening. Before the pandemic, he’d see four times as many applications. 

“It feels worse now than it did during the height of the pandemic,” Campisi said. “I’ve been in this space for 25 years. I’ve weathered Y2K, the last recession, and this period of time we’re going through right now, I’m worried.” 

This trend is also true in Federally Qualified Health Centers like Axis Medical Center, a Minneapolis clinic that mostly serves East African patients. Axis is currently getting half of the number of applications for open positions from job seekers that it did compared to before the pandemic. 

Mary Turner, a registered nurse at North Memorial and president of the Minnesota Nurses Association, said she’s particularly concerned about the many younger nurses she’s seen leave the profession during the past two years. Younger nurses want more flexibility with hours and pay, Turner said, and aren’t as hesitant to leave jobs or switch careers as older nurses might be.

Since the pandemic began, Turner said that the only time her 13-bed ICU unit wasn’t full came during one week this past summer. 

“The younger generation is expecting more under worse conditions,” said Turner, who works in the COVID-19 intensive care unit. “I don’t begrudge them, because it’s very frustrating to be in the fourth or fifth wave of this. It’s very frustrating to be headed into the second anniversary of the pandemic.”

While Mintah is accustomed to watching many of her work colleagues leaving health care over burnout, she said she has no plans to do so herself. 

“I do not quit because this is not the time to quit,” Mintah said. “That could be me lying on the hospital bed. I can’t do that to my patients.” 

She did, however, stop picking up the extra shifts.

*CORRECTION: An earlier version of this story misidentified the location of St. John’s Hospital.

Joey Peters

Joey Peters is a reporter for Sahan Journal. His work has appeared in Reuters, Public Radio International, Columbia Journalism Review, KFAI Radio, the Pioneer Press, City Pages, MinnPost and more. He previously...