Brian Raub believes that nursing is the noblest profession.
Raub, 50, of Lebanon, is such a firm believer in this maxim that he decided to make a career change into nursing after previously working in the wood trades and produce industries.
The decision to switch paths came with a daughter’s encouragement after she entered nursing following a tuition cost-share program at WellSpan provided funding toward her studies.
“I, for years and years, wanted to get into healthcare,” said Raub. “I said, ‘Yeah, I’m doing this.’ I left my career and jumped to that. I wasn’t there too long and people said, ‘You have to keep going on for an LPN or an RN because you were made for this.’”
Encouragement from family, friends and co-workers prompted Raub to register for the part-time LPN degree program at the Lebanon County Career and Technology Center (CTC) that was to begin last September with about 50 students.
Raub, who works full-time as a nursing assistant at WellSpan Hospital in its rehab unit, was looking forward to moving up the career ladder when he received some surprising news.
In an email dated Aug. 22 from CTC adult education coordinator Julia Ansel, Raub and his would-be classmates learned the part-time LPN class at the center was canceled following a vote of the Joint Operating Committee (JOC), which is the name for the center’s board of directors. Raub noted that it appeared Ansel did not know why it was canceled.
“They let me know that classes were canceled but I was under the impression that they were going to be resumed,” said Raub, who added a reason was not provided for the cancellation decision.
Ansel wrote to the September class: “The part time evening class for the years 2023-2025 was cancelled. This was a decision made by the JOC/school board to not run the class. We are sorry for the hardship and are aware that it is a major inconvenience in the lives of the prospective students. We hope to offer a class next year but are awaiting further information and do not have an answer at this time as to when we will definitely be having the next class start.”
The rescheduling of that class and a full-time nursing class this July were not to be, thus bringing to an end a 65-year tradition at the center, according to former CTC adult nursing instructor Mark Price.
Those classes, along with several other adult educational programs, were terminated as of June 30, following a vote of the JOC at a special session on Aug. 28.
Read More: Adult education programs at Lebanon County career center will end in June
The full-time LPN nursing program had about another 50 applicants wishing to study at the CTC beginning on July 1, according to Price, who spoke to LebTown for a previous article while still employed at the CTC. Since then, he’s found a new full-time job since his former position at the CTC would have ended in June.
The JOC’s action came as a surprise to Susan Bensing, a 1991 CTC graduate who is now the assistant director of nursing at Cedar Haven.
She said she attended the Aug. 28 meeting to support the program’s continuation, but told LebTown it was announced that the nursing programs were ending due to financial reasons and, she believes, to convert the adult education space for use by high school students.
“I was shocked, number one, the way that they are doing it, and number two, I thought, where are we going to get our nurses? That’s where we get them from. This program has been a stepping stone to a better nursing career,” said Bensing, who added that demand outweighs the healthcare worker supply.
Nursing demand is not new news nor is it unique to Lebanon County. Raub said that he recently saw on television that there is a shortage of 78,000 nurses nationwide.
An attempt by LebTown to further examine this crisis locally and obtain the total number of beds that several major local healthcare providers have, the number of nurses they employ and their average capacity fill rate was mostly stymied by a lack of public data sources.
Some local statistics, however, were located.
A 2021 report by the county’s aging agency is slightly outdated but provides a snapshot on the total number of nursing home beds located in the Lebanon Valley at that time. That same information is currently being compiled and updated by aging agency staff.
The 2021 report titled, “Nursing, Residential and Retirement Homes Available in Lebanon County” states that Lebanon County had 10 such facilities within the county. Former administrator Carol Davies, who has retired since the report was issued, wrote:
“Lebanon County nursing care facilities have a capacity for 1,585 nursing residents. Of these nursing beds, the State Medical Assistance Program assumes payment of nursing care for 690 patients occupying these beds. Of the 690 Medical Assistance residents, 265 are residents of Cedar Haven. There are 425 medical assistance residents who reside in private nursing homes throughout the county. Additionally, there are approximately 1,063 Personal Care, Assisted Living Residence or other types of alternative living units available in Lebanon County nursing facilities. These statistics were compiled from nursing care facilities located in Lebanon County only.”
WellSpan Hospital and Philhaven are owned by WellSpan Health and are listed as two of the top 10 employers in Lebanon County by the Pennsylvania Department of Labor and Industry as of the second quarter of 2023.
In an email response, Ryan Coyle, WellSpan’s senior manager of media relations, wrote: “Here is what I can share on this topic. At WellSpan we are committed to addressing the workforce challenges facing the healthcare industry. We acknowledge that nursing education programs are evolving at a rapid pace across the country, and we are actively working toward strengthening relationships with area educational partners as well as developing alternatives to continue the pipeline of nurses locally. We’re focused on leveraging technology in tandem with our valued care team members to improve the way we operate and deliver care for our patients.”
The VA Hospital in South Lebanon Township does not have a nursing shortage, according to Lebanon VA chief communications officer Douglas Etter.
“We only have a small percentage of openings due to our low patient to nurse ratios and various incentives like tuition reimbursement, flexible scheduling, on campus fitness center, on campus childcare, uniform allowance, military buy-back time and generous federal benefits including federal holidays, dental, vision and health care,” he said in an email. “Obviously, VA also supports RNs who wish to serve their nation through other roles such as in the Guard and Reserve.”
Etter further notes that the VA has 180 beds, a nursing staff of 528 workers and 2,328 total employees.
In Pennsylvania, where healthcare workers are licensed by the commonwealth, healthcare facilities must have a minimum of one LPN on duty for every 25 “residents” and one RN on duty for every 249 individuals in their care, according to Bensing.
Chris Daley, vice president of strategic communications for the Hospital and Healthsystem Association of Pennsylvania (HAP), said his organization released a report in January 2023 that calls for Gov. Josh Shapiro and state legislators to address this ongoing crisis that was exacerbated by the pandemic in 2020.
In “A Roadmap for Growing Pennsylvania’s Health Care Talent,” the report states: “Pennsylvania’s health care workforce is in crisis. The state’s health care workforce shortages – intensified by the COVID-19 pandemic – are some of the most severe and persistent in the country. State intervention and strategic policy are necessary to support the needs of health care professionals and their employers, and to ensure high-quality care remains available in Pennsylvania, regardless of ZIP code.”
Some notable statistics from HAP’s latest workforce survey released in January includes the following:
- Despite improvement over 2022, all hospitals across the state continue to report average vacancy rates of 19 percent for nursing support staff, 14 percent for registered nurses, and more than 10 percent for most direct care professions.
- Rural hospitals report average vacancy rates of 28 percent for nursing support staff and 26 percent for registered nurses.
- Pennsylvania needs to dramatically increase its health care workforce as its population ages and requires more care. A 2021 Mercer report projected that, by 2026, Pennsylvania will need an additional:
- 20,345 registered nurses (worst shortfall nationally).
- 277,711 nursing support professionals (third-worst shortfall nationally).
- 6,330 mental health professionals (third-worst shortfall nationally)
Daley noted an additional problem that is contributing to the nursing crisis: faculty shortages for nursing instructors.
A fact sheet from the American Association of Colleges of Nursing addresses the nursing faculty shortage: “Faculty shortages at nursing schools across the country are limiting student capacity at a time when the need for professional registered nurses continues to grow. Budget constraints, an aging faculty, and increasing job competition from clinical sites have contributed to this crisis.”
Daley said there are 89 board-approved nursing education programs in Pennsylvania listed on their website.
Raub said that Ansel included as a courtesy information in her email about nursing programs in Adams Berks, Dauphin, Lancaster, and Schuylkill counties for the convenience of those adults who were prepared to study last fall at the CTC.
Studying outside of Lebanon, however, is as problematic for Raub as it would have been for Bensing when she studied at the CTC if she had to travel elsewhere for her education.
“I work full-time, have children at home and it would cost time to drive to Reading or elsewhere for nursing classes,” said Raub. “Gasoline for one year would run about $2,800.”
Bensing said she had small children at the time when she became an LPN and was working as an aide at Cedar Haven when she studied at the CTC. She’s grateful she had access to that program locally – even though that year was one of the toughest in her life given the rigor tied to nursing studies.
“I couldn’t have done it without the CTC,” said Bensing about obtaining her LPN there before studying to get her RN license. “I wouldn’t have been able to go to Reading or Lancaster or anywhere else. I definitely would not be where I am now without that program.”
CTC executive director Andra Grollar and Price cited the rigor involved with the nursing program as a major reason students drop out of the program. Bensing said that when she studied, there were about 75 students and that approximately 50 graduated.
“It is very rigorous, it is extremely hard content. It is about the body and body chemistry, and medical processes and medication. It is terribly, terribly hard content,” said Groller. “Interview 100 nurses and they all will tell you the same thing. It is grueling, it is consuming, it truly is relentless. You don’t feel like you have a break and some people just can’t take it. Some people do well in the clinical setting and they don’t perform academically or vice versa.”
Enrollment figures and graduation rates are also lower today than they were 30 years ago. Grollar said enrollment has been lower since the onset of the pandemic and graduation rates have also fallen over the years.
As students drop out of the nursing program, they are refunded a portion of their tuition fee, which means revenue isn’t predictable. That has caused CTC ‘s administration to cut staff to ensure the center did not lose money, a state law requirement. Grollar told LebTown this made the current adult nursing education model unsustainable.
Also problematic for Price is that the CTC’s mission statement includes a statement about adult education. Grollar told LebTown that the center is currently constructing a new comprehensive plan that will review the center’s mission statement as part of that process.
For would-be students like Raub, the only current option to study nursing in Lebanon County is via the RN program at Lebanon Valley College.
For Raub, a full-time program is not currently an option in his educational wheelhouse.
“I don’t know that I want to become an RN, but I was really looking forward to getting my LPN,” added Raub, who said his income would have increased by obtaining his LPN license. “This was years in the making. I had waited for my chance and I jumped at the chance. There are certain tasks I can’t do (as a nurse assistant) and while I am happy to help out, I can’t do them because I haven’t passed meds. I enjoy helping people thoroughly, deeply. And healthcare is the noblest of occupations, absolutely.”
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