Vital Signs

First of its kind apprenticeship program in Alabama aims to address nursing shortage

Nurses are one of the top 25 highest-demand positions in the state, with more than 4,500 annual openings

Alabama, like many states, saw its nursing shortage only grow worse during the pandemic. Nurses are one of the top 25 highest-demand positions in Alabama, with more than 4,500 annual openings for RNs and LPNs.

Several reasons are being cited for the current nationwide shortage including burnout, nurses leaving jobs for better pay as travel nurses and retirements. It’s forcing states like Alabama to rely on hiring out-of-state travel nurses to fill the void at hospitals and healthcare facilities.

“Anecdotally, some hospitals report as much as 40% vacancy rate in their clinical nursing staff,” says Honor Ingels, Administrative Director of the Alabama Board of Nursing Center for Nursing Excellence. He adds, “It’s particularly a problem in rural parts of the state.”

Meredith Smith, statewide project manager, Alabama Office of Apprenticeship

To address its shortage, Alabama has developed its first nursing apprenticeship program for licensed practical nurses and registered nurses. “The healthcare industry is hurting. They are looking for workforce solutions to help them both recruit and retain highly skilled employees, both LPNs and RNs,” says Meredith Smith, Statewide Project Manager of the Alabama Office of Apprenticeship

And this solution, says Smith, is the result of extensive efforts among both private and public partners that also required changes to state legislation to allow for the nurse apprentice permit

“I like to say it’s a win, win, win, win, win. It’s an opportunity for apprentices to earn money while they are learning how to become nurses. They’re acquiring no student debt,” says Smith. “It’s an advantage to the employers in the fact that they can recruit these apprentices. They are getting to train them as their own.”

While the program is still months from launching, Smith sees it as a positive sign that she’s seeing interest from hospitals, nursing homes, community colleges and students inquiring about how they can participate. And, she says, a few states have reached out, expressing interest in the structure of Alabama’s program which will soon be put to the test. 

Community Colleges Partner in Nursing Apprenticeship Programs

Among the first schools to roll out the nursing apprenticeship program is Coastal Alabama Community College which is partnering with Infirmary Health, Alabama’s largest nonprofit health care provider. The first apprentice programs will be for licensed practical nurses.

Jean Graham, dean, Coastal Alabama Community College

Jean Graham, D.N.P., Dean of Nursing and Allied Health at Coastal Alabama Community College says more hospital partners are being added and apprenticeships for the registered nursing program will begin in the fall. She believes the paid apprenticeships could be especially helpful for the community college’s students. “They are not your typical students who have just graduated from high school. They are more of your nontraditional students in their late 20s, 30s, and 40s,” says Graham. She adds “They are trying to finish up their nursing school while working.” 

Graham says students must first be accepted into the college’s nursing program and then they can apply for apprenticeships. Employers will decide who to hire, she explains, and tuition is covered for students in the apprenticeship program either through federal sources or by participating health care facilities.

The program is designed so that students will become employees of the hospital and work one-on-one with a nurse journey worker – a mentor – and students get paid for their clinical hours. 

Tiffany Scarborough, department manager, Coastal Alabama Community College (Photo: Emily Lauren’s Gallery)

Minimum pay starts at $13 an hour and wages will increase as students meet certain benchmarks, according to Tiffany Scarborough, D.N.P., Departmental Director of Nursing and Allied Health at Coastal Alabama Community College.

She sees the financial factor as key for students. “It’s a piece that they have been needing that has prevented them at times from being successful, so I think that it’s going to impact the numbers of completions, graduation rates. We are hoping it has a positive impact on all of those numbers,” says Scarborough.

Nursing Programs

Coastal Alabama Community College’s program for licensed practical nurses is three semesters, after which students receive a certificate and are eligible to take a license exam

LPNs are entry level nurses and are generally supervised by registered nurses and other healthcare professionals.  In Alabama, the mean salary for LPN’s is $41,540 , according to the Bureau of Labor Statistics (BLS)

The registered nursing program requires an associate degree, is five semesters and students receive a certificate upon completion and are then eligible to take their license exam. RNs are responsible for more direct patient care and the mean salary in Alabama is $61,920, according to the BLS.

Hospitals Seeking Solutions

Alabama’s hospitals are welcoming the nursing apprenticeship program as they explore solutions to what is described as “significant shortages of staff.” 

Alabama’s Hospital Association tells WorkingNation in a statement:  “Our hospitals are very appreciative of the Alabama Board of Nursing’s leadership in developing the apprentice program.  It’s a great way to provide additional clinical training to nursing students, while helping fill some of the staffing vacancies in hospitals“ says Don Williamson, MD, president of the Alabama Hospital Association

Because the program hasn’t yet launched, projections on the numbers of nursing apprentices are hard to come by. 

But judging from the interest Coastal Alabama Community College’s is seeing so far, Tiffany Scarborough expects the nursing apprentice program could be a model for others. “It’s just offering another route and paving that career path so that the path is a little bit more straightforward and it’s not as difficult of a goal to attain.”