Carson City resident Terry Wildes is a vanishing breed.
A certified nursing assistant, she and others like her perform about 90 percent of the caregiving in nursing homes.
The problem: There aren't nearly enough of them.
Assistants bathe, groom and feed residents, filling a critical niche, according to Joy Provost, director of nursing at Carson Health Care in Carson City.
"They are the most important staffing in the building," she said. "They do the actual care 24 hours a day, seven days a week. ... If anything goes wrong with a patient, the nurses' aide will see it first. They are the front line."
Wildes said the work is both physical and stressful, but she wouldn't consider becoming a registered nurse.
"Registered nurses pass out the medications and do the paperwork. I like performing the hands-on care. It's hard work, but I'm good with hard work," Wildes said. "It's so rewarding. I love it.
"My patients have so many stories. They'll forget more than I'll ever remember and they love their caregivers," she said. "They greet us with hugs, kisses and smiles."
She said she approaches the job with a lot of compliance.
"Some have routines and at their age, they should have it their way," she said. "With me, they get what they want."
The shortage means eight to 16 hours of overtime per paycheck and exhausting shifts, according to Wildes. She handles between six and 10 patients per day and is frustrated by her inability to deliver the level of care she would like.
"The patients are losing out with this shortage," she said. "They don't get the quality time they deserve."
The tight job market in addition to the stresses are two of the problems related to this profession, according to Linda Smith, administrator of Carson Health Center. Potential workers are more inclined to work in retail outlets where the levels of stress are lower and the wage comparable and fewer are entering nursing because of the difficulties and emotional demands associated with the profession.
Provost said she faces the challenges brought on by the shortage every day. She currently has four unfilled beds in the 120-bed facility because she doesn't have the staff.
"We need the CNAs, but we aren't turning out enough of them," she said.
In Nevada certified nursing assistants must complete 75 hours of course work and pass a state exam administered by the Board of Nursing at the University of Nevada, Reno. Assistants must work a minimum of 400 hours per year and acquire 24 continuing education units every two years to maintain that license.
At current rates, the supply of nurse aides entering the health care field will not come close to keeping up with the demand.
According to a recent report from the General Accounting Office, about 800,000 nurses aides will be needed over the next seven years and an 87 percent increase by the year 2020 to keep up with the burgeoning demand for health care professionals. In a 1999 survey of state long-term care ombudsmen, more that 40 states reported critical shortages of direct care staff.
This shortage is a precursor to the crises ahead if the status quo is allowed to prevail. As the baby-boom generation reaches retirement age, between 2008 and 2010, the demand for skilled nursing care will skyrocket.
-- Western Nevada Community College offers six-credit classes in the fall, summer and spring. Deadline for signing up for the fall semester's class, entitled nursing 130 B, is Aug. 17.
For more information call the Science and Allied Health Department at 775-445-3296.
-- Carson Healthcare offers a three-credit, two-week course conducted at WNCC by instructor Doreen Reiman.
The two-week course begins Sept. 1 and deadline for registration is Aug. 27. A minimum of 11 students must sign up, and class sizes are limited to 15. For more information call Joy Provost at 775-841-4646.