Delaware responds to nursing shortage with ‘Tuition Incentive Program’

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As the demand for health care services continues to rise, the pervasive nursing shortage presents challenges in every state nationwide. In Delaware, this is evident as nurses manage additional responsibilities or step away from the healthcare profession.

Delaware has 11,490 registered nurses serving the state population of around one million people, according to a 2022 report from the U.S. Bureau of Labor Statistics on Registered Nurses. That equates to about 11 nurses for every 1,000 people, highlighting a substantial workload per nurse.

The demand for nurses is widespread, said Christopher Otto, a registered nurse and the Delaware Nurses Association executive director. The shortages are particularly evident in acute and long-term care settings, where the working conditions can become exhaustingly challenging.

“These are increasingly challenging working environments, more demands are being put on nurses in these environments as other resources are being cut [or] drawn back because of budget constraints,” he said. “Nurses are just exhausted. We also know that nurses in the last several years have made the decision to work part-time or reduced hours, some retiring altogether and leaving the profession.”

Some of those long-term care settings facing nurse shortages are in state-operated facilities within the Department of Health and Social Services and the Department of State. That includes the Delaware Psychiatric Center, the Delaware Hospital for the Chronically Ill, the Delaware Veterans Homes, and the Stockley Center.

“With certified nurse assistant vacancy rates of 40-50% in our state-operated healthcare facilities, it puts additional pressure on licensed and registered nurses in these facilities,” said Claire DeMatteis, Secretary of the Department of Human Resources.

To address this shortage, the state recently launched the ‘Tuition Incentive Program.’

“We are offering this first-ever tuition incentive to attract more state employees to serve as certified nurse assistants,” DeMatteis said. “With this new tuition incentive, along with signing and retention incentives for all types of nurses in our state facilities, we are investing significant state resources for the health and well-being of some of our most vulnerable residents.”

Three institutions have joined forces with this program to provide CNA training, including Bear Professional Institute, the Delaware Skills Center, and Sussex County Vocational Technical School District.

“The state will pay for the tuition costs, and the person will be a state employee during the training. And then once they’re certified they’ll work for the state and one of our four hospitals or nursing homes and agree to stay with the state for two years after the start of their employment,” she said.

In the event of an early departure before the two-year mark, DeMatteis states that individuals who received the CNA through the program will be required to refund the state for the tuition cost.

“If we had more CNAs and other personnel contributing and working side by side with nurses, then those LPNs and RNs are available to do the work within their scope of practice more completely or wholly to educate patients and families,” said Otto.

He said that while this incentive will help ease the workload for nurses, it should also be a driving force for retention efforts.

“This is one piece of that health care workforce development in terms of attracting and getting more Delawareans to have that certified nursing assistant,” he said. “However, we continue to advocate and look at this more broadly because retention in the work environment that all healthcare workers are currently working in needs to be addressed. Currently, we have a big issue with retention of our healthcare staff because of the demands, the lack of resources, and the violence that healthcare workers experience in all settings and a multitude of other issues.”

The next effort for the state is to launch a similar incentive for licensed nurses.